CARE HOMES FOR OLDER PEOPLE
Sampson Court Mongeham Road Deal Kent CT14 9PX Lead Inspector
Joseph Harris Unannounced 09/09/05 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 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. Sampson Court H56-H05 S37892 Sampson Court V244981 090905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Sampson Court Address Mongeham Road, Deal, Kent CT14 9PX Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01304 360909 Kent County Council Registered Care Home 35 Category(ies) of Old Age registration, with number of places Sampson Court H56-H05 S37892 Sampson Court V244981 090905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 17/03/05 Brief Description of the Service: Sampson Court is a 35 bedded home for Older People run by Kent County Council in the town of Deal. The service provides accomodation for people requiring dementia care and a residential service for older people over the age of 65. The home also provides a respite service.The home is situated in a residential area on the outskirts of Deal around two miles from the centre of town. There is a bus service that passes nearby into the town centre, which has good amenities and a range of facilities. The home is set over a single floor and has a dedicated EMI unit. All of the bedrooms are single occupancy and are reasonably well furnished. There is a good amount of communal space available in both sections of the home with open plan lounges and dining areas. There is a garden surrounding the building, which is accessible to the service users. Sampson Court H56-H05 S37892 Sampson Court V244981 090905 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection taking place on 9th September 2005 and lasted for around 4 hours. During the course of the inspection discussions were held with staff and service users. A range of documentation was viewed including service user plans, medication administration records, staff rotas and various health and safety documents. A partial tour of the premises was also undertaken concentrating on the residential unit. There were two recommendations made as a result of this inspection concentrating on the security of the premises and detail of staffing rotas. What the service does well: What has improved since the last inspection?
A new manager has been appointed to the service, which should bring a level of stability and direction to the service. Senior team members have worked very hard to maintain standards in the service, but readily acknowledge that it is difficult to develop ideas and improve the quality of service without a fulltime and committed manager. Documentation required for inspection was more readily available and administration processes were more organised for documents relating to service users and the running of the service.
Sampson Court H56-H05 S37892 Sampson Court V244981 090905 Stage 4.doc Version 1.40 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. Sampson Court H56-H05 S37892 Sampson Court V244981 090905 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Sampson Court H56-H05 S37892 Sampson Court V244981 090905 Stage 4.doc Version 1.40 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 standard(s) 3 and 6. Prospective service users’ needs are assessed prior to admission. Service users referred for intermediate care are helped to remain independent. EVIDENCE: The home ensures adequate levels of information are received prior to admission including joint assessments and care plans from care managers. The home also completes additional assessment information covering key aspects addressing needs. The majority of prospective service users are referred through care management and reasonably good links have been developed with local community health and social services. The home generates a care plan based on the assessment information provided following admission. The service does offer respite and intermediate care for people with dementia care needs and for residential service users. The home is well equipped to provide short-term care with adequate space and facilities available, although there are no dedicated areas for people receiving respite services. Continuity of support is maintained ensuring that service users continue to receive any required specialist input. One service user receiving respite care stated that he had “been made very welcome” and that “the staff were very helpful” although he was looking forward to going home.
Sampson Court H56-H05 S37892 Sampson Court V244981 090905 Stage 4.doc Version 1.40 Page 9 Sampson Court H56-H05 S37892 Sampson Court V244981 090905 Stage 4.doc Version 1.40 Page 10 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 standard(s) 7, 8 and 9. Service user plans set out, in adequate detail, the needs of residents and healthcare needs are met. Medication arrangements are satisfactory. EVIDENCE: Service user plans are based upon the needs assessments and are developed at the point of admission. A number of files were viewed at random, which adequately addressed individual needs providing staff with guidance to meet the assessed needs. Risk assessments are clearly documented covering the main risk areas such as falls and pressure area care. Plans are regularly reviewed and updated as required. The wishes and views of service users are taken into account where possible. The healthcare needs of service users are addressed in a timely fashion and monitored on an on-going basis. Where professional interventions are required the home keeps an accurate record of the input received and any outcomes to be followed through. All service users are registered with local GPs and, in the case of short-term clients, retain their own GP. The oral hygiene of residents is maintained and where a risk of developing pressure areas is present adequate measures are taken to prevent such an occurrence. The home has developed good relationships with community healthcare professionals including district nurses, occupational and physiotherapists. The dietary and nutritional needs of service users are
Sampson Court H56-H05 S37892 Sampson Court V244981 090905 Stage 4.doc Version 1.40 Page 11 maintained. Additional healthcare needs are met with access to dentists, chiropodists and opticians as required. The home has adequate storage facilities for medication and the administration records are kept up to date. Staff administering medication are provided with necessary training and there are comprehensive policies and procedures in place relating to all topics surrounding medication. The home completes a monthly audit ensuring that records are kept up to date. Some service users are enabled to remain self-medicating and appropriate documentation is retained in this regard. Sampson Court H56-H05 S37892 Sampson Court V244981 090905 Stage 4.doc Version 1.40 Page 12 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 standard(s) 13 Service users are enabled to maintain contact with families and friends. EVIDENCE: There is an open and positive attitude towards visitors in the home. A number of residents commented that they receive regular visitors and that the visiting times are flexible within reasonable bounds. There is adequate space available for service users to meet and greet visitors in relative privacy. Sampson Court H56-H05 S37892 Sampson Court V244981 090905 Stage 4.doc Version 1.40 Page 13 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 standard(s) 16 and 18. An adequate complaints process is in place and service users are protected from abuse. EVIDENCE: The home has a clear, comprehensive and accessible complaints procedure addressing all necessary issues. The home aims to address any concerns or complaints in an informal manner in the first instance, but should this be unsatisfactory then there are formal processes clearly set out. A copy of the complaints procedure is displayed in the home and accessible. A record of complaints is maintained. The home has clear policies and procedures in place aimed at protecting service users from potential abuse and mistreatment. Systems are in place to record and document any incidence of abuse should it occur and procedures for reporting such incidents are also in place. There is an awareness and understanding of legislation and responsibilities regarding the Protection Of Vulnerable Adults. Staff are provided with guidance and training relating to adult protection and demonstrated good levels of awareness. Policies and procedures regarding service users finances are clear and adhered to. Sampson Court H56-H05 S37892 Sampson Court V244981 090905 Stage 4.doc Version 1.40 Page 14 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 standard(s) 19 and 26. The home is generally safe and well-maintained, but attention needs to be given to the security of the main entrance. The home was clean and hygienic at the time of the visit. EVIDENCE: The home is a purpose built unit over a single floor and is suitable for its stated purpose. The manager is addressing the security of the front door, which has an automatic opening mechanism. The current situation needs to be reviewed ensuring that the independence of service users is not compromised, but that the safety and protection of vulnerable adults is paramount. At the present time visitors to the home are not required to ring the doorbell because the door opens as visitors approach, which could have an impact on security. Similarly when someone is leaving the building there is no system to alert staff members. The office is situated in a position enabling good observation of the front door, but this necessitates that someone is present at all times during the day. Refer to recommendation 1. Annual plans for routine maintenance and renewal are completed by senior managers. A new manager has recently been appointed and it advised that a full assessment of the premises should be
Sampson Court H56-H05 S37892 Sampson Court V244981 090905 Stage 4.doc Version 1.40 Page 15 undertaken to identify future priorities. The building complies with fire and environmental health department regulations. The home is maintained to a good standard of cleanliness throughout. Kitchen and laundry facilities are adequate for the needs of the home. Policies and procedures are in place for the control of infection and staff are provided with guidance on this topic through the induction process and additional training. Sampson Court H56-H05 S37892 Sampson Court V244981 090905 Stage 4.doc Version 1.40 Page 16 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27. There is an adequate number of staff on duty at all times, although staffing levels should remain under constant review. EVIDENCE: The home has 6 members of staff on duty throughout the day including a team leader on each shift. At night two waking staff are on duty with a team leader sleeping in. The duty rota needs some revision to demonstrate the role of each team member i.e. Team Leader, senior staff, etc. The rota should also clarify which staff are completing the sleep-in shift. Refer to recommendation 2. 3 of the staff on duty in the daytime work on the EMI unit with other staff deployed on the residential side of the home. Some staff comments suggested that increased staffing levels or a dedicated activities co-ordinator would be beneficial especially on the EMI unit. These comments included “We only have time for routine work, there’s not much time for activities” and “We’re rushed off our feet”. Nevertheless the staffing levels are adequate with reference to department of health guidance. The home has quite high sickness rates at the present time with 3 staff members on long-term sick leave, which does have an impact on service delivery, however the home uses relief staff who are familiar with the service to cover these shifts where necessary. All staff providing personal care are over the age of 18. Sampson Court H56-H05 S37892 Sampson Court V244981 090905 Stage 4.doc Version 1.40 Page 17 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 and 38. The home is run in the best interests of the service users. The health, safety and welfare of service users and staff are protected. EVIDENCE: There are adequate quality assurance measures in place to ensure that the home is run in the best interests of the service users. Regular monthly monitoring visits are completed by a member of the senior management team and reports sent to the Commission. There are processes in place to ensure service users and stakeholders in the service can provide feedback about the home. An annual development plan is put in place and followed through according to priority need. Policies and procedures are regularly reviewed and updated. The health, safety and welfare issues of the home are adequately addressed. Staff receive induction and mandatory training within appropriate time frames. Documentation was examined relating to health and safety and was maintained adequately with all necessary checks and routine maintenance
Sampson Court H56-H05 S37892 Sampson Court V244981 090905 Stage 4.doc Version 1.40 Page 18 completed. Environmental risk assessments are in place and the fire and accident books are up to date. Sampson Court H56-H05 S37892 Sampson Court V244981 090905 Stage 4.doc Version 1.40 Page 19 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 x 15 x
COMPLAINTS AND PROTECTION 2 x x x x x x 3 STAFFING Standard No Score 27 2 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x 3 x x x x 3 Sampson Court H56-H05 S37892 Sampson Court V244981 090905 Stage 4.doc Version 1.40 Page 20 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 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. 1. 2. Refer to Standard OP19 OP27 Good Practice Recommendations To ensure adequate security of the premises. To update care staff duty rotas to demonstrate senior staff on duty and sleep-in staff. Sampson Court H56-H05 S37892 Sampson Court V244981 090905 Stage 4.doc Version 1.40 Page 21 Commission for Social Care Inspection 11th Floor, International House Dover Place Ashford Kent TN23 1HU National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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