Inspection on 10/01/06 for Sandbanks

This inspection was carried out on 10th January 2006.

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.

Other inspections for this house

Sandbanks 25/11/06

Sandbanks 21/06/05

Sandbanks 09/12/04

Sandbanks 30/04/04

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Sandbanks St Andrews Road Littlestone New Romney Kent TN28 8RA Lead Inspector Wendy Mills Unannounced Inspection 10th January 2006 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 Sandbanks DS0000023512.V276816.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 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. Sandbanks DS0000023512.V276816.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Sandbanks Address St Andrews Road Littlestone New Romney Kent TN28 8RA 01797 367217 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) Belmont Sandbanks Ltd Mr Keith Peter Martin Hutchinson Care Home 25 Category(ies) of Dementia - over 65 years of age (25) registration, with number of places Sandbanks DS0000023512.V276816.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users without a diagnosis of DE(E) to be restricted to three (3) whose DOB are 02/05/1931; 25/05/1914; 04/03/1917. 21st June 2005 Date of last inspection Brief Description of the Service: Sandbanks is a residential care home providing care for up to 25 Older People. Nine beds are registered for older people with dementia and there is currently an application to register all beds for older people with dementia. Belmont Sandbanks, the registered providers, own another residential care home for Older People nearby. Since the last inspection, Mrs Selby, the registered manager has left the home and Mr Keith Hutchinson, the registered provider has now been registered as the manager for the home. The Home is located very close to the sea front at Littlestone and a mile from the small town of New Romney where there is a range of amenities and facilities. Accommodation for the residents is provided on two floors. There is a shaft lift. There are nineteen single bedrooms and three bedrooms for shared occupancy. Several rooms have sea views. Ensuite facilities are available in five of the single rooms. There are spacious sitting areas. In addition, there is a large conservatory at the rear of the home that overlooks a large, accessible, and well-maintained garden. Sandbanks DS0000023512.V276816.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection began at 09.30 and lasted three hours. Additional time was spent in preparation and report writing. The registered provider/manager, Mr Keith Hutchinson and Ms Zoë Kendall, the deputy manager, assisted with the inspection. Two residents were spoken with in the privacy of their own rooms and discussion was held with others in the communal areas. One relative and two members of staff were also spoken to during the course of the inspection. Documentation was examined and a tour of the home undertaken. Both indirect and direct observations were made throughout the inspection. Mr Hutchinson, his staff, the residents and their supporters are thanked for their help during this inspection. What the service does well: What has improved since the last inspection? The management structures have been changed so as to utilise staff skills to the maximum. For example, the expertise of the manager of the sister home is also used at Sandbanks to advise about pre-admission assessments and training. Communication has again improved within the home and a staff appraisal system has been established. Sandbanks DS0000023512.V276816.R01.S.doc Version 5.1 Page 6 The care plans have been reviewed and a simpler, more straightforward system has been introduced. This means that the staff can understand the needs of the residents better. Several environmental improvements have been made. New doorstops, linked to the fire alarm system, have been fitted; commodes have been replaced and one of the bathrooms has been converted to a shower room. Activities have improved and an activities needs analysis is in progress. This aims to help residents participate in the activities that are most appropriate and helpful for them. Residents can now access the new day centre that has been built in the grounds of the sister home, close by. 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. Sandbanks DS0000023512.V276816.R01.S.doc Version 5.1 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 Sandbanks DS0000023512.V276816.R01.S.doc Version 5.1 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&5 The home ensures that only those residents whose needs can be met are admitted to the home. EVIDENCE: Inspection of a sample of care plans showed that they had been recently reviewed and made clearer. The needs of the residents and how they should be met are clearly identified. Pre-admission assessments were on file. Relatives said that they had been able to view the home prior to helping their relatives make a decision about moving into the home. Residents told the inspector that they had been able to visit the home prior to admission and could have stayed for a trial period if they wished. Sandbanks DS0000023512.V276816.R01.S.doc Version 5.1 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, 9, 10 &11 There is a consistent care planning process that provides the staff with the information they need to care for the residents. The systems for the management of medicines are good. Clear and comprehensive arrangements are in place to ensure the needs of the residents are met. The home deals with end of life issues well. EVIDENCE: Care plans have recently been reviewed and put into a clearer format. Staff said that this is much better and has helped them to understand the needs of the residents better. Care plans are up-to-date and in good order. The specific needs of the residents are recorded. Health care professionals are contacted appropriately and their advice sought. All the residents were in good health on the day of inspection. Conversation with care staff confirmed that they are able to meet the needs of the residents. Staff were observed to treat the residents with kindness and respect. They were discrete in the way they offered help. Residents said that they are very happy and that the staff are “lovely”. Observation showed that there are positive relationships between the residents and the staff. Sandbanks DS0000023512.V276816.R01.S.doc Version 5.1 Page 10 Since the last inspection the policies and procedures for the management and administration of medicines in the home have been reviewed and strengthened. A member of staff now has lead responsibility for overseeing the ordering and disposals of medicines. The staff at the home hope to care for the residents for as long as they can meet their needs. When possible, they support them through terminal illness. They liaise well with local GPs and other healthcare professionals to give the residents the support they need at times of illness. Sandbanks DS0000023512.V276816.R01.S.doc Version 5.1 Page 11 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): 12, 13, 14 & 15 The home makes every effort to ensure that the residents are able to enjoy an interesting and fulfilling lifestyle. It helps the residents make choices when indicated. The home fosters good relationships with family and friends of the residents. The home demonstrates a clear understanding of the importance of good nutrition. EVIDENCE: The home employs an activities organiser. There are several appropriate games such a floor chess and skittles. At present an activities needs assessment is being carried out to ensure that all the residents participate in activities that are relevant to their needs and interests. The way the home records activities undertaken is improving. Life histories and likes and dislikes are recorded in the care plans. Staff were observed to offer choice in a way that was appropriate to each resident’s understanding. Food intake is monitored and weight is regularly recorded. Those requiring help to eat are given the assistance they require in a timely, discrete and Sandbanks DS0000023512.V276816.R01.S.doc Version 5.1 Page 12 kindly way. Recording of weight could be improved by including the reasons for weight monitoring, target weights, help needed at mealtimes, snack preferences and action to be taken if there is a significant and undesired weight gain or loss. Sandbanks DS0000023512.V276816.R01.S.doc Version 5.1 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 the following standard(s): 16 & 17 The home has a satisfactory complaints procedure with evidence that the residents’ views are taken into account and acted upon. The staff have a very good awareness of Adult Protection issues. This protects the residents from abuse. EVIDENCE: Inspection of relevant documentation at the previous inspection confirmed that there is a satisfactory written complaints procedure. Staff are clearly aware of their responsibilities to complain on behalf of residents who are unable to speak for themselves. Regular staff meetings and increased input from the registered provider/manager and the deputy have improved communication in the home. Staff said that they would always be prepared to complain on behalf of a resident. Staff have received adult protection training and have a good awareness of the whistle-blowing procedures. Sandbanks DS0000023512.V276816.R01.S.doc Version 5.1 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 the following standard(s): 19, 20, 22, 23, 24, 25 & 26 The standard of décor and furnishings in the home are good. This gives the residents a pleasant and comfortable place in which to live. However, the home needs to be more diligent with regards to regular temperature monitoring. The home has the equipment needed to support the specialist needs of the residents. EVIDENCE: The home was clean and free from offensive odours on the day of inspection. The standard of décor and furnishings are good and both communal and individual rooms are comfortable and homely. The rusty commodes identified at the last inspection have all been replaced and there is a planned maintenance schedule. Mr Hutchinson demonstrates a clear commitment to continuing to improve the environment. Some areas of the premises were quite cold on the day of inspection. Mr Hutchinson immediately took action to investigate the reasons for this and Sandbanks DS0000023512.V276816.R01.S.doc Version 5.1 Page 15 found that it was a thermostat problem. The home must ensure adequate temperatures in all areas of the building at all times. Bathrooms are fitted with hoists and rails. One bathroom has recently been converted to a shower room. Sandbanks DS0000023512.V276816.R01.S.doc Version 5.1 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 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, 29 &30 The staff have a good understanding of the needs of the residents. This is evident from the positive relationships between staff and residents and the good level of staff morale. Recruitment policies and procedures are sound but these are not always followed. EVIDENCE: There is a good level of staff training and there are regular staff meetings. Staff were very positive about the recent changes in the communication structures in the home. Staff said that their morale is good and “getting better”. They said that they are all willing to help each other. Staffing structures allow for clarity of roles and lines of responsibility. A system for staff appraisals has just been introduced. There are clear job descriptions but inspection of staff files showed that some pre-employment checks such as CRB and references had not been carried out. This puts the residents at risk because it results in the employment of staff who have not been properly vetted. The home must adhere strictly to its own recruitment policies and procedures. Sandbanks DS0000023512.V276816.R01.S.doc Version 5.1 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 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): 31, 32 33, 35, 36 & 38 There is clear leadership and good communication throughout the home. Health and safety measures in the home are mostly satisfactory but should be kept under constant review. EVIDENCE: The registered provider/manager is in the home four days each week and a new deputy manager, Ms Zoë Kendall, has been appointed. There are weekly management meetings. Staff spoke positively about communications in the home. Discussion with the registered provider/manager showed that he has a clear vision for the home and is prepared to make significant investment in both the environment and in staff. An appraisal system has been established and it is hoped that regular one-to-one supervision will follow. Sandbanks DS0000023512.V276816.R01.S.doc Version 5.1 Page 18 A tour of the home identified one health and safety hazard. Access to a staircase only used by staff could prove a danger if residents inadvertently wandered into this area. A risk assessment should be carried out. Staff were very positive about the management arrangements in the home and said that they felt the registered provide/manager values them and listens to their concerns and ideas. Sandbanks DS0000023512.V276816.R01.S.doc Version 5.1 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 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 3 X 3 3 3 2 3 STAFFING Standard No Score 27 3 28 X 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 3 X 2 Sandbanks DS0000023512.V276816.R01.S.doc Version 5.1 Page 20 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. 1. 2 Standard OP20 OP29 Regulation 23 18 Requirement Adequate temperatures must be maintained throughout the premises The home must follow its own recruitment policies and procedures to the letter. Written confirmation to CSCI that CRB and references have been taken up and are satisfactory. Timescale for action 10/01/06 10/01/06 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 15 Good Practice Recommendations The home should review the forms it uses to record the residents’ weight to include target weights, reasons for monitoring and action taken if indicated. Sandbanks DS0000023512.V276816.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Kent and Medway Area Office 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 © 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 Sandbanks DS0000023512.V276816.R01.S.doc Version 5.1 Page 22 - 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. 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