Inspection on 21/04/05 for Sandbanks

This inspection was carried out on 21st April 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Sandbanks 31/07/06

Sandbanks 06/12/05

Sandbanks 01/11/04

Sandbanks 11/05/04

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 Sandbanks 1 Cacklebury Close Hailsham Eastbourne, East Sussex BN27 3LW Lead Inspector Judy Gossedge Unannounced 21 April 2005 14:10 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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 Version 1.10 Page 3 SERVICE INFORMATION Name of service Sandbanks Address 1 Cacklebury Close Hailsham Eastbourne East Sussex BN27 3LW 01323 843234 01323 441796 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) East Sussex County Council Ms Anne Sharman Care Home 19 Category(ies) of Learning Disability (LD) 19 registration, with number of places Sandbanks Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: 1. The maximum number of service users to be accommodated is nineteen (19). 2. Service users must be aged between eighteen (18) and sixty-five (65) years on admission. 3. Service users with a learning disability only to be accommodated. 4. One named service user assessed as requiring nursing care, can use the facilites at Sandbanks to be provided with respite care. Date of last inspection 1 November 2004 Brief Description of the Service: Sandbanks is run by East Sussex County Council (ESCC), and is a purpose built property on two floors, set in its own grounds in Hailsham, about one mile from the town centre. Service user accommodation comprises of seven single bedrooms, one lounge, and kitchen/diner area on the first floor for the use of the long stay service users. Respite and short term care is provided within a separate flatlet of three single bedrooms, kitchen/diner and lounge, a bed sitting room, and eight single rooms with a large dining room, and lounge on the ground floor. There are specialist bathing facilities provided. Level access is facilitated by the provision of a passenger lift in the home. There is a garden at the side of the home and a central courtyard. Sandbanks Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over five hours on 21 April 2005. The Inspector was also accompanied by a CSCI Pharmacist Inspector following medication issues highlighted since the last inspection. A partial tour of the premises took place including communal areas and a selection of service users bedrooms, rotas and care records were inspected. Twelve of the fifteen service users were spoken with individually or in the communal areas. Due to communication difficulties it was not possible to speak to all service users individually, and so the opportunity was also taken to observe the interaction between staff and service users in the communal areas. The Manager and eight Support Workers were spoken with. One relative a regular visitor to the home was also spoken with by telephone after the inspection. What the service does well: What has improved since the last inspection? What they could do better: Sandbanks Version 1.10 Page 6 There are still areas which were asked to be looked at following the previous inspections which have still not been improved eg fire training is not being provided to staff as required. Also a written contract/statement of terms and conditions in place between the home and the service user needs to be provided. Currently there is still a heavy reliance on the home’s relief and agency staff to cover the rota, due to a number of staff changes and difficulties in recruiting to existing staff vacancies. Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Sandbanks Version 1.10 Page 7 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 Standards Statutory Requirements Identified During the Inspection Sandbanks Version 1.10 Page 8 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 standard(s) 2, 5 There is detailed information about Sandbanks available to be viewed prior to any admission to the home. There are pre-admission procedures in place to ensure that service users on planned admissions are appropriately placed at Sandbanks. Service users are not protected by the provision of a written contract/terms and conditions with the home. EVIDENCE: A detailed Statement of Purpose and Service Users Guide is available. There is regular quality assurance information collated for service users and their carers to read. A Social Care Assessment is completed by staff from one of ESCC Social Services Department’s Assessment Teams which is forwarded to the home. Staff also confirmed that they meet new service users to gain information to help them provide the required care. There was only one new service user at Sandbanks at the time of the inspection and the pre-admission information had been received. Service users also come to the home as an emergency admission. In these instances where it has been found subsequently that Sandbanks can not fully meet a service users care needs, systems have not always been in place to relocate a service user as soon as possible to a more suitable placement. Sandbanks Version 1.10 Page 9 A written contract between the home and the service user detailing the terms and conditions of any period of care provided is still not in place. Sandbanks Version 1.10 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 standard(s) 6, Not all the individual care plans in place adequately provide staff with the information they need to ensure that care needs are met. EVIDENCE: A selection of service users individual care plans were viewed. A new more detailed format to record service users care needs is now being used but is not yet fully implemented. Consequently the information detailed on care plans varied in detail and not all gave clear guidance to staff of the care to be provided, and how any identified risks are managed. A photograph was not in place for all the service users. Sandbanks Version 1.10 Page 11 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 standard(s) 14 and 17. Service users are encouraged and supported to pursue their own interests and hobbies. The meals in the home are good offering both choice and variety and catering for any special dietary needs. EVIDENCE: Service users were observed engaging in appropriate activities, and some spoke of participating in a range of leisure activities. One service user whose birthday it was on the day of the inspection had been out for the day with a member of staff, to have lunch and shop for new clothes for the summer. On the night of the inspection service users were watching television in the lounges, watching videos and listening to music in their bedrooms, working on jigsaws, or colouring in the communal areas. One service user was going out to a yoga class with a friend from outside of the home. A number of service users decided to go out for a drive in the mini bus, and were discussing with staff where they would like to go for the evening trip. Several service users spoke of a party being run by another local organisation that they were due to attend at the weekend. Service users being provided with long-term care do not have a part of the basic contract price the option of a minimum seven-day annual holiday outside the home. Sandbanks Version 1.10 Page 12 Food is prepared in the main kitchen in the home for the service users on respite and short term care. The evening meal consisted of cauliflower cheese, ratatouille and pasta, followed by bread and butter pudding and cake. The food was appetising and well presented. Staff and service users ate together, discussed their day and the proposed evening activities. The mealtime was relaxed and friendly. On the long stay unit the food is prepared in the unit’s kitchen. Staff work with each service user to choose a meal for one day of each week ensuring a varied and balanced weekly menu. Support Workers prepare the food and some service users also choose to help with some of the preparation. Service users spoke well of the food provided. Sandbanks Version 1.10 Page 13 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 standard(s) 18 and 20. Care and support is provided which is flexible and sensitive to individual service users. It was evident that positive relationships had been formed between staff and service users. The home has a good procedure to manage medicines that meet the needs of the service users. Medicine storage arrangements are poor. EVIDENCE: The sample individual care plans viewed, service users the staff spoken with, and from observations during the inspection confirmed that care and support given is sensitive to the individual care needs of each of the service users. Records referred to specialist advice and guidance which had been sought. Relationships between staff and service users and the care given was observed to be very good, and service users were treated with respect at all times. There are two medication storage areas in the home. Both areas consist of cupboards accessed from a corridor and this is not ideal. In one cupboard there was an exposed hot water pipe, which will not help to maintain the temperature below 25 C. The controlled drugs cupboard, although of the correct specification is not attached to the wall in the correct manner. There has been a problem balancing the medication stock, which has been reduced since an audit system has been implemented. Spare labels were seen (blank with instructions) which should be removed. There is no clear documentation Sandbanks Version 1.10 Page 14 for when medication is taken out of the unit to day care facilities. The medication administration policy involves two care staff and double checking at each stage. Sandbanks Version 1.10 Page 15 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 standard(s) 22. There is a clear and effective complaints procedure in place. EVIDENCE: ESCC has a detailed compliments and complaints policy and procedure in place. Any complaints received are monitored through the line management arrangements in place within the organisation. One complaint made by a service user was recorded in the complaints log since the last inspection, which was satisfactorily investigated under adult protection procedures. Although standard twenty-three was not inspected on this occasion there have been a number of issues raised in the home which have been satisfactorily investigated under adult protection procedures Sandbanks Version 1.10 Page 16 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 standard(s) 24, 30 The standard of the environment is good within the home providing service users with a safe, attractive and homely place to live. EVIDENCE: Décor in the home is to a good standard, and furnishings are of a good quality and domestic in style following the refurbishment of the home in 2003. There are nineteen single bedrooms of which eleven do not meet the minimum space requirements. Where possible particularly service users who are on long stay have been encouraged to select the colour of their bedroom and their own furniture. The bedrooms viewed reflected a range of individual styles and interests. There are no en-suite facilities, but there are sufficient toilet, and a selection of assisted bathing facilities in the home. There are several communal areas for service users to use, a kitchen/dining room and lounge on the long stay unit, a lounge in the flatlet, and a large dining room with seating area and a further lounge for respite and short term care service users. Service users were observed using all these facilities participating in a range of activities. Sandbanks Version 1.10 Page 17 Some of these areas are starting to show some evidence of wear and tear. The shower facility in the long stay unit has a badly marked floor and some of the tiling area is discoloured. The carpet in the long stay units kitchen is badly marked. This was discussed with the Manager who confirmed that work had already commenced to resolve these issues. The home was clean and odour free at the time of the inspection. Hot water from five wash hand basins and baths was tested, and were close to the recommended safe temperature. Confirmation is still required that the Water Supply Regulations 1999 are being met. Routine fire checks of the building were viewed and were adequate. Sandbanks Version 1.10 Page 18 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 34. There has been a period of considerable instability in staffing in the home, which has lead to a lack of consistency in communication and the care provided. ESCC recruitment policies and procedures need to be followed in order to protect service users. EVIDENCE: The home was calm and relaxed on the day of the inspection, and the staffing in place was adequate to meet the needs of current service users resident. It enabled staff to support one service user to visit their GP, a trip out to be arranged and service users remaining in the home to be supported in their chosen leisure pursuits. Staffing levels will need to be continually reviewed due to the changing service users in the home with varying care needs. Feedback from staff, the relative and records confirmed there has been a period of high reliance on relief and agency staff to provide staff cover in the home. This has been due to difficulties in recruiting to staff vacancies, and although there has been some recruitment of new staff there are still some staffing vacancies in the home. Some feedback from relatives during this period has raised concerns of the continuity of care, and communication with the number of agency staff working in the home. On duty during the evening were two relief staff alongside the homes permanent staff. Both had worked for ESCC for a number years and Sandbanks Version 1.10 Page 19 particularly at Sandbanks. Staff spoke well of working in the home, of a team working well together, variety of work and a relaxed atmosphere. One service user commented that ‘staff cannot do too much for you’ All recruitment is co-ordinated by the personnel section at ESCC’s head office, which the Inspector has visited and viewed sample documentation across the organisations registered services to support the recruitment process in place. Some gaps in the required documentation were found which need to be addressed. In future recruitment documentation will need to be available at the home as part of any inspection completed. Sandbanks Version 1.10 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39, Service users are enabled to give their views on the home and the care provided. EVIDENCE: The Manager has worked for ESCC for many years as a Senior Manager, has completed the Registered Managers Award, and is completing NVQ Level 4 in Care. There are opportunities for service users to put forward their views about the home and the care that they receive through service users meetings, and questionnaires which informs ESCC and staff in the home of the quality of the service being provided. The manager confirmed that a questionnaire to seek the views of stakeholders is due shortly to be sent out. Currently there is not an annual development plan for quality assurance in place in the home. Sandbanks Version 1.10 Page 21 Although standard forty-two was not inspected on this occasion the provision of fire training for staff is still not in place. One relief member of staff had not had moving and handling training to meet requirements. 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. Where there is no score against a standard it has not been looked at during this inspection. 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x x 2 Standard No 22 23 ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 x x x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 2 Standard No Sandbanks Standard No 31 32 Version 1.10 Score x x Page 22 11 12 13 14 15 16 17 x x x 2 x x 3 33 34 35 36 x 2 x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 x 2 x Standard No 37 38 39 40 41 42 43 Score x x 2 x x x x Sandbanks Version 1.10 Page 23 yes 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 6 Regulation 15 (1) (2) Reg 17 (1) (a) Requirement That service plans are subject to further development. The CSCI will receive written confirmation that this issue has now been addressed.(This issue is outstanding since 30.06.03, 31.01.04, 31.01.05) That a photograph of the service user is in place. That a contract is issued to service users detailing the terms and conditions of their stay at the home That better medication facilities are provided. That a clear policy is in place to follow around the administration of medication when the service user is absent from the home. That evidence is provided that the Water Regulations 1999 are met. That an annual quality assurance plan is in place. That staff receive appropriate fire training within the required timescale. The CSCI will receive written confirmation that this issue has been addressed. (This issue has now been outstanding since 31.01.05) Version 1.10 Timescale for action 30.06.05 2. 5 15 (1) 30.09.05 3. 4. 20 20 13 (2) 13 (2) 30.09.05 30.06.05 5. 6. 7. 30 39 41 13 (4) (a) 24 (1) (2) (3) 23 (4) (d) 30.06.05 30.06.05 31.07.05 Sandbanks Page 24 8. 9. 41 Reg 18 (1) (c) (i) That all relief staff have completed moving and handling training to meet requirements 31.07.05 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. 3. 4. 5. Refer to Standard 14 20 37 Good Practice Recommendations That service users in long term placements have the option of a minimum seven day holiday outside the home as detailed in 14.4. That there is a review to ensure that there are clear lines of responsibility in the medicine administration process. That the Manager meets the new training requirements. Sandbanks Version 1.10 Page 25 Commission for Social Care Inspection Ivy House, 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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 Version 1.10 Page 26 - 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. 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