Inspection on 25/11/06 for Sandbanks

This inspection was carried out on 25th November 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 10/01/06

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 09:30 25 November 2006 th 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.V298390.R01.S.doc Version 5.2 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.V298390.R01.S.doc Version 5.2 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.V298390.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 10th January 2006 Brief Description of the Service: Sandbanks is a residential care home providing care for up to 25 Older People with dementia. Mr Keith Hutchinson is the registered provider/manager. 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. The communal areas of the home are spacious and include a large conservatory at the rear of the home that overlooks a safe, accessible, and well-maintained garden. The fees range between £435 and £480. This includes the cost of toiletries and newspapers. Additional charges are made for hairdressing and chiropody. Sandbanks DS0000023512.V298390.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced visit lasted five and a half hours. The registered provider/manager, Mr Keith Hutchinson and the deputy manage, Miss Zoë Kendall assisted with the inspection. During the course of the inspection discussions were held with residents, relatives, staff and the management team. It was not possible to hold conversations with all the residents and where this was difficult, indirect observation was used. A tour of the home undertaken, documentation, including care plans, was examined. Responses to pre-inspection questionnaires were considered. Both indirect and direct observations were made throughout the inspection. As part of this unannounced inspection the quality of information given to people about the care home was looked at. People who use services were also spoken to, to see if they could understand this information and how it helped them to make choices. The information included the service users guide (sometimes called a brochure or prospectus), statement of terms and conditions (also known as contracts of care) and the complaints procedure. These findings will be used as part of a wider study that CSCI are carrying out about the information that people get about care homes for older people. This report will be published in May 2007. Further information on this can be found on our website www.csci.org.uk. What the service does well: The staff have a clear commitment to their work and care for the residents very well. They respect their privacy and dignity and help them to maintain as much independence as possible. Staff say that it’s like an extension of their own family. Residents and relatives say that the staff are lovely and friendly. The environment is spacious, well maintained, comfortable and homely. There is a continuous improvement plan. The administration of medicines is well managed. There are good systems in place for the safe handling of all aspects of medication, from placing the prescriptions at the pharmacy to receipt, storage and disposal. The home is well managed and communication is good at all levels. Staff are well trained and there is a good organisational structure that gives clarity of roles and responsibilities. Sandbanks DS0000023512.V298390.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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.V298390.R01.S.doc Version 5.2 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.V298390.R01.S.doc Version 5.2 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): 1, 2, 3, 4 & 5 The quality in this outcome area is good. This judgement is based on evidence gathered both before and during this visit. The home provides the residents, their relatives and supporters, with the information they need in order to make a decision about moving into the home. Appropriate pre-admission assessments are made. This ensures that only those residents who are suited to the home and whose needs can be met are admitted to the home. EVIDENCE: As part of this inspection we were asked to look very carefully at the standards that cover terms and conditions of residence. This was done by talking to those residents who were able to understand the concept, relatives, and the registered provider/manager and his deputy. Whilst, due to their mental incapacity many residents were unable to talk about this subject, some were aware that they had a written agreement and that they paid fees although short-term memory loss meant that they did not know the actual fees payable. Sandbanks DS0000023512.V298390.R01.S.doc Version 5.2 Page 9 Relatives said that they did have contracts and that they are kept informed of any changes in fees. They also said that they were aware of the terms in the contract and knew they could talk to Mr Hutchinson if they had any concerns. The statement of purpose has recently been reviewed and organisational structures have been changed. Discussion with the registered provider/manager and the deputy manager confirmed that they communicate well with the residents and their relatives and supporters about any changes that take place within the home. This includes changes of fees and terms and conditions of residency. There are sound policies and procedures for assessment and admission to the home that include pre-admission assessment and trial periods. Care plans were examined. There is clear evidence that good pre-admissions assessments have taken place. Sandbanks DS0000023512.V298390.R01.S.doc Version 5.2 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 the following standard(s): 7, 8, 9 & 10 The quality in this outcome area is good. This judgement is based on evidence gathered both before and during this visit. 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. EVIDENCE: 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. They all appeared well nourished and well cared for. Weights are recorded on a monthly basis and appropriate action is taken if significant changes are noted. It would be helpful if was a column on the weight chart to note exactly what action has been taken when this is noted. Sandbanks DS0000023512.V298390.R01.S.doc Version 5.2 Page 11 Conversation with care staff confirmed that they are able to meet the needs of the residents. There is a key worker system. This means that staff can get to know the needs individual residents and devote more time to them. Staff were observed to treat the residents with great kindness and respect. Supporters said that they felt that the dignity of their friends and relatives have improved greatly whilst in the home as the staff understand their needs. Indirect observation confirmed that personal care is offered gently and with great patience. Staff are very discrete in the way they offer help. Residents said that they are very happy and that the staff are very kind. One said, “They are lovely girls”. Previous inspections have confirmed that the storage of medicines is secure. There are now clearer lines of responsibility of the receipt, storage, administration and disposal of medicines within the home. The head of care assumes overall responsibility for ensuring that prescriptions are sent to the pharmacy in good time, making sure that medicines delivered to the home are recorded and then stored safely. Sandbanks DS0000023512.V298390.R01.S.doc Version 5.2 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 the following standard(s): 12, 13, 14 & 15 The quality in this outcome area is excellent. This judgement is based on evidence gathered both before and during this visit. The home supports residents remain as independent as possible. It helps the residents makes choices when needed. The home helps the residents to maintain contact with their family and friends. Nutrition services at the home are very good. EVIDENCE: The home employs an activities organiser. Residents said that they look forward to her visits. There is a wide range of indoor activities including floor draughts and skittles. Time is also spent in reminiscence activities, individual activities such as crosswords and discussion. When the weather permits the residents enjoy the large, safe garden. Some residents like to spend time in the kitchen. Supervision and risk assessments are in place for this. 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. Sandbanks DS0000023512.V298390.R01.S.doc Version 5.2 Page 13 The home is good at helping the residents maintain contact with friends and family. Visitors are made welcome to the home. Residents are taken to visit their relatives when appropriate. The home manages nutrition well. Most produce is purchased locally and there is always a choice of three dishes at lunchtime. There is always a vegetarian option. If residents do not like any of the options another meal is prepared for them. The choice is offered on the same day as the meal. This means that the residents are more likely to remember their choice. Food is presented in an appetizing way and residents said that they enjoyed their meals. Food intake is monitored and those requiring help to eat are given assistance appropriately and discretely. Special diets are catered for. Sandbanks DS0000023512.V298390.R01.S.doc Version 5.2 Page 14 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 & 18 The quality in this outcome area is good. This judgement is based on evidence gathered both before and during this visit. The home has a satisfactory complaints procedure with evidence that the residents’ views are taken into account and acted upon. The residents are protected from all forms of abuse. EVIDENCE: There are written policies and procedures to deal with complaints, concerns and comments. Staff are clear about their responsibility to make a complaint on behalf of a resident if necessary. Residents said that they had no complaints. Relatives said that if they ever had any concerns there were dealt with immediately and in a satisfactory way. Staff are aware of Adult Protection procedures. They said that they would have no hesitation in reporting any concerns to the registered provider/manager, deputy manager or head of care. Sandbanks DS0000023512.V298390.R01.S.doc Version 5.2 Page 15 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, 21, 22, 23, 24, 25 & 26 The quality in this outcome area is good. This judgement is based on evidence gathered both before and during this visit. The environment is homely, pleasant and well-maintained. EVIDENCE: The registered provider/manager continues to improve the environment. All areas well decorated. Wheelchairs are well maintained and stored safely. Rooms are redecorated when they become vacant. No offensive smells or health and safety issues were noted during a tour of the home. A second maintenance person has been taken on. He has responsibility for environmental heath and safety checks. The home is using the services of Peninsular to advise on health and safety. They have recently carried out a health and safety audit. Sandbanks DS0000023512.V298390.R01.S.doc Version 5.2 Page 16 Cleaning services are good; there are two cleaners who work well together. There is also a new laundry assistant. All areas of the home were very clean on the day of inspection. The maintenance, laundry and cleaning staff are commended for the work they do in the home. Residents say they like their rooms. Bedrooms have been personalised to reflect the interests and past lives of the residents. Sandbanks DS0000023512.V298390.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 The quality in this outcome area is good. This judgement is based on evidence gathered both before and during this visit. Good staffing levels, good staff training, low staff turnover and good communication mean that staff morale is high. Recruitment procedures are sound. EVIDENCE: There is a good level of staff training and there are regular staff meetings. Staff were very positive about the management team and the training opportunities. They said that working in the home is like being part of a family. There is a key worker system. This means that staff are able to work closely with individual residents. Staffing structures give for clarity of roles and clear lines of accountability. There are clear job descriptions and inspection of staff files showed that all appropriate checks have been made before offering employment to new staff. Currently six staff are undertaking a twelve-week course on infection control and a similar length course on dementia is planned for the near future. Sandbanks DS0000023512.V298390.R01.S.doc Version 5.2 Page 18 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, 34, 35, 36, 37 & 38 The quality in this outcome area is excellent. This judgement is based on evidence gathered both before and during this visit. EVIDENCE: There is a good management structure and clarity of responsibilities. The registered provider/manager, Keith Hutchinson, oversees the running of the home and ensures budgets meet the needs of the residents; the deputy manager, Zoë Kendall oversees the day-to-day running of the home; and the head of care takes responsibility for care issues, in the first instance. The manager of the sister home nearby, gives further support. She has extensive knowledge of mental health issues. Financial management within the home is good. Budgets for food, staffing, new equipment and maintenance are all generous. Sandbanks DS0000023512.V298390.R01.S.doc Version 5.2 Page 19 The deputy manager, Zoë, holds the NVQ in management and care and the registered Manager’s Award. She is currently undertaking the NVQ III in mental health. Discussion with Keith and Zoë showed that they are enthusiastic about the home and committed to continuing to improve both the environment and care practice. Staff and relatives say that it is easy to talk to any of the management team. There are regular staff meetings, one-to-one supervisions and annual staff appraisals. Staff were very positive about the management arrangements in the home and said that they felt the registered provider valued them and took notice of their concerns and ideas. Records were found to be stored securely and all staff understood the importance of confidentiality. Sandbanks DS0000023512.V298390.R01.S.doc Version 5.2 Page 20 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 3 3 3 3 3 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 3 3 3 3 4 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 4 4 3 3 3 3 4 Sandbanks DS0000023512.V298390.R01.S.doc Version 5.2 Page 21 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. 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 Refer to Standard OP8 Good Practice Recommendations The home should consider adding a column on the weight charts to record action taken if there is a significant variance in weight. Sandbanks DS0000023512.V298390.R01.S.doc Version 5.2 Page 22 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.V298390.R01.S.doc Version 5.2 Page 23 - 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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