Inspection on 06/07/06 for Sandbanks Care Home

This inspection was carried out on 6th July 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 Care Home 07/06/07

Sandbanks Care Home 15/02/06

Sandbanks Care Home 12/08/05

Sandbanks Care Home 04/02/05

Sandbanks Care Home 12/07/04

Sandbanks Care Home 02/02/04

Sandbanks Care Home 09/12/02

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE Sandbanks Care Home Southville Road Bedfont Middlesex TW14 8AP Lead Inspector Robert Bond Key Unannounced Inspection 6th and 13thJuly 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 Care Home DS0000032618.V300821.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 Care Home DS0000032618.V300821.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Sandbanks Care Home Address Southville Road Bedfont Middlesex TW14 8AP 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) 0208 890 4872 0208 890 1160 paula.bilbie@hounslow.gov.uk London Borough of Hounslow Miss Paula Carol Bilbie Care Home 34 Category(ies) of Dementia - over 65 years of age (8), Old age, registration, with number not falling within any other category (26) of places Sandbanks Care Home DS0000032618.V300821.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15th February 2006 Brief Description of the Service: Sandbanks is a purpose built home, for thirty four older people. It is owned and managed by the London Borough of Hounslow. It is situated in a residential area of Bedfont and there are local shops and public transport within half a mile. The home is a two-storey residential home, divided into four units, Swallows and the Intermediate Care unit being on the ground floor, and Lapwings and Magpies on the first floor. These are pleasantly furnished in a domestic style. In each of the units there are kitchen facilities, a lounge, dining area, a bathroom and toilets. A large communal lounge on the ground floor is used for entertainment, functions and meetings. There is a coffee room adjacent to the lounge for visitors, residents and staff to use. A large well-furnished conservatory is next to the lounge. This is used as the smoking area. The Rehabilitation unit provides a short-term service for seven services users who require rehabilitation either before returning home from hospital or prior to them becoming long-term residents of the care home. The rehabilitation service offers a maximum stay of six weeks. The unit has its own manager and team of staff, which includes a physiotherapist and occupational therapist. The home also has a unit for 8 service users with dementia. The home has an extensive garden with a pond and seating. A corridor links the home with a day centre, which has its own separate entrance and facilities. There is adequate parking for staff and visitors, both in front of the home and in the nearby road. The Registered Manager for the home has the title of Resource Centre Manager as she is responsible for all the facilities on the site. Sandbanks Care Home DS0000032618.V300821.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This CSCI inspection was a ‘key inspection’ that measured the home’s outcomes only for those National Minimum Standards (NMS) for older people’s care homes that are considered to be the most important (key) standards. In total the Inspector assessed 22 of the NMS, and found that 15 expected outcomes were fully met and 2 were exceeded, whereas 5 outcomes were only partly met. This led to the Inspector making 5 requirements and 2 recommendations. The Inspector visited the home twice, interviewed the Registered Manager, met other staff, talked to some service users, toured the home, and examined a range of records. The care files of three service users were case-tracked; that is examined in detail. The Registered Manager reported that all the long-stay beds within the care home are occupied. Five new care staff are currently being taken on, leaving only 60 vacant care hours, thus the use of agency staff is being curtailed. What the service does well: What has improved since the last inspection? Five new care staff are being taken on, hence the dependence on temporary agency members of staff has declined. Four of the new staff already have NVQ qualifications in care work. The rolling programme of refurbishment of the home has continued, with Lapwings lounge and diner and some bedrooms having been redecorated since the previous CSCI inspection. A revised and updated Statement of Purpose has been produced. Person centred care plans are being introduced throughout the home. Sandbanks Care Home DS0000032618.V300821.R01.S.doc Version 5.2 Page 6 A new dependency level monitoring form is being used. The homes medication procedure has been added to and staff have received additional training in following the procedure. The home now has its own Protection of Vulnerable Adults procedure and staff have been trained in its use. 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 Care Home DS0000032618.V300821.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 Care Home DS0000032618.V300821.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): 3 and 6 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to the service. More care must be applied when staff from the home are undertaking the assessment of potential service users. Service users who reside in the care home for rehabilitation are helped to maximise their independence and return home but more attention must be applied to their care needs whilst at the home. EVIDENCE: The Inspector examined in detail (case-tracked) the care records of the three most recent service users to move into the elderly-frail unit, the dementia unit, and the rehabilitation unit, respectively. The Inspector found that full and professional assessments had been provided to the home in each case by the referring agency. Staff from the home also had undertaken their own written assessment when the referral was for a longSandbanks Care Home DS0000032618.V300821.R01.S.doc Version 5.2 Page 9 term place. The assessment was undertaken using a two page form designed to make sure that the care home could meet the needs of the person referred. One of the two completed forms seen by the Inspector did not name the person who had undertaken the assessment. The other form seen did not have the section completed where the decision is made to accept the person referred, for residential care, or not. Requirement 1 and Recommendation 1. Based upon the care file examined by the Inspector, service users resident in the home for rehabilitation (intermediate care) are fully assessed in advance by the referring hospital, by occupational therapy and by physiotherapy. However none of these assessments were signed by the potential service user as a means of demonstrating their involvement in and agreement with the assessment. Recommendation 2. The potential service user however does sign their agreement to undertake rehabilitation therapy whilst at Sandbanks, and agrees to move out of the home subsequently when deemed fit to do so. Sandbanks Care Home DS0000032618.V300821.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 and 10 Quality in this outcome area is adequate overall. This judgement has been made using available evidence including a visit to the service. Service users’ health, personal and social care needs are set out in an individual plan of care, but not if the service user is in the home for rehabilitation. Risk assessments for manual handling purposes are not always satisfactory. Service users’ health needs are generally being met. Service users are protected by the medication procedures that the home has in place. Service users are treated with respect and their right to privacy is upheld. Sandbanks Care Home DS0000032618.V300821.R01.S.doc Version 5.2 Page 11 EVIDENCE: The Inspector examined the individual service plans (care plans) for the three service users selected. Both of the long term service users had person centred plans. Although one service user was in the elderly frail unit and the other was in the dementia unit, the Inspector was not able to easily tell from the care plans and the care files, which was which. The service user in the rehabilitation unit did not have a person centred plan or a care plan other than that prepared for occupational and physiotherapy, namely the ‘daily exercise programme’. NMS 7.2 requires the care home to have a service user plan for all residents that sets out in detail the action necessary to ensure that all aspects of the health, personal and social care needs of the service user are met. Requirement 2. Thus a comprehensive assessment will be required from the referrer so that an adequate care plan can be devised. The service user and/or their relatives and representatives must be consulted during this process. The Inspector found that manual handling risk assessments were completed on long-term service users. Greater care and attention must be applied when undertaking this task as one example seen by the Inspector did not name the service user, did not give her height and weight and, given that she had been admitted because of her history of falls, the risk assessment and the actions proposed to minimise the risks were not adequate. Requirement 3 and Recommendation 1. Additional training must be given to staff to re-emphasis the importance of accurate recording and proper risk assessment procedure. Requirement 4. The Inspector saw evidence of monthly reviews of care plans, and formal six monthly reviews of the placements. The key worker system is in use. The Inspector commends the formal asking of service users about their wishes for additional furniture in their rooms, and its subsequent recording on the care file. The Registered Manager reported that District Nurses visit the home twice a week, and that MacMillan nurses are used when required. Local GPs are always used; dentists, chiropodists, and opticians all visit the home. Occupational therapy and physiotherapy can be called upon. Medication is regularly reviewed. The Inspector checked the medication storage and recording in the dementia unit, and the recording of when medication is returned to the pharmacist. The Inspector observed that service users were being treated with dignity and respect by the staff, and their privacy was being upheld. Sandbanks Care Home DS0000032618.V300821.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 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Service users find the lifestyle experience in the home satisfies their social needs; contact is maintained with friends with relatives; choices are given, and the diet includes healthy options. EVIDENCE: The home provides a weekly programme of activities that includes cooking/baking within the units of the home, but little is organised at weekends other than a party once a month. The activity co-ordinator is only employed for three days a week. The Registered Manager however reported that other staff organise activities on a one to one basis especially in The Swallows unit. Occasional outings are organised. The Registered Manager reported that questionnaires have been used to discover the activity interests of service users. Sandbanks Care Home DS0000032618.V300821.R01.S.doc Version 5.2 Page 13 The Inspector examined the menu which included a good element of choice, including healthy options. Sandbanks Care Home DS0000032618.V300821.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 and 18 Quality in this outcome area is good This judgement has been made using available evidence including a visit to the service. Service users and their relatives should be confident that their complaints will be fully investigated, and that the home has in place the correct procedures for protecting service users from any form of abuse. EVIDENCE: The Inspector examined the home’s complaints record. It showed three complaints recorded since the previous CSCI inspection. All had been appropriately recorded and investigated. The home now has an internal procedure for the Protection of Vulnerable Adults (Safeguarding Adults). All staff have attended a training session on how to follow the procedure. Sandbanks Care Home DS0000032618.V300821.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 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Service users live in well furnished, equipped and decorated premises that are hygienic and clean. EVIDENCE: The Inspector toured The Swallow dementia unit part of the care home. The Inspector noted that various works had been undertaken in Lapwings unit, and that further refurbishment was planned in the Rehabilitation wing. The home was found to be clean, hygienic, and without any unpleasant smells. Sandbanks Care Home DS0000032618.V300821.R01.S.doc Version 5.2 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, 28 29 and 30 Quality in this outcome area is adequate overall. This judgement has been made using available evidence including a visit to the service. There are sufficient staff employed and deployed throughout the home. Staff are very well trained, and training records are excellent. The Inspector was not able to judge whether the home’s recruitment procedures adequately protected service users as recent recruitment records were not available for inspection. EVIDENCE: The Inspector examined the current staffing rota for the home. The Inspector examined the home’s training plan for the year ahead, which was excellent in terms of content and presentation. The Inspector noted that training in the Protection of Vulnerable Adults and in medication administration had recently been undertaken. The Registered Manager reported that 64 of the care staff had NVQs level 2 or 3 in Care, and that this was due to rise to 70 . The Registered Manager reported that her aim was to train all staff members in Dementia Awareness, and the next training session would be during October 2006. Sandbanks Care Home DS0000032618.V300821.R01.S.doc Version 5.2 Page 17 The Inspector examined the recruitment file of the most recent member of staff to join the permanent staff team. The Inspector found on file two references, a form that had been used to explain a gap in the applicant’s work record, and her training record since joining the team. Documentary evidence not available for the Inspector to examine included her application form, interview notes, identification check, permission to work in the UK status, photograph, qualification certificates, evidence of a satisfactory Criminal Records Bureau check, and an offer of employment letter or copy of her contract of employment. The Registered Manager reported that all these documents would be with the Human Resources Department of the London Borough of Hounslow, as she believed agreement had been reached between them and the CSCI that it was no longer necessary for each care home to keep a copy of those documents for inspection by the CSCI provided the HR department give the care home a completed check list that demonstrated that each document did exist. In the case examined by the Inspector, no such list had been supplied to the care home by the London Borough of Hounslow. Requirement 5. Sandbanks Care Home DS0000032618.V300821.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, 33, 35 and 38 Quality in this outcome area is good overall. This judgement has been made using available evidence including a visit to the service. Service users live in a home that is well managed, and operates in their best interests. Service Users’ financial records are well maintained, and service users’ health, welfare and safety are promoted. Internal quality assurance systems are in need of improvement. EVIDENCE: The Registered Manager has obtained the Registered Manager’s Award which she completed in January 2006. She is planning to undertake the Dementia Awareness training that is scheduled for October 2006. Sandbanks Care Home DS0000032618.V300821.R01.S.doc Version 5.2 Page 19 The Inspector examined minutes of resident and relatives meetings which are held quarterly. The Registered Manager reported that service user meetings also take place within individual units. The Inspector is concerned that the internal quality assurance system is not operating sufficiently well as it is not picking up on omissions in the assessment procedures, omissions in care record keeping, and poor risk assessments practice. Recommendation 1. The Inspector checked a sample of service users’ financial records, which were very well maintained. The Inspector checked a sample of temperature records for hot water, fridges and freezers. All were adequately kept. Sandbanks Care Home DS0000032618.V300821.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 x x 2 x x 2 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 x 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 x x x x x x 3 STAFFING Standard No Score 27 3 28 4 29 2 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 2 x 3 x x 3 Sandbanks Care Home DS0000032618.V300821.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. 1 Standard OP3 Regulation 14 Requirement The registered person shall not provide accommodation unless the needs of the service user have been properly and fully assessed. The registered person shall consult with the service user (including those receiving rehabilitation) and prepare a written plan as to how the service user’s needs in respect of health and welfare are to be met. The registered person shall make suitable arrangements, including undertaking risk assessments in order to provide a safe system for manual handling service users, and for preventing falls. The registered person shall train staff in understanding the importance of accurate recording and proper risk assessment procedure as a means to prevent service users being placed at risk of harm. The registered person shall maintain in the care home the records specified in Schedule 4. DS0000032618.V300821.R01.S.doc Timescale for action 01/08/06 2 OP7 15 01/09/06 3 OP7 13(5) 01/08/06 4 OP7 13(6) 01/09/06 5 OP29 17(2)Sch 4(6) 01/08/06 Sandbanks Care Home Version 5.2 Page 22 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 OP3 Good Practice Recommendations The internal quality monitoring system should be reviewed so that omissions such as those identified by the Inspector in completed internal assessment forms for potential service users, and in a manual handling risk assessment, can be spotted and corrected. Potential users of the rehabilitation service should be encouraged to read and sign the assessments that have been undertaken by occupational therapy and physiotherapy in order to demonstrate that they have been consulted and agree with the assessment. 2. OP6 Sandbanks Care Home DS0000032618.V300821.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection West London Area Office 11th Floor, West Wing 26-28 Hammersmith Grove Hammersmith, London W6 7SE 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 Care Home DS0000032618.V300821.R01.S.doc Version 5.2 Page 24 - 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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