Inspection on 19/01/06 for Sandbeck House

This inspection was carried out on 19th 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

Sandbeck House 05/10/06

Sandbeck House 15/09/05

Sandbeck House 10/02/05

Sandbeck House 11/11/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Sandbeck House 77-81 Sandbeck Avenue Skegness Lincs PE25 3JX Lead Inspector Jill Clifton Unannounced Inspection 19th 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 Sandbeck House DS0000002412.V278105.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. Sandbeck House DS0000002412.V278105.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Sandbeck House Address 77-81 Sandbeck Avenue Skegness Lincs PE25 3JX 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) 01754 766585 Mr Kanagasooriam Ravivaruman Lynn Annette Shipley Care Home 38 Category(ies) of Old age, not falling within any other category registration, with number (38) of places Sandbeck House DS0000002412.V278105.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15th September 2005 Brief Description of the Service: Sandbeck House is a former guesthouse and domestic premises, which have been combined, adapted and extended to offer accommodation on two floors. The home has recently increased the registration to 38 places after completing a further small extension and upgrading to the property. Access to the first floor is provided via an eight-person shaft lift and one stair lift. The two separate accommodation areas are connected by means of a large conservatory, which offers further seating. The home offers personal care only. The home is situated in a residential area fairly near to the sea front in the coastal resort of Skegness. It is within reasonable walking distance of the main shopping area of the town and more local shops are available within a few hundred yards. Car parking is available at the side of the home and on the roadside immediately outside the home, which can be a problem in the summer months. The gardens are restricted to a small attractive enclosed patio area situated in the middle of the home and a space at the front of the home, which is planted with shrubs and overlooks Sandbeck Avenue. The home offers the choice of three lounges, including a quiet area, and an open plan dining area. Sandbeck House DS0000002412.V278105.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection is unannounced and was conducted within five hours. The main method of inspection used was called ‘case tracking’ which involved selecting three service users and tracking the care they receive through the checking of their records, discussion with them, the care staff and observation of care practices. A tour of the building was conducted with the senior carer. Two staff were interviewed and six service users, one visitor and a visiting District Nurse. Care records were inspected. Feedback was given at the end of the inspection to the Manager and the Proprietor. What the service does well: 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. Sandbeck House DS0000002412.V278105.R01.S.doc Version 5.1 Page 6 The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Sandbeck House DS0000002412.V278105.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 Sandbeck House DS0000002412.V278105.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 and 5 Service users needs are assessed before being offered a place within the home. Service users and their families are given information about the home and offered a trial visit. EVIDENCE: A new service user said that prior to admission a family member had looked around the home and been given a lot of information. The home arranged to collect the service user together with a family member to spend the day as a trial visit in the home and to have a meal, which the service user said ‘helped me make my mind up as to whether I’d like to live here’. ‘Staff were welcoming and friendly and I felt that I could settle here’. There was evidence that the manager, in consultation with the service user and a family member had undertaken a pre assessment of care needs to ensure that the home could offer the appropriate care required. Sandbeck House DS0000002412.V278105.R01.S.doc Version 5.1 Page 9 Sandbeck House DS0000002412.V278105.R01.S.doc Version 5.1 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 and 10 Care plans identify all areas of need and provide sufficient care instructions for staff; this enables staff to provide appropriate care. The plans of care demonstrate that service users health needs are being met Service users are treated with respect and their dignity maintained through staff training and supervision. EVIDENCE: Each service user has a plan, which contains information relating to individual care needs. The care plans seen had been regularly reviewed as had related risk assessments. There was evidence that service users and families had been consulted about the plan of care. Although risk assessments were evaluated, there were in some cases, no signature or outcome recorded. Referrals and visits by District Nurses and Doctors are recorded. Service users weight and waterlow scores are recorded, which means staff can identify those service users who may be at risk from dedveloping pressure sores. The chiropodist visits every six weeks; opticians visit the home twice a year. At the time of inspection a senior carer was trying to access dental care for a service user. One staff member has the responsibility for undertaking and recording the blood sugar levels of those service users who are diabetic, the Manager Sandbeck House DS0000002412.V278105.R01.S.doc Version 5.1 Page 11 confirmed that the District Nurse had agreed to this, this was also confirmed by a visiting District Nurse; the Nurse also commented that staff communicated well to ensure service users needs were met; that she had no concerns about the care given to service users and staff were always courteous and helpful. Service users confirmed that staff always knocked on doors before entering and that they had been offered a key to lock their bedroom door. A lockable facility was provided in each bedroom for securing personal items or medication, if self medicating. Staff were noted to interact with service users in a patient and kind manner, service users confirmed this ‘staff here are lovely, nothing is too much trouble’. Sandbeck House DS0000002412.V278105.R01.S.doc Version 5.1 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): 15 Service users have a wide choice of food to choose from at every meal. Meals are nutritionally balanced and well presented. EVIDENCE: The menu showed extensive choice and variety at every meal, including a full English breakfast daily. Service users confirmed that there are choices at each meal and variations for those who required a vegetarian or diabetic option. All the service users spoken to had very positive comments to make about the meals and choices. A visitor commented that ‘I am always offered a meal when I visit and it is always enjoyable’. Service users commented: ‘The meals are really good, as is the choice’; ‘staff ask me what I fancy to eat everyday’; ‘I like it because there are two choices of puddings at a lunch time and at tea time’. There is a dining table set in a small lounge for service users who have visitors, this means that they can have a meal together with some privacy away from the main dining room. The main dining room tables were set out to hotel standard, with a view overlooking the small courtyard, which has a water feature. The dining chairs with ski type runners made accessing the table easier for service users. Discreet protective clothing was provided for some service users to maintain dignity. Sandbeck House DS0000002412.V278105.R01.S.doc Version 5.1 Page 13 Sandbeck House DS0000002412.V278105.R01.S.doc Version 5.1 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): 18 The homes policies, procedures and training help keep service users safe from harm. EVIDENCE: Service users spoken to said that they ‘felt safe in the home’ and that they felt that they could tell the manager of any worries or concerns that they may have. New staff confirmed that they had undertaken training in the protection of vulnerable adults. The Manager said that care staff are not allowed to work in the home until they had undergone the necessary checks, which helps keep service users safe, this was confirmed from talking to staff and from the recruitment files. Staff spoken to would have no hesitation in reporting any suspected abuse. Sandbeck House DS0000002412.V278105.R01.S.doc Version 5.1 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): 21 and 26 Service users ability to access bathrooms and shower rooms independently is severely compromised because these areas are being used for storage. The home was clean, non odorous and the prevention of cross infection was taken seriously. EVIDENCE: The majority of bathrooms and shower rooms were being used as storage areas for mattresses, toiletries and wheel chairs. In a shared ensuite facility the bath was used to store continence products, equipment and toiletries. The storage facilities must be urgently reviewed to ensure that all communal bathrooms and shower rooms are kept free from stored items to ensure that service users can have a choice of facilities and access these safely. The home was clean, well maintained and non odorous throughout. There is a housekeeper on duty daily. The laundry had sufficient equipment to cope with the laundry needs of up to 38 service users and was clean and organised, a laundry manager worked five days per week. Sandbeck House DS0000002412.V278105.R01.S.doc Version 5.1 Page 16 Throughout the bathrooms and toilets soap dispensers are provided together with paper towels, this is important to prevent cross infection occurring; staff also had individual liquid alcohol hand rub which also act as a protector against cross infection but only if used on clean hands and not as a substitute for hand washing. Towels should not be stored openly in bathroom areas. Gloves and aprons for staff to use when undertaking personal care duties are evident; these protect service users and staff from possible cross infection. Sandbeck House DS0000002412.V278105.R01.S.doc Version 5.1 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, 29 and 30 There are sufficient numbers of staff that have been safely recruited and trained to ensure that service users are cared for appropriately. EVIDENCE: The manager is supernumerary to the one senior and four carers on duty throughout the day and evening. There are two care staff on duty at night with a deputy and manager on call. A housekeeper, chef and assistant are on duty daily and a laundry assistant five days per week. The Manager stated that the proprietor checks staffing levels against the dependency levels of service users using a recognised assessment tool; at present the Manager stated that staffing hours are in excess of minimum levels required to meet service users needs. Service users felt there are enough staff on duty to meet their needs. ‘I’m never rushed the staff are patient and kind’. The manager met every service user on a daily individual basis to ensure that their care needs were being met by the staff on duty. Recruitment records showed that staff had been recruited safely by using an audit trail which included all the necessary checks including references and a Criminal Records Bureau check (CRB). New members of care staff confirmed that they had not been allowed to start without a CRB confirmation. A housekeeper had commenced work having had a POVAFirst check but was still awaiting CRB clearance, however the Proprietor and Manager confirmed that this member of staff was supervised at all times. Sandbeck House DS0000002412.V278105.R01.S.doc Version 5.1 Page 18 All new staff had undertaken induction training and TOPPS training which is a more advanced and comprehensive learning introduction into care. Staff records identified that training in the protection of vulnerable adults; Alzheimer’s disease, moving and handling, fire safety, medication and first aid had been undertaken and were ongoing. The home has nearly met its target of having 50 of staff trained in a National Vocational Qualification (NVQ) in care. Staff spoken to are able to confirm the training that they had received. Sandbeck House DS0000002412.V278105.R01.S.doc Version 5.1 Page 19 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): 33,35 and 38 The home provides a safe environment for service users and staff. There are systems in place to gain views of those living in the home. There is appropriate systems for the safekeeping of service users personal monies. EVIDENCE: The Manager met with every service user daily and there was evidence that any concern, suggestion that they made was recorded, comments are recorded but the Manager must record any action taken and the outcome in response to any concerns made. Service users were all very positive about the staff employed ‘I’m treat like a Lord here’; ‘the staff never presume, they always ask me how I would like things done’. Comment and suggestions cards were available in the entrance of the home, to encourage service users and visitors to suggest improvements. Sandbeck House DS0000002412.V278105.R01.S.doc Version 5.1 Page 20 The system for recording service users personal allowances, which are kept by the home for safekeeping, was checked. Receipts were evident and monies balanced against records. When transactions have taken place there are two staff signatures in place to confirm the transaction. In order to uphold service users dignity the manager was asked to rephrase the recorded term ‘pocket money’ to personal allowance. Where possible the signature the service user should be obtained to show consultation about transactions. Health and safety records, which include, service records for equipment in the home were all in date. There were no health and safety issues identified during the tour of the building. Staff had received training in fire and health and safety. Sandbeck House DS0000002412.V278105.R01.S.doc Version 5.1 Page 21 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 2 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 3 x x 2 x x x x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x 3 x 3 x x 3 Sandbeck House DS0000002412.V278105.R01.S.doc Version 5.1 Page 22 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 OP7 Regulation 15 (2) b Requirement Plans of care and risk assessments that are under review must have a recorded outcome, so that it is clear as to whether the plan remains appropriate or is in need of amendment. Bathrooms and shower rooms must be cleared of all stored items and suitable storage facilities created to store wheelchairs and equipment. Suitable storage facilities are to be provided in service users bedrooms for the storage of continence products. Timescale for action 19/01/06 2. OP21 23 (2) m 19/02/06 3. OP21 23 (2) m 19/02/06 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 OP35 Good Practice Recommendations Where possible, service users should countersign any transactions regarding their personal monies when held by DS0000002412.V278105.R01.S.doc Version 5.1 Page 23 Sandbeck House 2. OP33 the home for safe keeping; reference should be made to these monies as personal allowances and not as pocket monies. Outcomes should be recorded when service users have made comments or concerns regarding the care and attention they receive. Sandbeck House DS0000002412.V278105.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN 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. 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