Inspection on 22/04/08 for Sandilands Lodge

This inspection was carried out on 22nd April 2008.

CSCI found this care home to be providing an Adequate service.

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

Sandilands Lodge 10/01/08

Sandilands Lodge 25/09/07

Sandilands Lodge 28/02/07

Sandilands Lodge 19/04/06

Sandilands Lodge 24/11/05

Sandilands Lodge 23/11/04

Sandilands Lodge 17/06/04

Extracts from inspection reports are licensed from CQC, this page was updated on 28/09/2008.

CARE HOMES FOR OLDER PEOPLE Sandilands Lodge 228 Carshalton Road Sutton Surrey SM1 4SA Lead Inspector Mohammad Peerbux Key Unannounced Inspection 22nd April 2008 09:00 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 Sandilands Lodge DS0000007207.V362839.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. Sandilands Lodge DS0000007207.V362839.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Sandilands Lodge Address 228 Carshalton Road Sutton Surrey SM1 4SA 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) 020 8643 6291 020 8642 3788 bmwilliams@btconnect.com Ms Barbara Williams Ms Barbara Williams Care Home 15 Category(ies) of Dementia - over 65 years of age (15) registration, with number of places Sandilands Lodge DS0000007207.V362839.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care Home Only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Dementia - Code DE (E) (of the following age range: 65 years and over) The maximum number of service users who can be accommodated is: 15 10th January 2008 2. Date of last inspection Brief Description of the Service: Sandilands Lodge is registered to provide residential care for up to fifteen older peoples with dementia. The home is a large detached house situated on the Carshalton Road close to local shops and bus routes between Wallington and Sutton. It is an old property in need of refurbishment and difficult to adapt to modern standards of comfort and disability access. There are three single and six double bedrooms located over two floors. The home has a separate lounge and dining room on the ground floor. There are bathrooms and toilet facilities located on both floors. The home has a small kitchen and a laundry room. The office is also very small, too small to effectively manage the home. A small patio area and raised garden is to be found at the rear of the property and parking space to the front. The range of weekly fees is between £417 and £480. Sandilands Lodge DS0000007207.V362839.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is one star. This means the people who use this service experience adequate quality outcomes. This unannounced visit to the home was undertaken as a part of the inspection process for the year 2008/2009. In writing the report, consideration has also been given to information received throughout the year such as comments from people who use the service, reports of incidents and complaints. This is the first key unannounced inspection for the year 2008/2009.This inspection was facilitated by the Registered Manager and the Assistant Manager was also involved in the process. Some of the residents were spoken to and they commented positively on the care they are receiving. One resident stated, “They look after me well”. They are all thanked for their time and all of those who provided feedback for their support in the inspection process. A tour of the building was also carried out. What the service does well: What has improved since the last inspection? A lot of hard work has been put in with regards to the general environment of the home. There has also been improvement in care planning and standard of record keeping in the home. Sandilands Lodge DS0000007207.V362839.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. Sandilands Lodge DS0000007207.V362839.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 Sandilands Lodge DS0000007207.V362839.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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6 People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home undertakes an assessment of the healthcare needs of residents prior to their admission to ensure that their needs would be met. EVIDENCE: Standard 3 has been assessed as not fully met, as there has not been any new admission to the home recently. Previously it was noted that residents moved into the home without having their needs fully assessed prior to admission. A copy of the new assessment was seen and it now looked more comprehensive. This standard would be reassessed at the next inspection. Intermediate care for rehabilitation and return to the community is not provided by this home. Sandilands Lodge DS0000007207.V362839.R01.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Generally, residents’ care plans include detailed information about their needs and personal goals. This helps staff to know the residents’ needs and how to meet them. EVIDENCE: Three care plans were checked at random and it was noted that there have been a big improvement since the last inspection. It was positively noted that areas on social care needs have now been addressed and the care plans included all aspects of the health, personal and social care needs of the residents. Standard 7 has been assessed as partially met as it was agreed with the registered manager that there are still improvement to be made to ensure that all the needs of the residents are covered in their care plans. Residents’ care plans are now being drawn up with the involvement of the resident, agreed and signed by the resident whenever capable and/or representative (if any). This is in line with a requirement made at the last inspection. Sandilands Lodge DS0000007207.V362839.R01.S.doc Version 5.2 Page 10 The home actively promotes the residents’ right of access to the health and remedial services that they need, both within the home and in the community. Records show that the home arranges for health professionals to visit residents in the home and provides facilities to carry out treatment. The manager stated that none of the residents have pressure sores. The home has a medication policy which is accessible to staff, medication records are generally up to date for each resident and medicines received, administered and disposed of are recorded. Staff are aware of the need to treat residents with respect and to consider dignity when delivering personal care. The home arranges for residents to enjoy the privacy of their own rooms. Residents who were spoken to stated that they are happy with the way that the staff deliver their care and respect their dignity. One resident stated, “I am happy here and the staff look after me well”. Observation of the staff team interacting with the residents showed that the carers were mindful how they addressed residents, and they were seen to be polite and friendly. One visiting relative also commented positively on the care her mother was receiving. She stated, “My Mum is happy here, I do not have any concern”. Sandilands Lodge DS0000007207.V362839.R01.S.doc Version 5.2 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are being provided with a range of opportunities for recreational and social activity that is in accord with their social and cultural needs. They are assisted to maintain contact with family and friends, and links with the local community are encouraged. Dietary needs are well catered for and a well balanced diet is provided, to ensure health and enjoyment of food. EVIDENCE: Staff are aware of the need to plan the routines and activities of the home in a way, which meets the choice, and wishes of residents. The home tries to be flexible and attempts to provide a service, which is as individual as possible by using its staff and resources effectively. As far as possible the residents are consulted on how the home can work to provide them with a flexible lifestyle, and to achieve their wishes. The home has open visiting arrangements and residents know they can entertain their family and friends in their own room. If they prefer they can use communal areas of the home to talk to visitors. It is clear that the home Sandilands Lodge DS0000007207.V362839.R01.S.doc Version 5.2 Page 12 encourages individuals and groups from the community to visit the home. The home also holds regular meetings with the residents/relatives. Maintaining independence and enabling residents to make their own decisions about how they wish to live is a key objective of the home. Residents have the choice to bring personal possessions with them on admission to the home and are encouraged to keep personal items, which are important to them in their own room. It was clear from the menus that a wide variety of different food options were available in the home with a lot of consideration given to the nutritional value of the meals provided. Staff are ready to offer assistance in eating where necessary, discreetly, sensitively and individually, while independent eating is encouraged for as long as possible. The meals are balanced and nutritious and cater for the varying cultural and dietary needs of individuals. The manager is devising a picture menu for the residents so that it will be easier for them to choose what they would like to eat. Sandilands Lodge DS0000007207.V362839.R01.S.doc Version 5.2 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Complaints are generally managed well, which should ensure that residents’ and relatives’ concerns are listened to. EVIDENCE: The service has a complaints procedure that generally meets the national minimum standards and regulations. The complaints procedure is available within the home. Residents’ relatives/representatives and others associated with the provision understand how to make a complaint. An anonymous complaint was received by the Commission regarding the care of two residents who had recently died. As part of the investigation this was discussed with the manager and the Commission contacted the relatives of both residents and they both commented that they were very happy with the care at Sandilands and did not have any concerns. They were very unhappy about the allegation being made and stated that they would themselves have contacted the Commission if they had any concerns. The home is clear when an incident needs to be referred to the Local Authority as part of the local Safeguarding procedures in place. The manager stated that all staff working within the home are fully trained in Safeguarding Adults and know how to respond in the event of an alert. Presently there is an ongoing investigation by the Local Authority concerning the care of one resident who Sandilands Lodge DS0000007207.V362839.R01.S.doc Version 5.2 Page 14 was living at the home last year. The Commission will continue to monitor this standard. Sandilands Lodge DS0000007207.V362839.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. JUDGEMENT – we looked at outcomes for the following standard(s): 19,22 and 26 People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The environment does not always meet the residents’ needs however there is a rolling programme in place to improve the decoration, fixtures and fittings and general environment. EVIDENCE: There has been significant improvement to the environment since the last inspection. The home has an on-going maintenance programme in place. There has been a stair lift installed to help residents with mobility difficulties to go to the first floor. All residents must have a means of calling for assistance, however it was noted during this inspection that the some call bells in the residents’ bedrooms were broken. These need to be fixed so that residents are able to call for help. Sandilands Lodge DS0000007207.V362839.R01.S.doc Version 5.2 Page 16 The home is kept clean and hygienic and free from offensive odours throughout. Systems are in place to control infection in accordance with relevant legislation and published professional guidance. Sandilands Lodge DS0000007207.V362839.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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 People using the service experience good outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has the numbers and skill mix of staff sufficient to meet residents’ needs and ensure their safety. There is a staff training and development programme in place. This ensures that staff fulfils the aims of the home and meet the changing needs of residents. EVIDENCE: Resident spoken to during the visit all said they were happy with the care provided, they found the staff friendly and helpful. Generally residents have confidence in the staff that care for them. Rotas show well thought out and creative ways of making sure that the home is staffed efficiently, with particular attention given to busy times of the day and changing needs of the residents. The manager informed that more than 50 of staff have an NVQ level qualification at level 2. Recruitment procedures seemed appropriate. Three staff files were examined at random and found to contain all the information required by the Care Homes Regulations 2001 including a completed job application, terms and conditions of employment, an enhanced CRB check and proof of their identity. Sandilands Lodge DS0000007207.V362839.R01.S.doc Version 5.2 Page 18 The home ensures that all staff within its organisation receives relevant training that is targeted and focussed on improving outcomes for residents. The manager is aware that there are some gaps in the training programme. These are being addressed and further training sessions have been arranged. The manager must also update the individual staff training records. Sandilands Lodge DS0000007207.V362839.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,36 and 38 People using the service experience adequate outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home generally provides guidance and direction to staff to ensure residents receive consistent quality care. There is a quality monitoring system and this ensures the home is run in a way that is in the best interests of the residents. EVIDENCE: Since the last inspection there has been significant improvement made with regards to the general management, environment and some of the paperwork and the Commission acknowledges this. The manager and assistant manager are still working towards improving the service being provided. They are aware of the areas where they need to make improvements and have an action plan Sandilands Lodge DS0000007207.V362839.R01.S.doc Version 5.2 Page 20 for undertaking the work. However there is still progress to be made to ensure that the home is being run in the best interests of the residents and working to the basic processes set out in the NMS. The Commission will continue to monitor this standard. Effective quality assurance and quality monitoring systems, based on seeking the views of residents, are now in place to measure success in meeting the aims, objectives and statement of purpose of the home. The manager stated that the home does not handle residents’ monies. It was previously required that formal supervision sessions must be held with all care staff at least six times a year for the delivery of good quality services. Supervision records were sampled at random and it was noted that progress has been made with regards to the frequency of staff supervision. Records with regards to health and safety are of a good standard and are routinely completed. Certificates relating to health and safety were up to date servicing certificates. These included electrical wiring and installation, gas safety and fire safety. However the manager must ensure that the hot water temperature is within the recommended level of 43 degrees so that residents and staff are not at risk of being scalded. Sandilands Lodge DS0000007207.V362839.R01.S.doc Version 5.2 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 2 X X N/A 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 14 15 3 X X 2 X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 2 X 3 X N/A 3 X 2 Sandilands Lodge DS0000007207.V362839.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? Yes 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(1) Requirement Residents’ care plan must cover all aspects of their health, personal and social care needs and set out in detail the action, which needs to be taken by care staff to ensure these are met. (Previous timescale of 10/03/08 partially met). Call bells must be repaired to ensure that residents are able to call for help and for their safety. The home must be run in the best interests of the residents and work to the basic processes set out in the NMS. (Previous timescale of 10/03/08 partially met). The hot water temperature is within the recommended level of 43 degrees so that residents and staff are not at risk of being scalded. Timescale for action 22/07/08 2. OP22 23(2)(n) 22/05/08 3. OP31 12 22/05/08 4. OP38 13(4) 06/05/08 Sandilands Lodge DS0000007207.V362839.R01.S.doc Version 5.2 Page 23 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Sandilands Lodge DS0000007207.V362839.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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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