Inspection on 21/10/08 for Sandringham

This inspection was carried out on 21st October 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Sandringham 07/11/06

Sandringham 03/02/06

Sandringham 19/09/05

Sandringham 07/12/04

Sandringham 03/06/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

Extracts from inspection reports are licensed from CQC, this page was updated on 30/01/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Sandringham 5-7 Westcliff Avenue Westcliff On Sea Essex SS0 7QR     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Carolyn Delaney     Date: 2 1 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Sandringham 5-7 Westcliff Avenue Westcliff On Sea Essex SS0 7QR 01702352911 01702430650 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Anna Searle Type of registration: Number of places registered: Darby and Joan Organisation care home 20 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Sandringham provides accommodation for up to twenty older people, including people who have dementia. The home is situated close to the towns of Southend, Westcliff and Leigh and a short distance from the seafront. The homes facilities include a lounge, dining area, conservatory/quiet area and twenty single bedrooms with en-suite facilities. There is a passenger lift, which provides access to all floors. The home offers a small rear garden and there is limited off street parking to the front of the premises. The fees charged for a place in home range from £338.01 to £560.00 per week. 0 0 Over 65 20 20 Care Homes for Older People Page 4 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This was a routine unannounced inspection, which included a visit made to the home between the hours of 11.00 and 20.30 on 21st October 2008. As part of the inspection process we reviewed information we have received about the service over the last twelve months including notifications sent to us by the manager of any event in the home, which affects residents such as injuries, deaths and any outbreak of infectious diseases. We also looked at the information the manager provided us with in the homes Annual Quality Assurance Assessment. This document is a self-assessment which the registered provider / owner tell us what they do well, how they evidence this and the improvements made within the previous twelve months. We sent surveys to the home for residents, staff, their families and healthcare professionals to complete and tell us what they think about the home. We received surveys from three residents, Care Homes for Older People Page 5 of 26 one relative, ten staff and one healthcare professional. The views and comments expressed by these people were reflected in the report. When we visited the home we spoke with three residents, four members of staff and one relative. We also observed how staff interacted with residents when supporting them with activities such as meals, mobilising and providing recreation and stimulation. During the site visit, records including residents care plans and assessments, and staff training files were examined. A brief tour of the premises was carried out and communal areas including lounge and bathrooms were viewed. In addition some residents bedrooms were viewed. Information obtained was triangulated and reviewed against the Commissions Key Lines for Regulatory Activity. This helps us to use the information to make judgements about outcomes for people who use social care services in a consistent and fair way. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 7 of 26 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 8 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who move into Sandringham know their assessed needs will be met in a way which suits them. Evidence: We were told in the Annual Quality Assurance Assessment that all prospective residents will have a full needs assessment carried out prior to their admission and that wherever possible the person will be invited to visit the home and to have lunch to help them decide if they wish to move in. Two people who completed surveys told us that they had received information about the home to help them decide whether to move in. One person told us that their family had made all of the arrangements but it was their decision to move in. During the inspection we looked at the assessments which had been carried out for two people who had recently moved into the home. Both assessments had been Care Homes for Older People Page 9 of 26 Evidence: carried out by the homes manager before the person moved in. These assessments were detailed with information about each person and the support they needed to carry out activities of daily living such as washing and dressing, mobility, eating and drinking. Information was recorded about both persons preferences for how they spend their days such as what time they like to get up in the morning and retire to bed in the evening. Where a person had particular likes or dislikes these were recorded in the assessment. This helps staff to develop a plan of care which is suited to each individual. Both residents had moved into the home from hospital so it was not possible for them to visit the home before moving in. We saw that staff recorded how both people were introduced to staff and other residents and how they were helped to settle in to the home. We saw that residents receive a contract when they move into the home. This describes the care and support they will receive and the fees charged for living in the home. Detailed information describing the services and what a person can expect when they move in is provided in the statement of purpose and service users guide. Care Homes for Older People Page 10 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are very well cared for and have their health and personal care needs met. Evidence: We were told by the manager in the Annual Quality Assurance Assessment that residents are involved in their care. She told us that residents are supported and that staff ensure that they receive the treatment they need. Residents we spoke with told us that staff look after them well. Staff told us that they receive information about residents needs and any changes each day before they start work so that they can care for residents properly. Each resident has a plan of care, which describes what support and care the person needs to carry out activities of living. We looked at care plans for two residents. The way in which people prefer to be cared for was recorded, as was information about what the resident could do for themselves. This helps staff to support residents to be as independent as possible for as long as they can. We saw that staff review care plans each month and amend them where there have been changes to the needs of the Care Homes for Older People Page 11 of 26 Evidence: individual. One district nurse who completed a survey told us that staff act on their advice and always communicate any changes in residents condition. Staff assess and monitor risks to residents health and safety. Where there are risks to the safety of residents staff take appropriate action to minimise these risks. We observed that where there were risks to residents of developing pressure sores that they were provided with pressure relieving mattresses to minimise these risks. Also where people are at risk of injury from falls, particularly at night, staff have placed alarmed mats by their beds to alert staff that the person has got up. This helps to minimise the risk of them falling. The manager told us that she monitors closely any falls or injuries to residents and liaises closely with the local falls prevention team for advice and support. Residents who are assessed to be at risk of fractures are prescribed Calcium supplements as part of their treatment to help minimise risks. People living in the home usually rely upon staff to administer medicines. If a resident wishes to keep their medicines then staff will assess that the person is capable and support their wishes. Staff have access to a detailed policy and undertake training in the safe handling and administration of medicines. During the inspection we observed staff when administering medicines and they did so in accordance with the policy. We looked at how medicines were stored and the records that staff keep. Medicines were stored securely and staff keep good records to show when residents have received or refused medicines. Residents see their doctors when they are unwell and staff record this in their care plans. We observed that when a person becomes unwell and as they approach their death that staff review the plan of care and ensure that the resident is kept clean, comfortable and free from pain. Support is offered to grieving family members and we saw evidence of this on the day of the inspection. Care Homes for Older People Page 12 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents make choices about their daily lives. A review of activities and mealtimes would enhance experiences for some residents. Evidence: The manager told us in the Annual Quality Assurance Assessment that a range of activities are provided, which include access to the community library, outings to the seafront and theatre, hairdressing, arts and crafts and some chair exercises. When we visited the home the manager showed us the weekly plan for activities. These included reminiscence and getting to know you sessions, chair exercises and music. The manager has a dog who has been trained as a pat dog. She brings the dog to work three days per week and residents told us that they really enjoy this. Some residents who completed surveys and those we spoke with during our visit said that there are not always activities they like to participate in. Two residents told us that they would like to go out more. One person said I would like to go out but staff are too busy most times to take me out. The manager told us that staff take residents out and showed us records which indicated that some residents go out more than others. The manager has recently undertaken training in respect of providing activities for older people and an activities coordinator has been employed to work three day per week. This person Care Homes for Older People Page 13 of 26 Evidence: spends one to one time with those residents who do not wish to or who are too unwell to participate in activities. They also assist residents to send letters to friends and family and to take some more able people out shopping or to the seafront when the weather is fine. The manager told us that residents can go out with their families if they choose and residents confirmed this. A catering company is employed to cook meals. This allows staff to concentrate on supporting residents. There is a planned menu which the chef reviews regularly based upon comments and suggestions from residents. There is always a choice of meal available and on the day of the inspection residents were offered either fish fingers, chips and salad or a selection of cold meats, mashed potatoes and beetroot. Residents we spoke with and those who completed surveys told us they enjoy meals in the home. One person told us the cook is very good and the meals are lovely. Two people told us that the evening meal which is served at 5.30pm is too early. Residents told they have hot drinks and snacks at about 18.45 and manager confirmed this. One resident commented that it is a long time from evening drinks till breakfast. Some residents had requested to have their meals later and said that the manager had arranged this for them. Care Homes for Older People Page 14 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home are treated well and their complaints and concerns are taken seriously. Evidence: The manager told us in the Annual Quality Assurance Assessment that all staff have undertaken training in respect of safeguarding people from abuse and managing aggression. She told us that residents feel confident to raise any concerns or make suggestions about the service they receive. There is a complaints policy and procedure, which clearly describes how a person may raise concerns and how these will be dealt with. The policy is displayed by the lift where residents and visitors can easily access it. The people we spoke with during the inspection and those who completed surveys told us that they knew who to speak to if they were unhappy about anything. Three residents and one relative told us that they had no complaints and they were happy with the home. Staff we spoke with told us they would inform the manager if anyone raised concerns or if they witnessed any ill treatment of residents. The home has a policy for dealing with any allegations of abuse and staff we spoke with told us that they have received training to help them recognise signs of abuse and how to report any concerns. There is also a whistle blowing policy to assure staff who raise concerns that they will be protected from any repercussion. Four members of staff spoke with us and they demonstrated that they knew what to do if the witnessed Care Homes for Older People Page 15 of 26 Evidence: abuse of residents. We spoke with the manager about her role in dealing with allegations of abuse. She told us that she would speak to those involved and take statements. She did not demonstrate that she would report the allegation to the local safeguarding unit. One complaint had been made to the home since the last inspection. A resident said that staff had handled in an inappropriate way. The manager had investigated the complaint fully. However had not considered whether it was a safeguarding issue. We have not received any complaints or allegations about the home since the last inspection. Care Homes for Older People Page 16 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this 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 live in a clean, safe and comfortable home which suits their needs. Evidence: We were told by the manager in the Annual Quality Assurance Assessment that there is an ongoing programme for redecoration and during the inspection we saw rooms which had been redecorated since the last inspection. Resident have their own bedrooms most of which have en suite toilet and hand washing facilities. Residents who completed surveys told us that the home is always fresh and clean. We spoke with two residents who told us that they liked their bedrooms. Residents share a large dining room and two lounge areas. All areas of the home we saw including bedrooms, bathrooms and kitchen were clean and equipped for the needs of residents. There is a walk in shower and an assisted bath to make it easier for people with mobility problems to use. The home employs domestic and maintenance people and we saw records for the routine checks carried out for hot water and heating systems, fire detecting equipment and all other equipment is kept in good working order, repaired and renewed as needed. Care Homes for Older People Page 17 of 26 Care Homes for Older People Page 18 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in the home are well cared for by staff who are recruited thoroughly and trained to be able to meet their needs. Evidence: The manager told us in the Annual Quality Assurance Assessment that staffing levels are constantly reviewed and adjusted to meet the needs of residents. She told us that a team of catering and cleaning staff are employed so that care staff can concentrate on supporting residents. We were told that all new staff are recruited in line with the homes policies and procedures, that they undertake a period of induction and they receive relevant training. We looked at staff rotas and these showed us that a minimum of one senior and three care staff cover the day duty. One senior and one care staff cover the night duty. From the rotas we noted that some staff work excessive hours without sufficient time off. This practice if continued may impact upon the persons fitness to work and support residents. Staff who we spoke with and those who completed surveys told us that staff were usually available when needed. One person said staff always come and help me when I call. Another person said they would like staff to spend more time with them and to take them out more. All of the people we spoke with and those completed surveys said that staff were good and look after residents well. Care Homes for Older People Page 19 of 26 Evidence: We looked at how staff are recruited. We examined the files for three people who were employed since the last inspection. There was information about each persons skill and their previous employment. The manager had obtained references from previous employers, Criminal Records Bureau disclosures and PoVA First checks for each person before they commenced employment. These checks help to ensure that people who work in the home are competent and suitable to care for older people. We spoke with one person who had commenced their induction on the day of the inspection. They told us that they had been supported and that they would spend the week shadowing staff. This practice helps new staff to familiarise themselves with the routines, policies and procedures and the needs of residents. Staff we spoke with told us that there is lots of training available. One person said the manager ensures that we are skilled and updated with lots of training. The manager showed us training and development plans for staff. There was evidence that there is a comprehensive training and development programme and that staff receive training relevant to the needs of residents including managing incontinence, stoma care, pressure area care and supporting people who have dementia. Care Homes for Older People Page 20 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Sandringham is well managed and peoples needs are met. Evidence: The manager provided us with detailed information about the service in the Annual Quality Assurance Assessment. This told us what the home does well, where improvements could be made and plans for improvement for the coming twelve months. Staff who spoke with us and those who completed surveys all told that the manager is very supportive and approachable. One member of staff told us she always ensures that we have relevant training and supervision. The manager has a very hands on approach to management and one resident we spoke with said that she comes to see if I am happy most days. Residents meet twice every year to discuss how the home is managed and to make comments and suggestion about what they like and anything they would like changed. We looked at the minutes from the most recent meeting. This indicated that people were satisfied with the home. Care Homes for Older People Page 21 of 26 Evidence: There are arrangements in place for residents to have money kept in bank account on their behalf. Records for all monies paid and any financial transactions were maintained so as to minimise the risk of mishandling. The manager told us that the account does not attract interest and that residents have signed an agreement for money to be deposited in this account. Copies of the agreements were seen. The manager told us that residents, relatives and friends are invited to complete surveys each year and to comment on the service. At the time of this inspection this survey had not yet been carried out for this year. Care Homes for Older People Page 22 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 23 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 18 13 All staff working in the home 30/12/2008 must be trained to manage allegations of abuse and be aware of their roles. This is to ensure that any allegations will e dealt with appropriately and residents Will be assured that they will be safeguarded. 2 27 18 Staffing levels must be reviewed and appropriate numbers of staff must be employed in the home so that staff do not work excessive hours without appropriate time off. This is to ensure that staff are fit to carry out their duties and support residents. 29/12/2008 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 24 of 26 1 12 A wider range of activities should be provided to meet the needs of all residents living in the home and more support for people who would like to take trips out of the home. Meal times should be reviewed to ensure that they suit the needs and wishes of residents. 2 15 Care Homes for Older People Page 25 of 26 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 26 of 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!