Inspection on 19/07/06 for Sandringham Care Home with Nursing

This inspection was carried out on 19th 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Sandringham Care Home with... 17/01/08

Sandringham Care Home with... 08/08/07

Sandringham Care Home with... 26/02/06

Sandringham Care Home with... 10/08/05

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Moor House

Mendip House

Beaconsfield Court Care Home

Little Sisters Of The Poor

Manor House

Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

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

CARE HOMES FOR OLDER PEOPLE Sandringham Care Home with Nursing Sandringham Care Home with Nursing Escomb Road Bishop Auckland Co Durham DL14 6HT Lead Inspector Bridgit Stockton Unannounced Inspection 19th July 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 Sandringham Care Home with Nursing DS0000063946.V303236.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. Sandringham Care Home with Nursing DS0000063946.V303236.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Sandringham Care Home with Nursing Address Sandringham Care Home with Nursing Escomb Road Bishop Auckland Co Durham DL14 6HT 01388 660966 01388 660967 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) Ladhar Group Homes Joan Purcell Care Home 90 Category(ies) of Dementia (31), Dementia - over 65 years of age registration, with number (35), Old age, not falling within any other of places category (24) Sandringham Care Home with Nursing DS0000063946.V303236.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home may accommodate named individuals as set out in the letters to the registered person dated 14 June, 29 July & 8 August 2005 which establishes the basis on which the individuals` needs will be met by the home. Where necessary the homes statement of purpose shall reflect any changes in service provision required for this arrangement. This condition may not apply to anyone else, other than the named individuals who fall outside the registered category. 03/07/06 Date of last inspection Brief Description of the Service: Sandringham Care home is a care home with Nursing including Dementia opened in May 2005 and provides accommodation for 90 older persons. The building is purpose built and provides accommodation on three floors. The home is located near to the general hospital and town centre. The home provides safe accessible outdoor areas with seating for service users to enjoy. The current range of fees is from £364.50 to £576.00. Sandringham Care Home with Nursing DS0000063946.V303236.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out over a period of 5 hours on 19th July 2006. The plan for the inspection was to check whether the home had met previous requirements and recommendations; to talk with service users about living in the home; to meet with care staff and the home’s management team; and to look at records. The deputy manager and the area manager assisted during the inspection. What the service does well: What has improved since the last inspection? Since the last inspection the way in which service users medication is managed has improved, and a clear audit trail is now in place to make sure service users get the right medication and that it is recorded properly. The way in which risk assessments are recorded on service users who present with challenging behaviour has been improved, so care staff can look after people safely. Sandringham Care Home with Nursing DS0000063946.V303236.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. Sandringham Care Home with Nursing DS0000063946.V303236.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 Sandringham Care Home with Nursing DS0000063946.V303236.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): 2,3, &6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective service users can be assured that their needs are appropriately assessed prior to admission to the home and that they are given sufficient information to make an informed choice before moving into the home. EVIDENCE: The home’s Statement of Purpose and Service User Guide have been updated. These guides contained all of the information that is required to enable people to make an informed choice about where to live. Evidence was seen in service users files that a contract had been signed by service users or their representatives. The contracts were detailed and included a breakdown of the fees and who was responsible for paying them. Sandringham Care Home with Nursing DS0000063946.V303236.R01.S.doc Version 5.2 Page 9 The deputy manager confirmed that visits to prospective service users always take place before their admission to the home, to carry out an assessment of needs. Four service users files inspected had pre admission assessments and care management assessments so that a decision could be made about whether the home was able to meet the needs of the individual. Intermediate care is not offered at Sandringham Care Home therefore this standard was not assessed. Sandringham Care Home with Nursing DS0000063946.V303236.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9&10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Systems are in place to ensure that health care needs of the service users are met. Service users can be confident that their privacy and dignity is protected and that they are treated with respect. EVIDENCE: The way in which peoples care is recorded has improved, since the last inspection. A service user plan has been developed for each service user that identifies needs associated with health and personal care. This ensures that staff are clear about what is required of them in meeting residents needs. The care plans of four residents were inspected. Careful and thoughtful strategies to address particular needs or problems of some service users were well documented and sensitively written. Risk assessments on the use of bed rails, moving and handling of service users had been reviewed. Since the unannounced inspection risk management plans are in place for staff to follow Sandringham Care Home with Nursing DS0000063946.V303236.R01.S.doc Version 5.2 Page 11 if service users become physically or verbally challenging. The plans need to be kept under constant review by all staff and the manager must monitor this. The plans sampled did not contain any social/recreational care plans and highlighted all the negative aspects of care. It is recommended that care plans be developed further to incorporate how service users social interests and leisure pursuits are met within the home and by the staff team. The way in which service users wound care is documented needs to be reviewed. Some care plans contained pictures of pressure sores to detail improvement, it was unclear as to the size of the sores or if any improvements had been made. This was because measurements had not been recorded at the time of the photograph. In addition there was no evidence to suggest that consent had been gained for these pictures to be taken. There was evidence of involvement of specialist healthcare people such as the community psychiatric nurse, the dietician and continence nurse. Since the last inspection the way in which the medication is managed at the home on behalf of service users has had a total review by the area manager. There now is a clear auditable system for receiving, recording, administering and destroying of medication. All staff who are responsible for administering medication are to have a refresher course on the safe handling of medication. The residents spoken to felt that the staff “are great” and that their particular needs and wishes were addressed in a kind and professional manner. Residents confirmed that their privacy is maintained and respected by staff. One visitor to the home said ‘staff are alright, there isn’t many of them, sometimes it’s a bit thin on the ground’. Another resident said ‘it’s okay here, we all get on. I really like my room, sometimes I just want to sit quiet in there, the staff know what needs to be done and will pop in to see if I am alright.’ Sandringham Care Home with Nursing DS0000063946.V303236.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14&15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users had some activities arranged, but would benefit from an activities organiser for a more structured individual approach. A good selection of meals with choices and alternatives are available for service users at the home. EVIDENCE: Currently the home does not employ an activities co-ordinator. People were observed to be sitting during the inspection with little stimulation or activity. This was of particular concern in both dementia units. One service user was walking into the nearby town. The grounds of the home were pleasant to sit in and some service users were taking advantage of the fine day and sitting in the garden. Service uses are encouraged to maintain links with the community and visitors to the home were allowed to visit at any reasonable time. One service user said that her family and friends were always made to feel welcome at the home. All of the service users spoken to said that the meals were good. One service user said ‘ the foods okay they do their best, we get good sized portions, the choice is good to’. The lunchtime meal was being served during the inspection. It looked nice and service users said they enjoyed it. Staff were able to assist Sandringham Care Home with Nursing DS0000063946.V303236.R01.S.doc Version 5.2 Page 13 service users who needed help. Currently the main meal of the day is served on an evening and a lighter meal is served at lunchtime. Sandringham Care Home with Nursing DS0000063946.V303236.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16&18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users can be confidant that their concerns and complaints are dealt with appropriately and that safeguards are in place to protect them from abuse. EVIDENCE: There are adequate written policies and procedures in place to deal with complaints and the care staff spoken to confirm they were aware of these. Staff knowledge of these help ensure that they were able to address any issues or anxieties of the residents, relatives and visitors to the home. Staff training has taken place in the protection of vulnerable adults in abuse. Staff recruitment procedures were adequate and staff were employed and deployed following appropriate CRB and POVA checks. The staff team were clear and confident in the protection of vulnerable adult procedures. Sandringham Care Home with Nursing DS0000063946.V303236.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 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users can be assured that the home is a clean and comfortable place to live. EVIDENCE: Some service users bedrooms and all the communal areas and bathrooms were inspected. These were all nice and clean and fresh. Infection control procedures are implemented throughout the home. The bedrooms and communal areas were comfortably furnished, and all the dining rooms were bright and airy. The laundry area was cluttered with racks and skips of unlabelled items of clothing, the deputy manager said that it was her intention to write to all service users and families asking them to check through these items to see if Sandringham Care Home with Nursing DS0000063946.V303236.R01.S.doc Version 5.2 Page 16 any of the clothing could be returned to it’s owner. A better system for monitoring the laundry service needs to be in place. Several comments received about the service did raise concerns about items of clothing not being returned from the laundry. Sandringham Care Home with Nursing DS0000063946.V303236.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29&30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The recruitment and training of staff is good which contributes to the ongoing safety of service users. EVIDENCE: The home had staff files in place that provided evidence that the appointment of new staff are made through proper recruitment processes. This includes the vetting of staff through the use of references, POVA first checks and Criminal Record Bureau (CRB) checks. All new staff receive a thorough induction and this was documented in the staff files examined. 39 of the care staff are trained to NVQ level 2 or above in the provision of care. All staff receive fire training, moving and handling training and training in the protection of vulnerable adults. Staff are employed and deployed in sufficient numbers to meet the current service users needs. Currently there is a vacancy for an activities organiser, as staff are trying to provide activities as well as care, this is not an ideal situation and the manager must look at recruiting to the post without delay. Sandringham Care Home with Nursing DS0000063946.V303236.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&38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The records regarding administration of residents’ personal allowances were inspected. All transactions are recorded correctly and receipts are kept. Unfortunately due to the manager and administrator both being away from the home, a full audit of service users personal allowance could not take place, as these are the only two people who have access to the safe. The and The and area manager confirmed that residents and relatives meetings take place that she has attended them when particular issues needed addressing. company are about to send out service questionnaires to gain service user relatives views about the service they are in receipt of. DS0000063946.V303236.R01.S.doc Version 5.2 Page 19 Sandringham Care Home with Nursing There were health and safety checks taking place to ensure a safe environment. Some areas in the home had hot water temperatures that were just over the safe hot water temperature. The area manger requested a plumber to visit the home on the afternoon of the inspection to rectify this. Equipment was being serviced regularly to make it was safe to use, and valid certificates were available for inspection. Sandringham Care Home with Nursing DS0000063946.V303236.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 Sandringham Care Home with Nursing DS0000063946.V303236.R01.S.doc Version 5.2 Page 21 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 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 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 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 1 X X 3 Sandringham Care Home with Nursing DS0000063946.V303236.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 Requirement The manager must ensure that Care plans contain more in depth information with regard to pressure sore assessment and treatment. Remains outstanding from 31/05/06 In order to promote privacy and dignity of service users the manager must demonstrate how consent has been obtained to take photographs of service users pressure sores and wounds. Service users must have access to there own money at all times. Timescale for action 31/08/06 2 OP10 14 31/08/06 3 OP35 12 31/08/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Sandringham Care Home with Nursing DS0000063946.V303236.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Darlington Area Office No. 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk Sandringham Care Home with Nursing DS0000063946.V303236.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. 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!