Inspection on 08/08/07 for Sandringham Care Home with Nursing

This inspection was carried out on 8th August 2007.

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

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

Sandringham Care Home with... 19/07/06

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

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

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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 Escomb Road Bishop Auckland Co Durham DL14 6HT Lead Inspector Bridgit Stockton Unannounced Inspection 09:30 8 August 2007 th 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.V340021.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.V340021.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Sandringham Care Home with Nursing Address Escomb Road Bishop Auckland Co Durham DL14 6HT 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) 01388 660966 01388 660967 pkilburn@ladhar.co.uk Ladhar Group Homes Mr Paul Anthony Kilburn 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.V340021.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. Named Individual: The home may accommodate a named individual as set out in a letter to the registered person dated 7 August 2006 which establishes the basis on which the individual’s needs will be met by the home. Where necessary the home’s 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 individual, who falls outside the registered category. 19th July 2006 2. 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.V340021.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 7 hours on 8th August 2007. The home did not know the inspection was going to take place. The plan for the inspection was to talk with people about living in the home; to meet with care staff and the home’s management team; to look at records and follow up on the requirements and recommendations made at the last inspection. A questionnaire had been returned to the Commission from the homes manager, along with surveys from people who live at the home. Some of this information has been included within this report. Currently the homes management team are working closely with social services and the primary health care trust to resolve concerns that have been raised about the home. An action plan has been implemented and several meetings have taken place to monitor progress. What the service does well: What has improved since the last inspection? There have been a lot of improvements made at the home, making it better for people who live there. The way in which people’s care is recorded in care plans has also improved. The care plans are now clear and give staff good information and instruction on how to care for people. Staff have received training in moving and handling, first aid and medication administration. There is now in place a planned programme of training for all staff and this includes training for the nurses who work at the home to keep updated on the additional skills and knowledge they require to do their job properly. Three unit managers have been appointed to strengthen the management team. Sandringham Care Home with Nursing DS0000063946.V340021.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. Sandringham Care Home with Nursing DS0000063946.V340021.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.V340021.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): 1,2,3&6 Quality in this outcome area is good. People 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. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Visits to new clients always take place before their admission to the home, to carry out an assessment of their needs. Four care plans examined contained notes from assessments made on these visits. Also, each care plan contained assessments from the placing authority that were responsible for commissioning people’s care at the home. The statement of terms and conditions/contract issued to all residents was looked at. The manager has started to write to people explaining how the fees Sandringham Care Home with Nursing DS0000063946.V340021.R01.S.doc Version 5.2 Page 9 for the home are paid and what each person’s contribution is. All the terms and conditions seen had been signed and agreed by the resident or their representative. The home does not provide intermediate care. Sandringham Care Home with Nursing DS0000063946.V340021.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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is good. Systems are in place to ensure that health care needs of the people are met. People can be confident that their privacy and dignity is protected and that they are treated with respect. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The recording in people’s care plans has improved. A new care planning system has been introduced and all staff have worked very hard on writing the plans. Each persons needs are recorded and clear instructions are set out for staff to follow. The plans need to be kept under constant review by all staff and this must be monitored by the manager. Some risk assessments were in place, however these need to be developed further. One person was prone to not taking tablets, and although this was Sandringham Care Home with Nursing DS0000063946.V340021.R01.S.doc Version 5.2 Page 11 documented in the daily evaluation of the care plan there was no risk assessment or strategy in place to deal with this. Care plans indicated that people had access to other health care professionals such as the community psychiatric nurse, opticians and chiropodists. Some documentation errors were found in the medication records. However all medication could be accounted for and on the whole people’s medication was managed safely. One person commented on the support they had received from the staff, in improving their mobility. A relative spoken to said ‘People get very good care here, they are treated with dignity and love, all the staff are brilliant’. Staff were seen to be treating people with respect and dignity and this was also reflected within the care plans. One person said that the ‘girls are kind’ A relative commented ‘ I feel this is a very well run home in which my mother is well cared for, we are confident that she gets the very best care. She is very poorly the staff are always popping in and out to make sure everything is okay. I know she is safe and cared for’. Sandringham Care Home with Nursing DS0000063946.V340021.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14, &15 Quality in this outcome area is good. The recreational and social needs of service users are well catered for which enables service users to make daily choices and promotes independence. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home employs two part time activities coordinator, who work over the three units, affording all of the people who live at the home an opportunity to participate in some social or leisure activity. Outside entertainers are used and one person said they really enjoyed the sing-a-long. A monthly news letter is produced at the home and displayed on the notice boards, the mobile library now visits the home to allow people to choose their own books and shopping trips have been organised for small groups of people supported by care staff. Everyone said the food was good. The cook was very knowledgeable about peoples diet requirements. He takes the opportunity to speak to all the people in the home to make sure they are happy with the menus and knew what people liked. The main meal is served at teatime, people said they liked it this Sandringham Care Home with Nursing DS0000063946.V340021.R01.S.doc Version 5.2 Page 13 way. Snacks and drinks are available over 24hrs. Fresh fruit and home baked cakes and biscuits are also served with the morning and afternoon drinks, Milk shakes and fruit smoothies are also available at these times. Sandringham Care Home with Nursing DS0000063946.V340021.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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There are adequate written policies and procedures in place to deal with complaints and the care staff spoken to confirmed they were aware of these. A visitor to the home said that if they had a concern they would be confident to speak to any member of staff. Service users said they would complain to the manager if they were at all unhappy. Written records of complaints and the outcomes are kept at the home. One relative said they had raised a concern with the manager and it had been dealt with immediately. Currently the homes management team are working closely with Social Services, the Commission for Social Care and Inspection and the Primary Health Care Trust to resolve some concerns that have been raised about care practices within the home. An action plan has been implemented and several meetings have taken place to monitor progress. 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. Sandringham Care Home with Nursing DS0000063946.V340021.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): Quality in this outcome area is Adequate. The home was clean, comfortable and well-maintained providing people with a pleasant environment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Individual bedrooms and communal areas were suitably furnished and decorated in a style liked by people living there. The home was nice and clean and fresh. One person commented ‘my room is cleaned daily, the beds get changed and the windows washed, I’m glad I’m not doing it’. Several areas have been redecorated and refurbishment of bathrooms is about to start. Sandringham Care Home with Nursing DS0000063946.V340021.R01.S.doc Version 5.2 Page 16 Staff training in fire safety awareness was out of date, and staff need to have training in this area without delay, in accordance with the local fire and rescue guidance. Sandringham Care Home with Nursing DS0000063946.V340021.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): Quality in this outcome area is good. The recruitment and training of staff is good which contributes to the ongoing safety of people. This judgement has been made using available evidence including a visit to this service. EVIDENCE: From the duty rota examined during the inspection staff are on duty in sufficient numbers to meet the current dependency of people who live at the home. Three unit managers’ posts have just created and appointed to, which will strengthen the management team at the home. There is a commitment at the home to having a trained workforce with 31 care staff having completed NVQ level two or three training in care. All new staff receive a thorough induction and this was documented in the staff files examined. Training for all staff has taken place in catheter care, infection control, moving and handling and wound care. The home had staff files in place that provided evidence that the appointment of a new staff is 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. Sandringham Care Home with Nursing DS0000063946.V340021.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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38 Quality in this outcome area is good. People can be confident that the home is well managed. Systems and safeguards are now in place to ensure the health, safety and welfare of service users and staff is protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Mr Kilburn is experienced in managing a care service. There was an open, friendly culture between the management team and the staff at the home. Staff said they felt supported in their work by the manager. People said that the manager was very approachable and they would go to him or any of the Sandringham Care Home with Nursing DS0000063946.V340021.R01.S.doc Version 5.2 Page 19 staff if they had any concerns. One relative said ‘ I like Paul I would go to him if I had any complaints. Things have defiantly improved around here since he came.’ The process regarding administration of residents’ personal allowances was discussed. All transactions are recorded and receipts are kept. The Regional Manager audits these accounts and verified they were correct. The homes health and safety file was examined; all equipment in the home is regularly checked with valid certificates issued. There are no outstanding issues from environmental health inspections or the fire and rescue services. Sandringham Care Home with Nursing DS0000063946.V340021.R01.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 X X N/a HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 1 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 3 X X 3 Sandringham Care Home with Nursing DS0000063946.V340021.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? 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 OP19 Regulation 12 Requirement In order to keep people safe all staff must be trained in fire procedures, at regular intervals as determined by the fire and rescue services Timescale for action 01/10/07 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 2 Refer to Standard OP7 OP31 Good Practice Recommendations It is recommended that risk assessments are kept under review to ensure that people are kept safe It is recommended that the manager reviews peoples care plans regularly to ensure that the peoples care is properly recorded and instruction to staff is clear. Sandringham Care Home with Nursing DS0000063946.V340021.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Darlington Area Office No. 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS 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. Extracts may not be used or reproduced without the express permission of CSCI Sandringham Care Home with Nursing DS0000063946.V340021.R01.S.doc Version 5.2 Page 23 - 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. 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