Inspection on 10/10/05 for Sandringham House

This inspection was carried out on 10th October 2005.

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 House 25/10/08

Sandringham House 29/10/07

Sandringham House 02/06/06

Sandringham House 15/03/06

Sandringham House 03/02/05

Sandringham House 07/10/04

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

CARE HOMES FOR OLDER PEOPLE Sandringham House 26 Sandringham Road Lower Parkstone Poole Dorset BH14 8TH Lead Inspector Martin Bayne Unannounced Inspection 8:45 10 October 2005 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 House DS0000020491.V250198.R01.S.doc Version 5.0 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 House DS0000020491.V250198.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Sandringham House Address 26 Sandringham Road Lower Parkstone Poole Dorset BH14 8TH 01202 744409 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) Miss E Smith Mrs Doreen MacLennan Care Home 16 Category(ies) of Dementia - over 65 years of age (16) registration, with number of places Sandringham House DS0000020491.V250198.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. To admit two persons, as known to the NCSC, under the category DE (under 65) 3rd February 2005 Date of last inspection Brief Description of the Service: Sandringham House is situated in a residential area of Lower Parkstone, a short walk from the local shops and within easy reach by car or public transport of Parkstone, Poole and Bournemouth. A passenger lift and stairs provide access to the resident’s bedrooms, which are on both floors of the home. A half landing between floors is accessible only by the stairs and a single bedroom and assisted bath are situated on this level. The communal areas of a lounge/dining area and kitchen are located on the ground floor. The home provides adequate toilet and bathroom facilities as well as sluicing area on both floors. The laundry room is sited in the garden to the rear of the home and also serves as a staff room. The home provides some off road parking at the front of the home. Sandringham House DS0000020491.V250198.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place between 8.45am and 1.15pm. The aim being to follow up on the 14 requirements and 2 recommendations of the last inspection, evaluate the home against some of the core standards, and to follow up on concerns about the care of one particular resident raised by Poole Primary Care Trust. It was found that in general, the requirements and recommendations had been complied with and the home was meeting the needs of the residents. Two requirements were made during the inspection and these are detailed in the main text of the report. One requirement from the last inspection remains in force. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Sandringham House DS0000020491.V250198.R01.S.doc Version 5.0 Page 6 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 House DS0000020491.V250198.R01.S.doc Version 5.0 Page 7 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Pre-assessment procedures have been improved since the last inspection but should be carried out by one of the registered nurses to ensure that the home can meet the needs of those admitted. EVIDENCE: During the inspection a sample of two resident’s files were used to track the care provided to residents against the required paperwork. The aim of the assessment as a means to determine whether the home can meet the needs of the person referred was discussed as a requirement was made at the last inspection that one of the trained nurses who work at the home undertake the pre-admission assessment of residents before they are offered a place at the home. It was found that Miss Smith, the registered provider was still doing the pre-admission assessments, however she informed that she now did the assessment with a trained person from the referring hospital and discussed the assessment with the trained nurses at the home before a decision was made to offer a place. However it remains a requirement that one of the trained nurses at the home carry out the pre-admission assessment. Sandringham House DS0000020491.V250198.R01.S.doc Version 5.0 Page 8 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): 789 The care planning system can be improved to ensure that resident’s needs are met and an accurate record of the care is maintained. Medicines are safely administered to residents. EVIDENCE: One of the residents tracked though the inspection had been the subject of concern by the PCT. This person had been admitted to the home from hospital with pressure areas and skin breakdown. The care of this resident was discussed and their records viewed. At the last inspection a requirement was made concerning care planning for skin care. It was found that some improvements had been put in place such as a body map of the skin pressure areas however the records did not provide a good account of the nursing interventions or the plan of care that was needed to be carried out by the staff. At the last inspection a requirement was made that records are maintained of interventions carried out through the community mental health team. The records of one resident whose behaviour became difficult to manage and required assistance from the mental health team were viewed. It was found that the daily records recorded the changes in the residents behaviour, Sandringham House DS0000020491.V250198.R01.S.doc Version 5.0 Page 9 however the care plan remained the same and had not been updated. It is required that the care planning system be reviewed to better inform staff of the actions they should be undertaking with residents and to provide a record of the care received. The medication procedures and practice were discussed. The nurse on duty administers medication. The home has a medication trolley that is kept locked to the wall in the lounge area. The home uses a unit dosage system and the pharmacist delivers medication to the home. The medication cabinet was inspected and it was found that medicines were stored correctly. The medication administration records for all of the residents were seen and these were completed with no gaps within the records. It was agreed that a facsimile machine would be purchased for the home so that should a GP make a verbal change to a prescription a fax can be sent to confirm this. The home is currently negotiating with the pharmacist a system for the disposal of unwanted medication. The home has a system that can audit all medication entering the home thus meeting the requirement of the last inspection. Sandringham House DS0000020491.V250198.R01.S.doc Version 5.0 Page 10 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 15 The staff team support resident’s preferences and expectations. Residents are supported to maintain links with their families. The food provided was of a good standard and appropriate assistance is offered to residents. EVIDENCE: The residents looked well cared for with attention paid to their personal appearance. On the day of the inspection the hairdresser was visiting the home and another resident went out with one of their relatives. Staff were observed to have good relationships with the residents who appeared relaxed with the staff. One of the residents who was able to give feedback said they were comfortable and cared for. The four staff spoken with said that they had sufficient time to spend time individually with the residents. At lunchtime a wholesome meal was served to the residents that was ample in portion. Staff were observed to assist those residents appropriately who required assistance with eating. Sandringham House DS0000020491.V250198.R01.S.doc Version 5.0 Page 11 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 The home’s complaints procedure is well publicised and staff receive training in adult protection. EVIDENCE: As reported at previous inspections the complaints procedure is detailed within Service User Guide and the terms and conditions residence as well as being displayed on the notice board in the hallway. There have been no formal complaints made about the home, but a letter of concern was sent to the home from the PCT. It was noted that staff had recently been given training in adult protection and abuse awareness. Sandringham House DS0000020491.V250198.R01.S.doc Version 5.0 Page 12 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 The home provides a safe and suitable environment to meet the needs of the residents. EVIDENCE: On the day of inspection the home was found to be clean and in reasonable decorative order throughout. The home provides a homely environment that meets fire protection standards. The Environmental Health Officer has also recently inspected the home. A requirement was made at the last inspection that the home be assessed by an occupational therapist and this has now been carried out and a grab rail will be fitted in one of the bathrooms as recommended. A requirement was also made that residents share rooms with their consent. Miss Smith reported that relatives were informed at the preassessment stage where a vacancy was for a shared room and the assessment process takes account of compatibility of residents sharing. Radiators have been covered to protect residents from burns. The front door to the home is kept locked to safe guard residents from wandering from the home and getting lost. The front door is linked to the fire safety panel. Sandringham House DS0000020491.V250198.R01.S.doc Version 5.0 Page 13 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 29 30 Residents are supported by sufficient numbers of staff to meet their needs. By employing staff at the home before satisfactory checks have carried out safety of residents could be compromised. Newly employed staff are now provided with suitable induction and foundation training. EVIDENCE: Pictures and names of the staff team are displayed in the entrance hallway. The home maintains the same staffing levels as reported at previous inspections, which are above those recommended by the Residential Forum. There is a nurse on duty at all times. The staff spoken with said they felt that the staffing levels were sufficient to meet the needs of the residents. Since the time of the last inspection there has been no new care staff employed at the home. The recruitment records for the cleaner who has been employed since the last inspection were viewed and a POVA First check had been carried whilst awaiting the return of their CRB form. It was found however that the member of staff had started work before the POVA First check had been returned. It is required that staff do not start work at the home until the return of the CRB or POVA First check. A requirement was made at the last inspection that staff are receive induction and foundation training that met TOPPS specification, (now Skills for Care). Miss Smith was able to demonstrate compliance having obtained a training package for new staff that meets these standards. Sandringham House DS0000020491.V250198.R01.S.doc Version 5.0 Page 14 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33 38 The home now has a better quality assurance system in place to ensure that the home is run in the interests of the residents. The required tests’ and inspections to the fire safety system are now being carried out. EVIDENCE: At the last inspection a requirement was made that Miss Smith as Registered Person should make visits to the home and prepare a subsequent report on the conduct of the home. Miss Smith reported that she visits the home on at least three occasions a week and has regular meetings with the registered manager, when notes are made. It was agreed that to satisfy Regulation 26, copies of these notes should be kept at the home and also sent to CSCI. A requirement was also made in respect of quality assurance. Miss Smith was able to show that a survey of residents’ and relatives’ views had been carried out since the time of the last inspection. Sandringham House DS0000020491.V250198.R01.S.doc Version 5.0 Page 15 A requirement was made at the last inspection concerning records of monies held on behalf of residents. Miss Smith informed that the home no longer held money for residents. The fire log book was inspected as it was found that there had been no visual inspection of the fire fighting equipment at the last inspection. It was found that all the checks and inspections to the fire safety system had been carried out to the required timescale together with staff training and fire drills. Sandringham House DS0000020491.V250198.R01.S.doc Version 5.0 Page 16 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 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x x x x x x STAFFING Standard No Score 27 3 28 x 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x 3 x x x x 3 Sandringham House DS0000020491.V250198.R01.S.doc Version 5.0 Page 17 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. Standard Regulation Requirement You are required to ensure that a valid CRB or POVA First check has been carried out prior to a person starting work at the home. Service uses must only be admitted to the home based on a full assessment undertaken by people trained to do so. This is a repeated requirement from the inspections on 7-10-04 and 3-2-05. You are required to review the care planning system to ensure that assessed needs of residents are met. Timescale for action 17/11/05 1 OP29 Schedule 2 2 OP3 14 24/10/05 3 OP7 15 28/11/05 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 House DS0000020491.V250198.R01.S.doc Version 5.0 Page 18 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Sandringham House DS0000020491.V250198.R01.S.doc Version 5.0 Page 19 - 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!