Inspection on 02/06/06 for Sandringham House

This inspection was carried out on 2nd June 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 House 25/10/08

Sandringham House 29/10/07

Sandringham House 15/03/06

Sandringham House 10/10/05

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 08:45 2nd June 2006 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 DS0000020491.V298626.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. DS0000020491.V298626.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Sandringham House Address 26 Sandringham Road Lower Parkstone Poole Dorset BH14 8TH 01202 744409 01202 744409 bookstand@lineone.net 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 DS0000020491.V298626.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. To admit two persons, as known to the NCSC, under the category DE (under 65) 15th March 2006 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. DS0000020491.V298626.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key unannounced inspection and was carried out between 8.45am to 3.30pm. The aim was to assess the home against the core standards and to follow-up on the requirements and recommendations from the last inspection. The inspector was assisted by the nurse on duty at the home and later in the day by Miss Smith, the Registered Provider. The home accommodates people with dementia and so it was not possible for them to give much of an account of life at the home. Four residents were spoken with, relatives of three residents who were visiting that day and three members of staff. Records were seen to evidence outcomes for the residents of the home. 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. DS0000020491.V298626.R01.S.doc Version 5.2 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 DS0000020491.V298626.R01.S.doc Version 5.2 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&6 The Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. A procedure has been agreed for the pre-admission assessment of residents referred to the home to ensure that the home meets the needs of residents admitted to the home. EVIDENCE: At the last three inspections a requirement has been made in respect of the pre-admission assessment of residents. Miss Smith historically has always carried out this assessment process and a requirement was made initially after the home admitted a person from hospital who had pressure sores. An adult protection meeting had been convened in respect of this person and it was decided that the trained nurse should carry out the assessment. The requirement was discussed at this inspection and Miss Smith outlined the changes to the admission procedure that should ensure that the home only admit people who’s needs the home can meet. It was agreed at this inspection that Miss Smith would visit the person referred and include either the manager of the home or the nurse from where the person is being referred in the assessment process. Miss Smith will then discuss the referral with the manager of Sandringham House, who will take up any matters of concern with DS0000020491.V298626.R01.S.doc Version 5.2 Page 8 either the care manager or with the unit from where the person is being referred. This procedure should ensure that the home only admits resident who’s needs the home can meet. Since the time of the last inspection there has been one new resident admitted to the home. Their care records were seen and it was found that a detailed assessment had been carried out, covering all of the topics set out in the Older Person’s standards. Once a decision has been made to admit a person to the home a letter is sent to them or their relatives offering a trail placement. The home does not provide an intermediate care service and therefore Standard 6 does not apply. DS0000020491.V298626.R01.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 The Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans are developed through the assessment process to enable staff to meet needs of residents that also take account of risk assessments that are carried out. A monthly reviewing of the care plans will ensure that these are kept up to date. Health needs of residents are met at the home. The home has policies and procedures for the safe administration of medicines within the home. Privacy and dignity of residents was being upheld in the home. EVIDENCE: At the last inspection requirements were made with respect to the care planning and risk assessment systems within the home. At this inspection a sample of three residents’ files was used to track the required paperwork that the home must maintain on resident’s care. It was found that for all three a care plan had been developed from the care management assessment. The care records each contained a photograph of the resident concerned, key DS0000020491.V298626.R01.S.doc Version 5.2 Page 10 information and contacts and a care plan. These were found to contain sufficient information that would allow a new member of staff to provide care to that particular person. The care plans linked to a system for minimising risk, with particular regards to moving and handling of residents and use of cot sides, where these have had to be used. It was also found that specific care plans and monitoring forms had been put in place in cases where residents required monitoring of skincare or nutritional. An instance was seen where the care plan had been up dated where the needs of one person had changed, however there was a system for monitoring of care plans six monthly where standards require a monthly monitoring system. A requirement was made that care plans are monitored monthly to ensure that they provide up to date information for carers. Due to the mental frailty of the residents, they do not sign their care plans. The residents appeared well cared for with their hair tended to, being clean and dressed in clean clothes. Residents were observed to be at ease with the staff and the staff spoken with were aware of the care needs of each resident. With regards to health needs, there was evidence in the care plans and daily recording that doctors visits are arranged when required. A chiropodist regularly visits the home as well as the optician. The relatives of residents spoken to said that they were very pleased with the care provided at the home and all remarked that their relatives condition had improved since being at the home. A discussion took place with the staff on how they met the outcomes of privacy and dignity of the residents. Residents in shared rooms are provided with screens, residents are changed in their rooms and talked to when personal care is given explaining what is being done, residents are provided with different clothes each day. The medication cabinet was seen and medicines were found to be stored correctly. The home has a separate cabinet for storing controlled drugs with a controlled drugs register. The medication administration records for all of the residents were seen and it was found that these were being completed correctly with no gaps within the records. There is always one nurse on duty at the home and they are responsible for the administration of medicines. The nurse on duty also holds the key to the cabinet and is responsible for all medications when on duty. Within the office there is a small fridge for the storing of medicines that require refrigeration. The fridge as a maximum/minimum thermometer and records are maintained on fridge temperatures. The home has a contract for the destruction of unwanted medication and again appropriate records are maintained. DS0000020491.V298626.R01.S.doc Version 5.2 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 The Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The staff support residents to exercise choice within their capabilities and balanced against the staff’s duty of care. Residents are supported to maintain contact with their families and friends with visiting welcome at the home. Residents are provided with a varied and balanced diet and assisted where necessary. EVIDENCE: With the aim of understanding and meeting the needs of residents, where possible a life history is obtained through relatives about each resident. Residents are got up in the morning but are able to go back to their rooms should they choose. Breakfast is provided between 8am – 9am, lunch at about noon and a light meal in the evening. When a person is admitted to the home they are assessed as to whether they need assistance with eating or to have their food cut up or pureed. One relative spoken with, who often visits during the lunchtime period commented that the food was of a good standard. On the day of inspection fish, chips and peas was the main choice of meal. Staff DS0000020491.V298626.R01.S.doc Version 5.2 Page 12 reported that they get to know likes and dislikes of residents and will provide an alternative should they know the residents did not like something. On the day of inspection an Extend session was taking place in the home. Music is played in the home that suits the taste of the residents. Individual time is spent with residents and it was agreed that more information would be recorded in the daily recording to provide evidence that residents were receiving some stimulation within the home. During the summer time the garden is available to residents. The relatives spoken with said that they could visit when they wished and that they were made welcome at the home. DS0000020491.V298626.R01.S.doc Version 5.2 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 The Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home publicises the complaints procedure and relevant policies and procedures for adult protection are held within the home. Staff are trained in adult protection. EVIDENCE: The home as a complaints procedure that complies with the guidance set out in the Standards for Older People. Due to the mental frailty of the residents, they are not able to understand or retain the complaints procedure and so rely heavily on their relatives or representatives to complain on their behalf. The complaints procedure is displayed in the hallway, within the Statement of Purpose and Service User Guide and within the Terms and Conditions of Residence. Relatives are sent a copy of the Statement of Purpose and in many cases they sign the terms and conditions of residence, so are made aware of how to make complaints. Since the time of the last inspection there have been no complaints made about the home. The home has copies of the relevant procedures on adult protection and all of the staff have received training in this field. DS0000020491.V298626.R01.S.doc Version 5.2 Page 14 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 The Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Work has been undertaken to address the requirements made at the last inspection and improvements have been made to aspects of the physical environment. Policies and procedures are in place for infection control. Work to the laundry area that is to be completed will provide an area that is more easily cleaned. EVIDENCE: At the last inspection five requirements and four recommendations were made concerning the building. An immediate requirement was made regarding the fitting of domestic lighting and the removal of fluorescent lighting. This was found to have been addressed, so too the requirements about temperature regulation of the hot water outlets, the home being clean and hygienic and waste bins being emptied. With regards to the recommendations centring on the laundry area, Miss Smith informed that there was a plan of action to have DS0000020491.V298626.R01.S.doc Version 5.2 Page 15 the walls painted and a vinyl floor laid so that the surfaces washable. This requirement will remain in place until such time as this work is carried out. Since the last inspection many of the wash hand basins in residents’ room have had new vanity units fitted below basin with the plan they will be fitted under all basins in bedrooms. With regards to the exterior of the home, Miss Smith informed that some replacement windows had been ordered as some of the original wooden frames were starting to rot. New patio doors have been ordered and consideration of an awning being purchased for the patio doors was discussed. This would provide a shaded area for the garden and also help keep the lounge cooler in the summer months. A grab rail has been fitted in one of the bathrooms has been fitted, meeting a recommendation from the last inspection. The lounge has been re-decorated since the last inspection and much of the ‘clutter’ mentioned at the last inspection has been removed. New tables have also been purchased since the last inspection. Within the home all of the radiators have had covers fitted in order to protect residents’ from burns and as mentioned earlier the thermostatic mixer valves serviced so that hot water outlets to bathes does not go above 43 degrees. In general the home was found to be clean and there were no adverse odours. Staff are provided with gloves and aprons in interests of infection control and there are relevant policies and procedures in place. DS0000020491.V298626.R01.S.doc Version 5.2 Page 16 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 The Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Suitable staffing levels and training ensure that residents are in safe hands. The home has a record of carrying out good recruitment procedures. EVIDENCE: The home continues to provide the same level of staffing as at the time of the last inspection, with one trained nurse on duty at all times. During the daytime there are also two care assistants on duty, a cook and a cleaner. During the night time period there is one nurse and one care assistant on night duty. A staff duty roster was seen and this reflected the above staffing. Records are also maintained of who has worked each shift. Two of the staff were spoken with who said that staff meetings were held regularly and that they could voice their opinions. The home has a longstanding team of staff and there have been no new staff employed since the last inspection. The staff records were therefore not viewed as they were found at the last inspection to contain all required documentation. Both Miss Smith and the staff spoken with thought that the staffing levels at the home met the needs of the residents. Staff at the home receive training in core subjects such as moving and handling, first aid, fire, abuse and adult protection and infection control. DS0000020491.V298626.R01.S.doc Version 5.2 Page 17 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 The Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is effectively managed with health and safety of staff and residents promoted. EVIDENCE: Mrs MacLennon is the registered manager of the home since March 2003 and has undertaken NVQ level 4 training in management. She is also a trained nurse. Miss Smith, the registered provider also maintains a high presence in the home. At the last inspection a requirement was made that in respect of quality assurance. Miss Smith informed that she had investigated formal recognised quality assurance systems and will introduce one system. The requirement will remain in place until this has been introduced. DS0000020491.V298626.R01.S.doc Version 5.2 Page 18 The fire logbook was inspected and it was found that tests and inspections of the fire safety system were taking place to the required timescale. All of the staff have received training in fire safety. A requirement was made that the portable electrical equipment wiring be tested. The home had a certificate for employers liability insurance. DS0000020491.V298626.R01.S.doc Version 5.2 Page 19 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 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 2 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 2 X 3 X X 2 DS0000020491.V298626.R01.S.doc Version 5.2 Page 20 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 It is required that the care plans are reviewed monthly to ensure that needs of residents are met. The Registered Provider must introduce a thorough quality assurance system. The requirement is repeated from the inspection of15/03/06 The portable electrical equipment must be tested. Timescale for action 01/07/06 2. OP33 24(1)(a) 01/08/06 3. OP38 12 (1) (a) 01/08/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP26 Good Practice Recommendations The laundry floor and walls should be readily washable to prevent the spread of infection DS0000020491.V298626.R01.S.doc Version 5.2 Page 21 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 DS0000020491.V298626.R01.S.doc Version 5.2 Page 22 - 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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