CARE HOMES FOR OLDER PEOPLE
Sandrock Nursing Home 1-3 Sandrock Road New Brighton Wallasey Wirral CH45 5EG Lead Inspector
Mrs Christine Marshall Announced Inspection 18th March 2006 08:30 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 Sandrock Nursing Home DS0000064921.V284279.R01.S.doc Version 5.1 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. Sandrock Nursing Home DS0000064921.V284279.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Sandrock Nursing Home Address 1-3 Sandrock Road New Brighton Wallasey Wirral CH45 5EG 0151 630 3254 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) Prasur Investments Limited Karen Dorothy Lea Care Home 28 Category(ies) of Old age, not falling within any other category registration, with number (28) of places Sandrock Nursing Home DS0000064921.V284279.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 3rd December 2005 Brief Description of the Service: Sandrock Nursing Home provides general nursing care for up to 28 people, and is situated in a quiet area of New Brighton, a popular seaside town. The home offers single and twin bedded rooms on all three floors, and has assisted bathing and toileting facilities with call alarm in all areas. The home has a large lounge, divided into two main areas, a dining room and a conservatory, which opens out onto a patio area in the back garden. Sandrock benefits from being close to all amenities and is a few minutes walk from local bus stops. The registered providers are Prasur Investments Ltd and the proposed registered manager is Karen Lea. Sandrock Nursing Home DS0000064921.V284279.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This is the second of two inspection visits, scheduled from 1st April 2005 to 31st March 2006. The people living at Sandrock will be referred to as residents. This announced inspection took place over four hours, from early morning to after lunch. A full tour of the home was undertaken, including bedrooms, lounge and dining areas and bathrooms. All areas were clean and hygienic. The policies, procedures and administration records for the management of the home were looked at, and comments on this are to be found in the body of this report. A number of the residents were spoken to, and three visiting relatives. Each resident seemed to be well cared for and those who were able said that they were happy with the care at the home. The visiting relatives readily praised the home and the staff for their care. The owners, nurses and care staff spoke who were spoken to showed that there is a very good team approach to the care given to the residents. The registration certificate still does not reflect the category of one of the residents at the home and this has been passed on to the Commission’s regulation manager to investigate. What the service does well:
The registered provider has a definite plan of refurbishment for the home, so that the environment will be of a higher standard. The home has a very quiet and friendly ambiance. The owners, manager and staff are very friendly and welcoming to visitors and relatives of the residents. Residents appeared to be warm, nicely dressed and contented when approached. Sandrock Nursing Home DS0000064921.V284279.R01.S.doc Version 5.1 Page 6 Relatives spoke very highly about the manager and care staff, saying that the standard of care is excellent There is a portable nurse-call unit in each room so that residents can have them by their side wherever they might be sitting or lying. What has improved since the last inspection?
The registered provider and manager have worked very hard since the last inspection visit and many improvements have been made to raise the standards of care for the residents. Care plans reviews are now signed by the residents or their relatives to make sure that the agreed and right care is being given. A staff handbook has been developed so that nurses and carers can be made aware of the home’s policies and procedures. A copy of the General Social Care Council’s Code of Conduct for Carers has been given to each carer so that they are aware of the guidelines for caring and ensuring quality care for older people. A general staff induction pack/programme has been developed: A programme for staff basic training in health, safety and care practises is underway, so that they are confident and competent in their duties. All of the staff have undertaken abuse awareness training. This makes sure that the people living at the home are protected and supported. Supervision programmes have been developed so that staff are monitored and supported in their work. Recruitment files for employees who have joined the home since the new providers took over in September 2005 now contain records according to Schedule 2 of the care Homes Regulations 2001 (amended 2003). This schedule includes proof of identity (photograph), written references, health declarations confirming that they are fit both mentally and physically and Criminal records Bureau (CRB) checks. The manager is currently checking all of the existing staff files to make sure that they also contain all of the required records. A new staff room has been provided so that nurses and carers can have breaks and smoke in private. A gas safety certificate has been obtained to ensure that the home is safe for the people who live there.
Sandrock Nursing Home DS0000064921.V284279.R01.S.doc Version 5.1 Page 7 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. Sandrock Nursing Home DS0000064921.V284279.R01.S.doc Version 5.1 Page 8 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 Sandrock Nursing Home DS0000064921.V284279.R01.S.doc Version 5.1 Page 9 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): 1&4 Residents who wish to enter the home are given enough information to be able to make an their choice. EVIDENCE: The home’s statement of purpose has been reviewed and amended to include accurate information about the home and its service. Although the service users guide is temporarily adapted to include the new providers name, a new guide is being prepared for the printers. Meantime, information labels are being fixed to the existing guide. Sandrock Nursing Home DS0000064921.V284279.R01.S.doc Version 5.1 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): 8 & 10 People living at the home are treated with dignity and respect: They are supported in their health care and daily lives. EVIDENCE: The residents’ records show that they have full access to health care; visiting professionals to the home can include: The GP of choice, Community Psychiatric Nurse, Tissue Viability Nurse (a specialist in wound care), optician, dentist, hearing services, dietician, speech therapist, continence advisor, diabetic liaison nurse, Social Services care review team, hairdresser and ministers of religion. Those residents who were able said that they had the GP of their choice and visits from the optician and that they were treated with dignity, and that their privacy was respected. Visiting relatives agreed with this. Staff said that they were very aware of keeping the residents’ privacy and dignity and induction programmes included this kind of training.
Sandrock Nursing Home DS0000064921.V284279.R01.S.doc Version 5.1 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): 13, 14 & 15 Lifestyles for the residents are flexible at this home and there is an open door policy for relatives and friends. Meals are nutritious and the residents have a good choice. EVIDENCE: A number of residents and relatives were spoken to and each said that they had full choices of their daily routines. When they went to bed, or got up was their own choice as was when they want their breakfast, lunch or tea. There is an open door policy at the home and relatives are welcomed at any time. Two visiting relatives said that their relatives were unable to speak for themselves but that they were very happy with the home, residents were treated with dignity and respect and that they were always welcomed whenever they visited. There are varied menus for the residents, who all said that they liked the food. There is a full choice of breakfast, a set lunchtime meal, with options if needed, a set teatime meal, again with options and suppers are served from about 8pm to 9pm.
Sandrock Nursing Home DS0000064921.V284279.R01.S.doc Version 5.1 Page 12 Currently the residents eat in their armchairs and the manager is working toward making the conservatory into a no-smoking area so that the tables can be set and the residents can sit there if they choose. The majority of the residents are not able to move and so the manager and staff feel that it is more comfortable for them to eat in their comfy chairs. The records of the meals given to the residents are being reviewed to make sure that each resident has a record of what they have eaten. Sandrock Nursing Home DS0000064921.V284279.R01.S.doc Version 5.1 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 Residents and their relatives are able to voice their complaints and know who to speak to if they have any concerns. Staff training programmes make sure that residents are protected from abuse. EVIDENCE: There is a written complaints procedure in place and a copy of this is displayed in the entrance of the home. There have been no complaints either to the manager of the home or to the Commission for Social Care Inspection. There have been renewed abuse awareness training programmes at the home and the new staff induction programmes include training on abuse awareness; staff confirmed that they are given this training, which ensures that the residents are protected and supported. Sandrock Nursing Home DS0000064921.V284279.R01.S.doc Version 5.1 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): 26 The home offers a comfortable environment in that it is kept clean and hygienic. EVIDENCE: The laundry area is compact, clean and contains laundry equipment that has a sluicing programme for soiled items. The laundry assistant was able to describe the Control of Substances Hazardous to Health (COSHH) guidelines for the safe use of laundry solutions and substances. All areas of the home are kept clean and hygienic. The residents who were able and visiting relatives said that they were happy with the girls who worked in the laundry, and with the standard of cleanliness at the home.
Sandrock Nursing Home DS0000064921.V284279.R01.S.doc Version 5.1 Page 15 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 & 30 There are good levels of staff who are well on their way to having the appropriate training, qualifications and experience necessary to give a good care service to the residents. EVIDENCE: The list of staff on duty showed that there are good levels of nurses, carers and domestic staff on duty at the home. Carers were very friendly and helpful and showed that there is a very good mix of people in place. A sample of staff training and personal files showed that staff training programmes are in place and ongoing. All staff are currently undertaking mandatory training in moving and handling, fire, health and safety and food hygiene; this should be complete by 30th June 2006. Sandrock Nursing Home DS0000064921.V284279.R01.S.doc Version 5.1 Page 16 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, 35 & 38 The home is pursuing quality systems that will make sure that the best interests of the residents are protected; there are regular health and safety checks that focus on the safety of the environment that the residents live in. EVIDENCE: Moves have been made to bring in a recognised quality monitoring system and an assessment for this is being done within the next three months. Currently the manager does quality checks through residents, relatives and staff surveys and monthly accident and incident audits; feedback on these surveys are going to be through a monthly newsletter or pinned on the notice board. Some personal monies are kept for a small number of residents, however the records for these were not available. The registered provider and manger gave strong assurances that these were recorded properly and witnessed for accuracy. The residents concerned were unable to confirm this.
Sandrock Nursing Home DS0000064921.V284279.R01.S.doc Version 5.1 Page 17 Health and safety maintenance certificates were examined and are now all in order. Sandrock Nursing Home DS0000064921.V284279.R01.S.doc Version 5.1 Page 18 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 X X 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 3 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 X X X X X X X 3 STAFFING Standard No Score 27 3 28 X 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 2 X 3 3 X 3 Sandrock Nursing Home DS0000064921.V284279.R01.S.doc Version 5.1 Page 19 Are there any outstanding requirements from the last inspection? No 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 OP30 Regulation 10 Requirement All staff must undertake mandatory training, moving & handling, fire, health & safety and food hygiene. Timescale for action 30/06/06 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. 3. Refer to Standard OP4 OP10 Good Practice Recommendations The service users guide should be re-printed to include the new registered provider details. Hairdressing facilities should be provided rather than using a resident’s bedroom. Safety locks should be fitted to residents’ bedrooms on request and as a matter of routine before any room is reoccupied. 4. OP15 A kitchen assistant should be employed to ease the
DS0000064921.V284279.R01.S.doc Version 5.1 Page 20 Sandrock Nursing Home workload of the cook. Records for the meals that are served to each resident should be reviewed in line with the guidance in Schedule 3 of the Care Homes Regulations. Dining tables should be made available in a non-smoking area for the residents to sit at tables for their meals, if this is their preference. 5. 6. 7. OP19 OP21 OP30 The lounge carpet should be replaced by July 2006. A redundant bathroom should be re-fitted as a shower room to improve the bathing facilities at the home. The manager should be allocated adequate supernumerary hours to fulfil her role and responsibilities. This was identified during the last inspection visit and should be strongly considered. Feedback from quality surveys should be given to those involved, either via a newsletter or pinned on to the home’s notice board. 8. OP33 Sandrock Nursing Home DS0000064921.V284279.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Liverpool Satellite Office 3rd Floor Campbell Square 10 Duke Street Liverpool L1 5AS National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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