Inspection on 30/11/05 for Sandstones

This inspection was carried out on 30th November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Sandstones 02/05/06

Sandstones 25/08/05

Sandstones 26/01/05

Sandstones 07/10/04

Sandstones 08/02/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Sandstones 9 Penkett Road Wallasey Wirral CH45 7QF Lead Inspector Inger Moynihan Unannounced Inspection 30th November 2005 09:00 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 Sandstones DS0000018936.V270244.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. Sandstones DS0000018936.V270244.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Sandstones Address 9 Penkett Road Wallasey Wirral CH45 7QF 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) 0151 691 1449 Anchor Trust Ms Julie Harwood Care Home 35 Category(ies) of Old age, not falling within any other category registration, with number (35) of places Sandstones DS0000018936.V270244.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 26th January 2005 Brief Description of the Service: Sandstones is a purpose built property owned by The Anchor Trust. It was registered to accommodate and provide residential care for 35 older people. The home is close to Liscard town centre and New Brighton. A bus terminal in Liscard gives easy access to other parts of the Wirral and Liverpool. Accommodation is provided in single occupancy flat-lets, this being bed-sitting rooms with a fridge and snack making facility. All of the rooms have an ensuite facility comprising of a hand wash basin and toilet. On the ground floor there is an open plan communal area which comprises of a lounge / dining area. There is a smaller sitting off the lounge were service users may sit if they wish privacy. This area is not however, a separate room. There are two toilet facilities on the ground floor provided for people with mobility needs. There are four bathrooms and a shower facility. The home is furnished and decorated to a high standard throughout. There is a garden at the front of the home but not at the back. There are no parking restrictions within the immediate vicinity of the home. Security lighting has been installed around the building. Sandstones DS0000018936.V270244.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over 5.5 hours and was the statutory unannounced inspection for 2005/2006. A partial tour of the premises took place and staff and service users records were inspected. Five staff and six service users were spoken to during this inspection. What the service does well: Efficient medication administration systems are in place to ensure service users good health. Service users said they are always treated with respect and their right to privacy is upheld. A range of social activities are provided which contribute to creating an interesting environment for the service users to live. The routines in the home are flexible which enables service users to exercise choice and control in their lives. A varied and nutritious diet is provided which ensures service users interest and good health. A complaint procedure is in place to ensure service users views are taken into account with regard to the care they receive. An adult protection procedure is in place to ensure service users safety and welfare. The standard of decoration throughout the home remains very high and provides a comfortable and pleasant environment for the service users to live. The required staffing levels and skill mix are provided to meet service users assessed needs. Staff are provided with a range of appropriate training to ensure they are suitably qualified and competent to care for vulnerable adults. There are clear lines of management and accountability within the home which is run for service users best interest. Effective quality assurance systems are in place to ensure the high standards of care provided at Sandstones are maintained. Sandstones DS0000018936.V270244.R01.S.doc Version 5.0 Page 6 The health, safety and welfare of the service users is well promoted throughout the home. 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. Sandstones DS0000018936.V270244.R01.S.doc Version 5.0 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 Sandstones DS0000018936.V270244.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 A detailed assessment of service users care needs has been carried out. However more detailed information does need to be collated to ensure it accurately reflects service users full care needs. EVIDENCE: An assessment of service users care needs has taken place which ensures the package of care provided meets their individual care requirements. However, not all of the necessary information relating to service users specific care needs and their deteriorating health had been recorded. A discussion took place with the registered manager around this issue and the importance of ensuring all assessments were up to date and an accurate reflection of the service users needs. The purpose of having up to date assessments is to ensure all staff know how to look after the service users and ensure their safety. Without this information important aspects of care may be missed and service users may be left vulnerable to the risk of harm. In the light of this the registered person is required to ensure all staff receive training in this aspect of care provision and Sandstones DS0000018936.V270244.R01.S.doc Version 5.0 Page 9 the assessments are reviewed. It was agreed with the registered manager this work would be completed by 28th February 2006. It was also agreed that one assessment in particular would be updated by the following day. This issue will be taken up with the registered manager following the inspection. The issue of inadequate assessments has been raised at the last three inspections and to date has not been fully addressed. The inspector gave advice and guidance on how to improve this system and the recording of this information. All of the service users spoken to during the inspection confirmed their needs were met in every way. One service user stated the staff are excellent, they are patient and kind and care for me in the way I want. The service users discussed some of their particular care requirements with the inspector and outlined how the staff met these needs. It is the inspectors opinion the service users are receiving a high standard of care which is in line with good practice. However, this must be supported with appropriate documentation to demonstrate how the care is being provided Sandstones DS0000018936.V270244.R01.S.doc Version 5.0 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7 More detailed information needs to be included in the care planning process to ensure service users care needs are fully met. Efficient medication administration systems are in place to ensure service users good health. Service users said they are always treated with respect and their right to privacy is upheld. EVIDENCE: A documented plan of care, by way of a lifestyle agreement, has been compiled for each service user. The lifestyle agreement covers a range of issues relating to service users care needs and offers staff guidance on how to look after the service users in accordance with these identified needs. However, not all the of the necessary information had been collated and in one instance the care plan had not been reviewed to reflect the service users recent challenging behaviours and poor health. A discussion took place with the registered manager around the way in which the care plans are formulated and how improvements could be made. The registered manager agreed to Sandstones DS0000018936.V270244.R01.S.doc Version 5.0 Page 11 ensure all care plans were reviewed and streamlined by 28th February 2006. It was also agreed that the care plan for one particular service user would be updated by the following day. This issue will be followed up after the inspection. The purpose of a care plan is to ensure staff know how to look after the service users in accordance with their particular needs. Without this information important aspects of care may be missed and service users and staff may be left vulnerable to the risk of harm. In the light of this the registered person is required to ensure all staff receive training in this aspect of care provision and the care plans are reviewed as agreed. The service users spoken to during the inspection confirmed they had access to relevant health care professionals when necessary. They confirmed they could speak freely to staff about any concerns they had and that these concerns were acted upon appropriately. All of the service users spoken to during the inspection confirmed the staff treated them with respect and dignity at all times and particularly when carrying out personal care. One service user commented the staff are all angels, they are all lovely. I am very happy with the standard of care I receive. Other service users confirmed the staff were always very discreet when assisting with personal care. Efficient systems are in place for the safekeeping and handling of service users’ medication and only trained staff are allowed to administer medication. All of the service users spoken to during the inspection confirmed they received their medication as prescribed by their GP. When service users are unwell or become vulnerable in anyway, they must rely on the staff to care for them properly. It is clear from the service users comments that staff are providing a good standard of care which is in line with good practice. However, this must be supported with appropriate documentation to demonstrate how the care is being provided. A district nurse visiting Sandstones confirmed that while she had only visited the home three times, she had a very good impression of the staff team and confirmed her patients appeared well cared for. Sandstones DS0000018936.V270244.R01.S.doc Version 5.0 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 and 14, 15 A range of social activities are provided and contribute to creating an interesting environment for the service users to live. The routines within the home are flexible which enables service users to exercise choice and control in their lives. A varied and nutritious diet is provided which ensures service users interest and good health. EVIDENCE: A basic programme of activities is in place each week which service users are free to participate in if they wish. Some service users stated they did not wish to become involved in these activities and were happy the staff respected their decision. One service user commented I am aware the social activities take place and I know I can join in if wish. However, I am happy with my own routines and like to keep myself to myself. A number of service users confirmed they had their own routines with regard to social activities and were free to go about their day as they wished. This is a positive aspect of the home and ensures service users can exercise choice and independence. Sandstones DS0000018936.V270244.R01.S.doc Version 5.0 Page 13 The registered manager stated plans were being made to recruit an activity organiser for the home which will enhance this aspect of care provision. Arrangements are being made to provide a range of activities over the Christmas period such as an outside entertainment, carol singers and a party which would include the relatives and friends are both staff and service users. The deputy manager explained how staff liked to make a sense of occasion of the christmas activities including dressing the christmas tree and decorating the home. During discussion the service users confirmed their friends and relatives could visit the home at any time. Mealtimes are flexible and service users dietary requirements are met. A varied and balanced diet is provided to ensure service users interest and good health. The cook confirmed that service users medical needs are catered for in the menu planning. All of the service users spoken to commented on a high standard of food provided and said they always had enough to eat and drink. One service user commented the food is lovely and I am always given an alternative if I do not like what is offered that day. Another service user commented the food is very good, a cooked breakfast is offered every day. The service users spoken to confirmed they could have breakfast in bed if they wished. Sandstones DS0000018936.V270244.R01.S.doc Version 5.0 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 A complaint procedure is in place to ensure service users views are taken into account with regard to the care they receive. An adult protection procedure is in place to ensure service users safety and welfare. EVIDENCE: The home’s complaint procedure is displayed. Service users spoken to were aware of who they should contact in the event of them wishing to make a complaint about the care provided. A notice board in the hallway also displayed information on the different agencies service users could contact in the event of them wishing to express concerns about the standard of care they receive. The home should be commended on the approach they take with regard to the issue of protection. All of the service users spoken to during the inspection said they were very happy with the standard of care they received and had no complaints to make. One service users stated the staff are very good and very polite, I have never been spoken to badly by anyone. In the past staff have been provided with training in relation to the protection of service users from abuse by way of work books provided by the Anchor Trust. More recently the registered manager has purchased a video on this aspect of care which all staff will be required to watch. A copy of the most recent adult protection procedure was given to the registered manager to support any future training. Sandstones DS0000018936.V270244.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 The standard of decoration throughout the home remains very high and provides a comfortable and pleasant environment for the service users to live. EVIDENCE: The standard of the décor throughout the home remains very high and a planned programme of maintenance is in place. The home has an open plan lounge and dining room. The design of this area, even though it is open plan continues to have clearly defined areas. The outdoor space is easily accessible by wheelchair users. On the day the inspection new carpets were being fitted in all corridors. There are sufficient bathing facilities for the number of service users living at the home. All bedrooms have en-suite facilities which comprise of a wash hand basin and toilet. Each of the bedrooms is supplied with a small refrigerator and drink making facilities. All of the bedrooms inspected were clean and comfortably furnished and service users had personalised their rooms with their own belongings. Sandstones DS0000018936.V270244.R01.S.doc Version 5.0 Page 16 Equipment and facilities are provided to assist service users with their mobility and to ensure their safety within the home. On the day of the inspection the home was clean, tidy and comfortably warm. The domestic staff are clearly working very hard to ensure a comfortable environment is provided for the service users to live. Policies and procedures for the prevention of cross infection are available for staff reference. Sandstones DS0000018936.V270244.R01.S.doc Version 5.0 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 and 30 The required staffing levels and skill mix are provided to meet service users assessed needs. Staff are provided with a range of appropriate training to ensure they are suitably qualified and competent to care for vulnerable adults. EVIDENCE: The staff rota indicated staff are evenly deployed across the week and that the required staffing levels, as agreed by the Registering Authority are provided. The staff spoken to during inspection stated there were sufficient staff employed in the home to enable them to carry out their work properly. However a number of service users did comment they felt the staff were always in a hurry and had little time to stop and chat. In the light of this, the registered person is required to review the staffing levels and ensure they meet service users individual care needs. The staff spoken to confirmed they had completed a range of training relating to the care of older people and stated the organisation always encouraged them to become involved in any training relevant to the care of older people. This is a positive aspect of the home and ensures the service users are being cared for in accordance with their particular needs and in line with current good practice. Sandstones DS0000018936.V270244.R01.S.doc Version 5.0 Page 18 The Anchor Trust is committed to ensuring equal opportunities are promoted throughout the home and their policy is clearly displayed. Staff spoken to during inspection confirmed they had already undertaken training around the issue of diversity, although they did acknowledge this needed to be updated. To ensure service users are receiving the care they require in relation to their religion, sexuality and cultural background, the registered person is required to ensure training in this area is provided to all staff. The staff have a positive attitude towards their work with one member of staff stating I love my work and feel the staff all work well as a team. The deputy manager stated I think we have a very good staff team who are hardworking, flexible and reliable. This is a very positive aspect of the home and contributes to maintaining a positive working environment where high standards of care are set and maintained. Sandstones DS0000018936.V270244.R01.S.doc Version 5.0 Page 19 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 and 38 There are clear lines of management and accountability within the home which is run for service users best interest. Effective quality assurance systems are in place to ensure the high standards of care provided at Sandstones are maintained. The health, safety and welfare of the service users is well promoted throughout the home. EVIDENCE: The registered manager demonstrated she was aware of her responsibilities with regard to the management of the home, supervision of staff and the care of service users. Through discussion she demonstrated her commitment to supporting the staff within their role and demonstrated an open and positive style of management. Discussion with service users confirmed that Sandstones DS0000018936.V270244.R01.S.doc Version 5.0 Page 20 Sandstones is run and managed for service users best interest. The service users spoke highly of the registered manager and stated she was always available for support and help when necessary. Staff spoken to confirmed the registered manager and senior staff were always available for advice and support when necessary. Effective quality assurance systems are in place to ensure high standards of care are set and maintained. Safe working practices are promoted throughout the home. Staff confirmed they had completed appropriate training in this aspect of care and are provided with sufficient materials to carry out their work and ensure service user safety. Regular fire safety checks are carried out on all equipment and staff have been provided with regular fire safety training. The temperature of the water was tested in several places around the building and was within the recommended safe limits. The home is subject to its own health and safety inspection from within the organisation and all accidents are monitored. The inspector noticed that oxygen was being used in one bedroom although a sign was not displayed on the bedroom door. The registered person is required to address this issue to ensure the safety of all in the home. To further promote service users health and safety, the registered person is advised to keep up to date with the information provided on the Health and Safety Executive and Medical Devices Agency websites. Sandstones DS0000018936.V270244.R01.S.doc Version 5.0 Page 21 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 2 8 x 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 x COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x x x x x 3 STAFFING Standard No Score 27 2 28 x 29 x 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x x x x 3 Sandstones DS0000018936.V270244.R01.S.doc Version 5.0 Page 22 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 3 Regulation OP14 Requirement The registered person is required to ensure a detailed and up to date assessment of service users care needs is in place. The registered person is required to ensure all staff receive training on the care planning process. The registered person is required to ensure more detailed information is recorded in service users care plans and that this information is reviewed more often. The registered person is required to ensure all staff are provided with training on issues of diversity. The registered person is required to ensure sufficient staff are employed in the home to meet service users full care needs. The registered person is required to ensure a sign is displayed on the service users bedroom door where oxygen was stored. Timescale for action 30/11/05 1 7 OP18 28/02/06 2. 7 OP15 28/02/06 3 30 OP18 31/03/06 3. 27 OP18 31/01/06 4. 38 OP13 30/11/05 Sandstones DS0000018936.V270244.R01.S.doc Version 5.0 Page 23 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 OP38 Good Practice Recommendations It is recommended that for service users safety, the registered person is advised to keep up to date with the information provided on the Health and Safety Executive and Medical Devices Agency websites. Sandstones DS0000018936.V270244.R01.S.doc Version 5.0 Page 24 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 © 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 Sandstones DS0000018936.V270244.R01.S.doc Version 5.0 Page 25 - 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!