CARE HOME ADULTS 18-65
Sandy Lodge Southchurch Avenue Shoeburyness Essex SS3 9BA Lead Inspector
Nicola Dowling Unannounced Inspection 14th February 2006 10:00 Sandy Lodge DS0000015559.V282733.R01.S.doc Version 5.1 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 Sandy Lodge DS0000015559.V282733.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 Adults 18-65. 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. Sandy Lodge DS0000015559.V282733.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Sandy Lodge Address Southchurch Avenue Shoeburyness Essex SS3 9BA 01702 298064 01702 298064 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) Estuary Housing Association Limited Care Home 9 Category(ies) of Learning disability (9) registration, with number of places Sandy Lodge DS0000015559.V282733.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Excluding any person who is liable to be detained under the provisions of the Mental Health Act 1983 6th September 2005 Date of last inspection Brief Description of the Service: Residential care with nursing is currently provided at this purpose built home. The house is situated within a residential area. There are seven single rooms and one double room. There is no passenger lift and bedrooms are situated on both floors. There is a living room, fitted kitchen and dining room. Assisted toilets and bathrooms are available as are a full range of moving and handling equipment. The home has a small garden. The home is situated in a residential area of Shoeburyness. Shops are located nearby and a bus route runs regularly Sandy Lodge DS0000015559.V282733.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection took place over one day. The inspection consisted of a tour of the home, reading documents, talking with staff and observing residents and the care that they received. There were two residents at home on the day of inspection, these residents had communication difficulties therefore the care that they received from staff was observed. There were no relatives visiting the home during this inspection therefore their views have not contributed to this report. Currently Estuary Housing Association have submitted an application to change the registration of Sandy Lodge from Care Home with Nursing to Care Home with Personal Care. The outcome of this application is soon to be concluded. A thank you is extended to the staff and service users who took part in the inspection and for their help and hospitality. What the service does well: What has improved since the last inspection?
All the home’s safety certificates are up to date creating a safe environment for the residents to live in. There is better consistency with agency staff, this means that the same agency staff are used in the home to fill gaps in the staff rota. The staff recruitment records were complete demonstrating that the home is checking that the staff they are employing are suitable to work with vulnerable people. The hygiene in the home has improved with handwash available in the toilets. The odour that was in one resident’s bedroom has now gone. Sandy Lodge DS0000015559.V282733.R01.S.doc Version 5.1 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Sandy Lodge DS0000015559.V282733.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Sandy Lodge DS0000015559.V282733.R01.S.doc Version 5.1 Page 8 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: Standards 2, 3, 4, were met at the last inspection and not inspected at this inspection. The home is currently full and there have not been any new admissions since the last inspection Sandy Lodge DS0000015559.V282733.R01.S.doc Version 5.1 Page 9 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6 and 7 Where possible residents are supported to make their own decisions and their individual care plans are informative. EVIDENCE: Two care plans were checked. They were up to date and there was evidence that the resident had received a review of their care. The care plans were detailed and now include trigger factors for those residents that suffer from epilepsy. Staff support residents with decision making. The home use advocacy services. Meetings with other care professionals and family members are held when bigger decisions are required. Sandy Lodge DS0000015559.V282733.R01.S.doc Version 5.1 Page 10 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 13 and 16 Staff care for residents in a respectful way and help residents take part in local community facilities. EVIDENCE: The staff take residents out to use the local facilities. For example residents use the local library and pub. Outings to the seafront and the local theatre are also organised. Staff know the residents daily routines and habits and allow for these during the day. For example residents that like to be on their own are given this time. One resident likes to watch their own DVD in their room and staff help them to do that. Any personal mail is always given straight to the resident and staff will open it with them if needed. Staff used their preferred names and were observed to talk with the residents through the day. Sandy Lodge DS0000015559.V282733.R01.S.doc Version 5.1 Page 11 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, and 20 The residents receive good healthcare and support from the home. One element of the medication policy does not reflect the practice at the home. EVIDENCE: There is good recording of health care in the residents care file. Keyworkers were able to explain the daily routines of the residents and what equipment they needed to assist them. Staff were able to explain how to use the moving and handling equipment and confirmed that they had regular update training in this area. Personal hygiene is attended to in the resident’s bedroom. For intimate care two staff assist the resident, one of which is always a female. The administration of medication was carried out properly and care staff have received training in the giving of medication and oxygen therapy. The home also has a contract with a waste disposal company to return their old or disused medication. The disposal of medication records was checked. These records did not record why the medication was being disposed of as detailed in the home’s medication policy. Sandy Lodge DS0000015559.V282733.R01.S.doc Version 5.1 Page 12 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: Standards 22 and 23 were met at the last inspection and not inspected at this inspection. There have not been any recorded complaints about the service since the last inspection. There have not been any recorded incidents of abuse at the home. Sandy Lodge DS0000015559.V282733.R01.S.doc Version 5.1 Page 13 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 The residents have a warm and comfortable environment to live in EVIDENCE: The premises are safe, comfortable, bright, clean and cheerful and free from offensive odours. The odour that was present in one resident’s bedroom at the last inspection has been dispelled. The room was fresh and clean. The toilets and bathrooms had handwash available and the bathing equipment had been washed down and was clean for use. Sandy Lodge DS0000015559.V282733.R01.S.doc Version 5.1 Page 14 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34 and 35 The staff team have the competencies and skills to care for the residents. EVIDENCE: There is an improving staff picture. New staff have been recruited and have a detailed induction programme to follow. There are less agency staff used and the agency staff are regular and familiar with the home and residents. The duty rota was checked and during the period from January - February there were two core team members on each shift. The duty rota for March also evidenced the same. The staff confirmed that they had received training in various subjects and that this training was ongoing. Less than 50 of the work force hold an NVQ in care. Staff are being encouraged to undertake this qualification. A sample of recruitment records was checked and the documents required were present. This provides evidence that the organisation are checking that staff employed are suitable to work with vulnerable people. Sandy Lodge DS0000015559.V282733.R01.S.doc Version 5.1 Page 15 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37 and 39 The acting manager continues to run the home in a safe way with the support of the senior managers at Estuary Housing Association. EVIDENCE: Estuary Housing Association seek the views of the residents in all of their homes and this is called their Quality Network Review. The organisation produce an annual report reflecting the findings of the review and an action plan to improve their service which is informed by the residents. Sandy Lodge is included in this review and a selected number of residents take part in it. The acting manager continues to be in post and is supported by the service managers from Estuary Housing Association. No application has been received to register a manager at this home. Sandy Lodge DS0000015559.V282733.R01.S.doc Version 5.1 Page 16 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 x 2 x 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 x 23 x ENVIRONMENT Standard No Score 24 3 25 x 26 x 27 x 28 x 29 x 30 x STAFFING Standard No Score 31 x 32 2 33 3 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x x x LIFESTYLES Standard No Score 11 x 12 x 13 3 14 x 15 x 16 3 17 x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 x 2 x 3 x x x x Sandy Lodge DS0000015559.V282733.R01.S.doc Version 5.1 Page 17 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA20 Regulation 13(2) Requirement The Registered Person must ensure that the recording of the disposal of medication is thorough and matches the home’s drug policy The registered person must appoint a person for the position of registered manager. Timescale of 09/11/05 not met Timescale for action 06/06/06 2. YA37 8(1)(a) 06/06/06 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. Refer to Standard YA32 Good Practice Recommendations The Registered Person should encourage staff to undertake the National Vocational Qualification in care. Sandy Lodge DS0000015559.V282733.R01.S.doc Version 5.1 Page 18 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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