Inspection on 06/03/07 for Sidegate Lane 214

This inspection was carried out on 6th March 2007.

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 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

Sidegate Lane 214 21/11/05

Sidegate Lane 214 25/07/05

Sidegate Lane 214 07/01/05

Sidegate Lane 214 21/07/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bramley Avenue (73)

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

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

CARE HOMES FOR OLDER PEOPLE Sidegate Lane 214 214 Sidegate Lane Ipswich Suffolk IP4 3DH Lead Inspector Jane Offord Unannounced Inspection 6th March 2007 09:30 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 Sidegate Lane 214 DS0000037157.V332028.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. Sidegate Lane 214 DS0000037157.V332028.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Sidegate Lane 214 Address 214 Sidegate Lane Ipswich Suffolk IP4 3DH 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) 01473 588575 01473 588573 tania.moore@socserv.suffolkcc.gov.uk Suffolk County Council Mrs Tania L Moore Care Home 30 Category(ies) of Dementia (24), Dementia - over 65 years of age registration, with number (24), Old age, not falling within any other of places category (10), Physical disability (6), Physical disability over 65 years of age (6) Sidegate Lane 214 DS0000037157.V332028.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 1 The home is able to provide a service to people with a physical disability and dementia 21st November 2005 Date of last inspection Brief Description of the Service: 214 Sidegate Lane is owned and run by Suffolk County Council. It was purpose built in the early 1970s and in 2000 the Home was fully refurbished. The home is divided into five units. Twos Company offers 18 places for older people who require extra care because of their individual needs arising from their dementia. Four of these places are for short-term care. Twos Company is on the ground floor divided into three units that are connected by corridors that overlook the enclosed gardens. The residents also benefit from a sunroom and conservatory. Pleasant View is on the first floor and is a unit for a further six people with dementia. Each unit has en suite bedrooms, a lounge and kitchen/diner. Rooftops is the intermediate care unit run in conjunction with the intermediate care team from the Ipswich Hospital. The purpose of the unit is to prevent hospital admission or to take a person from hospital where acute care is no longer required to ensure they have time to build confidence and in some cases regain life skills in order to return home. The fees for accommodation are £368.00 per week and do not include hairdressing, chiropody, toiletries, newspapers, transport and telephone calls. Sidegate Lane 214 DS0000037157.V332028.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key unannounced inspection looking at the core standards for care of older people took place between 9.30 and 15.30 on a weekday. The registered manager was on annual leave but the team leader was available all day and helped with the inspection process. This report has been compiled using information available including evidence found during the inspection. A tour of the building was undertaken with a member of staff but all areas were re-visited later in the day. Three residents’ files, three new staff files, the policy folder, the complaints log, some maintenance records, the duty rotas and menus were all seen. A number of residents and staff were spoken with in the course of the day. Part of the medication administration round and the serving of the meal at lunchtime were observed. On the day the home was clean and tidy although there was an odour of urine in one unit. Residents were relaxed and looked comfortable, using all areas of the home. Health professionals were working with residents in the intermediate care unit and carers in some of the other units organised seated activities for residents. What the service does well: What has improved since the last inspection? There were no requirements or recommendations left following the last inspection. The home has continued to consult with residents and staff and change practice as a result of learning from complaints. Some new recliner chairs have been bought for the residents’ use. Sidegate Lane 214 DS0000037157.V332028.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Sidegate Lane 214 DS0000037157.V332028.R01.S.doc Version 5.2 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 Sidegate Lane 214 DS0000037157.V332028.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3, 6. Quality in this outcome area is adequate. People who use the intermediate care service can expect to be supported to maximise their independence and return home but people using the residential service cannot be assured that a pre-admission assessment of needs will be undertaken prior to their admission. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The files and care plans of four residents were seen. Three were residents from the residential service and one from intermediate care. In the residential files one contained notes of a pre-admission meeting that was just dated ‘July 2006’, one contained some notes about the resident but it was not signed or dated, so it was unclear if they were taken pre-admission and the third file had no documentary evidence of pre-admission assessment, although the team leader said they remembered going to the hospital to see the resident. Sidegate Lane 214 DS0000037157.V332028.R01.S.doc Version 5.2 Page 9 The file for the resident in intermediate care showed records of multidisciplinary meetings to assess how best to support the resident to improve their skills to return home. The care plan had interventions for mobility, continence, dressing/undressing, personal hygiene, self-medicating and kitchen practice. The interventions were all aimed at promoting independence. Sidegate Lane 214 DS0000037157.V332028.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10. Quality in this outcome area is good. People who use this service can expect to have a care plan to help meet their needs, be treated with respect and protected by the medication policy and practice. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The care plans and daily records for three residential residents were inspected and showed individual interventions were used to meet residents’ needs. Areas of care such as personal hygiene, continence, mobility and communication were addressed and there were also interventions for night needs, diet, oral hygiene and panic attacks. There was evidence that the care plans were regularly reviewed with the resident if they were able or the family if the resident was unable to understand the process. As noted in the previous section of this report the care plan for a resident in intermediate care contained interventions to promote their independence. Sidegate Lane 214 DS0000037157.V332028.R01.S.doc Version 5.2 Page 11 The files seen contained contact details of health professionals involved with the resident and recorded visits to or by them. Risk assessments for moving and handling, falls, skin integrity and, in one case, wandering had been completed. One file had a review of the equipment needed by the resident such as a rise and fall bed, a pressure mat and wheelchair. Another contained a record that the resident had received an influenza vaccination. Residents in the intermediate care unit have the benefit of therapists from the intermediate care team. A physiotherapist was aiding one resident to mobilise to the dining area and another resident said they had been given some guidance on getting dressed because they had broken a wrist and still had a plaster on. They said they were going on a home assessment the following day to see how they would manage when they returned after their plaster was removed. Staff were observed to knock on residents’ doors before entering the rooms and giving people choice about where they wanted to be or what they wanted to do. Staff got down to the level of the resident to make eye contact when talking to them. Interactions overheard were friendly and respectful. The medication policy was comprehensive and covered ordering, storing, administering and disposing of medicines. A risk assessment for one resident who refused to take essential medicine was seen. It showed that the staff and the GP had assessed the situation and it had been agreed that for this resident medicine could be disguised to ensure that they took it. The resident’s next of kin had been involved in the process and given written agreement to the process. The home uses a monitored dose system for medicines so tablets are supplied in blister packs from the local pharmacy for individual residents. Residents’ own medicines are stored in a locked cupboard in their room. The team leader carries the key to the cupboards. No residents in the residential units selfmedicate but those in intermediate care do in preparation for returning home. The home has an assessment process for those wishing to self-medicate. Medication administration on the day of inspection was safe and residents were helped with their tablets sensitively. The medication administration records (MAR sheets) seen were completed correctly. The controlled drugs (CD) register and stock were checked and found to tally. The team leader said they had had medication training from the pharmacist and it was regularly updated. Sidegate Lane 214 DS0000037157.V332028.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15. Quality in this outcome area is good. People who use this service can expect to be encouraged to maintain contact with family and friends, be offered meaningful pastimes and receive a wellbalanced diet. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The residents’ files seen contained details of the contact for and relationship of the resident’s next of kin. Each file had a photograph of the resident and some life history work. Visitors were seen to come and go during the day and the staff welcomed them. Nineteen relatives/visitors comment cards were received by CSCI prior to this inspection and without exception they said they were always made to feel welcome when they visited. Records were made of a resident’s particular interests and hobbies and notes kept of any activities participated in. One record said, ‘Enjoyed a game of hangman with other residents and then attended the church service’, another recorded, ‘enjoyed a one-to-one with a carer’. Sidegate Lane 214 DS0000037157.V332028.R01.S.doc Version 5.2 Page 13 The home has a number of volunteers who visit regularly for planned activities so for the month of March there are to be ‘exercises with Paul’, an accordion player, some gospel singers, a clothing sale and a visit from the ‘pat dog’. Carers arrange other pastimes such as bingo, quizzes, recreational cookery, art and craft, board games, manicures and karaoke. Staff said that in the better weather the gardens are frequently used by the residents for fetes, barbeques, gardening and just sitting in the sun. Groups of residents make trips to local garden centres, the seaside, the shops and the public house opposite the home. The menus work on a four week rotation with one main course offered at lunch and teatime, however there is a standing alternative menu always available that offers soup, fish, a vegetarian choice, all day breakfast, jacket potatoes and fillings, salad or pies. Similarly for the dessert just one pudding is offered as the main option but there are always ice cream, yoghurts, mousse, jelly, fruit cocktail, fresh fruit or cheese and biscuits available as an alternative. The main meal on the day of inspection was cold sliced beef with potatoes, carrots, Brussels sprouts and gravy. The vegetables were served in separate dishes for residents to help themselves if they were able. One resident did not want beef and the cook supplied them with their preferred corned beef. The vegetables looked fresh and well cooked. Residents appeared to enjoy their meal. The kitchens were visited and found to be clean and tidy. The food stores were well stocked with fresh fruit and vegetables available. The cook said they make cakes and puddings for diabetics from a special recipe book the home has. Temperatures of refrigerators and freezers were recorded daily and showed they were functioning within safe limits for food storage. Sidegate Lane 214 DS0000037157.V332028.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18. Quality in this outcome area is good. People who use this service can expect to have any complaint taken seriously and investigated and be protected from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Suffolk County Council has a leaflet explaining how to make a complaint about any of its services. Copies of these are available in the home. Seventeen of the nineteen relatives/visitors comment cards received by CSCI prior to this inspection indicated that they were aware of the home’s complaints policy. The complaints log was seen and showed three complaints had been made since the last inspection. One was from a member of staff complaining that their shifts had been changed and they had not been notified, one from a relative about lack of information when a short term resident was discharged and one from another relative about one resident verbally attacking another resident. There was evidence that they had all been thoroughly investigated and a written response sent to the complainant. The home has an up to date copy of the vulnerable adults protection committee guidelines and the training matrix shows regular POVA updates for all staff. Staff spoken with were clear about their duty of care and the home has a whistle blowing policy to protect them if the need arose. Sidegate Lane 214 DS0000037157.V332028.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 26. Quality in this outcome area is good. People who use this service can expect to live in an attractive environment that is well maintained but cannot be assured that odour control will always be good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is divided into five units of six residents each, three on the ground floor and two on the first floor. Each unit has a kitchen/diner, a lounge, a laundry room and a cleaners’ cupboard. The units are connected by glass sided corridors that overlook the secure gardens. All the units were attractively furnished with co-ordinating furniture and soft furnishings and fresh flowers in the lounges. Residents’ own rooms were individually furnished and personalised with pictures, photographs and ornaments. In one unit there was a smell of urine that remained all day. Sidegate Lane 214 DS0000037157.V332028.R01.S.doc Version 5.2 Page 16 The carers on each unit are responsible for the laundry and the residents’ clothes of their unit. The laundry rooms are equipped with automatic feed washing machines that have a sluice wash programme. The rooms are all kept locked when no staff are present and control of substances hazardous to health (COSHH) regulations are observed. Protective gloves and aprons are available for infection control purposes and all hand washing basins seen had supplies of liquid soap and paper towels. Sidegate Lane 214 DS0000037157.V332028.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30. Quality in this outcome area is excellent. People who use this service can expect to be supported by adequate numbers of correctly recruited and well-trained staff. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The duty rotas were seen and showed that during the day there was a team leader on duty supported by six carers and at night a team leader supported by three carers. On the day of inspection the team leader said they had some shortages in the kitchen due to sickness. One carer had gone to do a shift as cook, they had previous experience in catering, but there was a new carer doing a ‘shadow shift’ as part of their induction. The team leader said they would give the new carer another ‘shadow shift’ as there would not be the opportunity to teach as much as required during this shift. In addition to the care team there is a team of housekeepers, a maintenance person and a part time administrator. The files of three new staff were seen and contained documentary evidence that identification checks had been made, two references had been taken up and criminal records bureau (CRB) checks had been completed prior to commencing in post. There were recent photographs of the member of staff and complete work histories. Sidegate Lane 214 DS0000037157.V332028.R01.S.doc Version 5.2 Page 18 There was evidence that staff undertook a ‘skills for care’ induction programme covering health and safety, POVA, communication, moving and handling, safety at work and dementia awareness. They also worked at least two supernumerary ‘shadow shifts’ before being counted in team numbers. The training matrix was seen and showed that all mandatory training such as moving and handling, fire awareness, health and safety and food hygiene is offered regularly and staff spoken with confirmed they have attended training sessions recently. Additional training in special areas of care such as care of the dying and medication administration are given to develop staff knowledge. Staff are actively encouraged to achieve an NVQ qualification and the home has over 50 of the care team with the award at either level 2 or 3 in care. Five senior members of the care team are NVQ assessors. Sidegate Lane 214 DS0000037157.V332028.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36, 38. Quality in this outcome area is good. People who use this service can expect to be consulted and have their finances and welfare protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager has been in post over ten years. They hold a social work and nursing qualification and have twenty years experience working in care homes for older people. Staff spoken with said the manager gave good leadership and was approachable. Minutes of team meetings were seen and showed a wide range of subjects were discussed from team and key working to fire training and staff supervision. Sidegate Lane 214 DS0000037157.V332028.R01.S.doc Version 5.2 Page 20 Many of the residents would be unable to respond to a questionnaire in regard of their care but the relatives of newly admitted residents are asked to complete a questionnaire about the admission and settling in period. One relative had responded with, ‘I can visit freely and am always made welcome’. The views of short stay and intermediate care residents were sought. One intermediate care resident said, ‘everyone has been very helpful and kind. I am very grateful for the respite care’. The system for managing residents’ personal monies was explained. The home holds a petty cash float that is used to supply residents with any money they need. The resident’s account held by the Local Authority is then debited. Statements are supplied regularly to the resident or family. No individual’s cash is held in the home. In staff files seen there was evidence of supervision contracts and the notes made during supervision sessions. Supervision of staff was also discussed and recorded in senior staff team meetings. Staff spoken with said they received supervision every six to eight weeks and training and development needs were identified during these sessions. A number of maintenance records were seen and showed a loler test was done on the hoists in December 2006. There were records of weekly fire alarm tests and fire route checks and the last fire drill had taken place in January 2007. It had involved fifteen staff, three contractors and two visitors and the records stated that they had all evacuated following the correct procedures. Emergency lighting is tested monthly and there was a certificate for testing portable fire extinguishers annually that was dated April 2006. A maintenance person was PAT testing all portable electrical appliances on the day of inspection. Sidegate Lane 214 DS0000037157.V332028.R01.S.doc Version 5.2 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 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 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 4 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X 3 Sidegate Lane 214 DS0000037157.V332028.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? None were given last time. 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 OP3 Regulation 14 (1) (a) Requirement The registered persons must ensure pre-admission assessments are carried out and that documentary evidence is retained in the resident’s file. The registered persons must take steps to eradicate unpleasant odours in the home. Timescale for action 06/03/07 2. OP26 16 (2) (k) 06/03/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Sidegate Lane 214 DS0000037157.V332028.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Suffolk Area Office St Vincent House Cutler Street Ipswich Suffolk IP1 1UQ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Sidegate Lane 214 DS0000037157.V332028.R01.S.doc Version 5.2 Page 24 - 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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