Inspection on 12/05/05 for Sue Ryder Care Centre

This inspection was carried out on 12th May 2005.

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

Sue Ryder Care Centre 24/09/08

Sue Ryder Care Centre 22/06/07

Sue Ryder Care Centre 13/12/05

Sue Ryder Care Centre 30/11/04

Sue Ryder Care Centre 06/05/04

Sue Ryder Care Centre 21/01/04

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Ruskin Lodge

Dystlegh Grange

The Good Companions

Springfield Cottage

Cuerden Grange Rest Home

Cornmill Nursing Home

Vitalise Sandpipers Centre

Sue Ryder Care Birchley Hall

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

CARE HOME ADULTS 18-65 Sue Ryder Care Centre Cuerden Hall Shady Lane Bamber Bridge, Preston, PR5 6AZ Lead Inspector Anne Taylor Announced 12 May 2005 09:15 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 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 Stationary 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. Sue Ryder Care Centre Version 1.10 Page 3 SERVICE INFORMATION Name of service Sue Ryder Care Centre Address Cuerden Hall, Shady Lane, Bamber Bridge, Preston, Lancashire, PR5 6AZ Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01772 627374 01772 629290 Sue Ryder Care Mrs Anne-Marie Potter Care Home 37 Category(ies) of Physical Disability (37) registration, with number Terminally Ill (6) of places Sue Ryder Care Centre Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: 1. Up to 37 service users in the category PD - Physical Disability. 2. Up to 6 service users in the category TI - Terminally Ill. 3. The Registered Provider should, at all times, employ a suitably qualified and experienced Manager who is registered with the National Care Standards Commission. 4. Staffing must be provided to meet the dependency needs of the service users at all times and will comply with any guidelines which may be issued through the National Care Standards Commission regarding staffing levels in care homes. Date of last inspection 30th November 2004 Brief Description of the Service: Sue Ryder is a thirty-seven bedded care home, which provides residential, nursing and day care to young physically disabled people. It is a mixed gender home that takes residents between the ages of eighteen and sixty-five. At the time of inspection there were thirty-five people living at the home and four attending for day care. The home was set up ten years ago to provide long term care for peole with life threatening conditions and illnesses such as Huntingtons disease, multiple sclerosis, acquired brain injury and other neurological disorders. Formerly a stately home, the Sue Ryder Centre is set in eleven acres of parkland close to motorway network and Bamber Bridge. Accommodation is provided over three floors in single or shared roooms. There is wheelchair access and a passenger lift to all floors. Other facilities include a multi sensory room, large activities area, physiotherapy department and a range of specialist equipment tailored to meet the needs of residents. The home has a designated activities team that provides a wide range of recreational events and activities. Sue Ryder Care Centre Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection that took place over one and a half days in May 2005. The majority of National Minimum Standards had been met and for those not fully met only minor shortfalls were identified. The overall standard of care provided was good and the management team had addressed issues raised at the last inspection with good effect. The inspection involved discussion with the people who lived and worked at the home, examination of records, policies and procedures and a tour of the premises. Comment cards completed by residents, relatives and visiting health care professionals have also been used in the compilation of this report As part of the inspection process the inspector used “case tracking” as a means of assessing some of the National Minimum Standards. This process allows the inspector to focus on a small group of people living at the home. All records relating to these people are inspected along with the rooms they occupy in the home. They are invited to discuss their experience of the home with the inspector, however this is not to the exclusion of other people living at the home. All residents spoken to were more than satisfied with the care they received. They said, “the care is brilliant, they do most things for me, anything I ask”. One resident asked to speak to the inspector and said, “Just wanted to tell you there are no problems here”. What the service does well: The Sue Ryder Centre offers a home for life for younger adults with life threatening illnesses. The medical and healthcare needs of the residents living at this home are complex and a lot of multi-disciplinary input is needed in order to meet those needs. The procedures and management processes in place to assess and address health care needs are highly developed and individual needs are met in a supportive and caring environment. The staff team work well together and show a good understanding of the needs of the people living at the home. The staff team receive appropriate training that provides them with the knowledge and experience needed to care for this client group. This is a care home where residents are put first and they are supported to take risks as part of an independent lifestyle. People living at the home benefit from the happy relaxed atmosphere and good relationships have been established between residents and staff. Sue Ryder Care Centre Version 1.10 Page 6 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 full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Sue Ryder Care Centre Version 1.10 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 Standards Statutory Requirements Identified During the Inspection Sue Ryder Care Centre Version 1.10 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 standard(s) 2 & 4 A thorough pre admission procedure ensured that prospective residents could be involved in the process and their individual aspirations and needs properly assessed. Opportunities to visit the home were available to residents and their family so they could make an informed decision about coming to live there permanently. EVIDENCE: Records seen showed that care management summaries had been obtained from social workers and the acquired brain injury team. In addition a registered nurse had undertaken a comprehensive pre admission assessment of need for anyone coming to live at the home. Registered nurses were able to discuss with the inspector the assessment process and how they involved residents or their representatives. Residents spoken to said, “yes, I came to look round from hospital”, and “I came to look round and I have also been here three times for respite, It was great because I like to know my surroundings but it still took a while for me to settle” and “we all have information in our rooms about the home”. Sue Ryder Care Centre Version 1.10 Page 9 Staff were able to discuss the individual needs of the people they cared for and Said, “we are told about new admissions and what specific things we might have to do for them or help them with”. Sue Ryder Care Centre Version 1.10 Page 10 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 standard(s) 6,7 & 9 The Sue Ryder Centre promoted an independent lifestyle, which allowed residents to make decisions, take controlled risks and be involved in the care planning process. EVIDENCE: The standard of record keeping in relation to care planning was good. This helped the care process and protected the welfare of residents. A care plan had been developed and agreed with each resident. For residents whose condition did not allow this relatives had been approached to discuss and agree the plan of care. The plans were detailed and based upon information obtained during the pre admission assessment process. A small number of care plans had not been reviewed the previous month due to the named nurse being off sick. This had not affected the standard of care delivered and staff spoken to were aware of individual needs. One care plan contained descriptions of an uncommon specific neurological condition, presenting symptoms, prognosis and any treatment available. This Sue Ryder Care Centre Version 1.10 Page 11 made sure staff were aware of any restrictions the condition might impose upon the resident’s abilities and lifestyle. When asked about care plans residents said, “staff talk to me about it and there is one in the office and a programme for each of us in our room”, and “yes I know about it and if you’re not happy you tell them or your key worker about it”. Risk assessments were in place to ensure the provision of health care was done so safely and residents able to maintain an independent lifestyle. Sue Ryder Care Centre Version 1.10 Page 12 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 standard(s) 12, 15 & 16 The daily routines were inclusive and promoted independence and individual choice so that residents were able to have some control over their lifestyle. EVIDENCE: The statement of purpose and service user guide contained information about maintaining contact with family and friends. One resident said “we all have a copy of the service user guide in our room”. Records showed that appropriate attention was paid to helping residents to take part in valued and fulfilling activities that were already established or developed in the home. One resident was learning French and also taught on a voluntary basis at a local school. She thoroughly enjoyed both of these ventures. The French lessons enabled her to develop new skills and also talk to new members of her family. Voluntary teaching enabled her to continue her career and maintain links with the community. Sue Ryder Care Centre Version 1.10 Page 13 Leaflets were available in the reception area that provided residents with information about local activities and resources. Volunteers and staff provided help and support for residents that chose to be involved in local activities. Residents said, “I have made friends here and kept friends from before, there are no restrictions”. When asked about the routines of the home and lifestyle experience residents said, “I choose when I get up and go to bed and tell staff what I want to wear”. “I’m in activities for most of the day every day and I’m going to London with some other residents and staff because I entered an art competition”. 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 standard(s) 18 & 19 Residents received sensitive and flexible personal support and nursing care in a way that maximised their rights and ability to have control over their lives. EVIDENCE: Sue Ryder Care Centre Version 1.10 Page 14 Discussion with residents showed that they received personal support and care in the way they preferred and needed. When asked residents said, “ I’m very happy, they help me when I need it, I have a bed bath every day but can go in the ordinary bath if I want”, “I can do some things for myself and they help if needed, I have a shower it’s great”. Discussions with staff and service users showed that personal support was provided in private and by a carer of the same gender whenever possible so that residents’ rights to privacy and dignity were respected. One resident said, “All staff knock before coming into my room and if they take me to the bathroom they make sure the door is closed”. Designated key workers provided consistency and continuity of support, supervised by trained nursing staff. Residents spoken to knew who their key worker was and liked having a specific person to discuss things with. A large number of technical aids and equipment were available to residents to assist in the management of their care needs and maximise their independence. Preferred routines were recorded in care plans so that all staff were aware of personal choices made by residents. Care plans seen were detailed and informative. They showed that service users had been supported and helped to take control of and manage their own healthcare if they were able. Their health needs had been monitored, potential problems identified and specialist advice obtained if necessary. Regular input from a range of health care professionals had been arranged and their advice implemented and evaluated by staff at the home. Residents spoken to said that they felt staff understood their needs and worked hard to meet those needs. Care plans contained information relating to health checks unrelated to the primary disability or condition that had been offered to service users, including vision and hearing tests. Sue Ryder Care Centre Version 1.10 Page 15 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 standard 22 The home had a clear complaints procedure that ensured residents knew how and who to complain to. Complaints were managed effectively so that residents were confident that any issues they raised would be acted upon. EVIDENCE: The complaints procedure was included in the statement of purpose and service user guide. Each resident had a copy of the service user guide in his or her bedroom. Resident’s spoken to felt that they were encouraged to raise any concerns they might have about the home, that they would be listened to and action would be taken on any issues raised. Resident’s said, “I know there’s a procedure”, “I don’t have any complaints but I know what to do” and “I’m listened to and they do something about it”. The home had received five complaints since the last inspection all of which had been resolved. Discussion with the manager and staff showed that residents and relatives were actively encouraged to use the complaints procedure as a means of improving the service. Sue Ryder Care Centre Version 1.10 Page 16 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 standard(s) 24 & 30 The home was clean, comfortable, and homely and provided an environment that was suitable for it’s stated purpose. Improvements were needed to ensure the continued safety of residents. EVIDENCE: Comment cards received from residents showed that they felt safe living at the Sue Ryder Centre and liked living there. Comments from relatives about the environment included, “the staff make it as homely as possible for those aware of their surroundings, “their rooms are decorated to their choice” and “ this is a lovely home in beautiful surroundings”. The home was accessible to all residents. Ramps allowed easy access to the outside and a passenger lift was provided to access all floors. Doors to the main lounge opened automatically allowing easy access for residents that used a wheelchair. Sue Ryder Care Centre Version 1.10 Page 17 A large number of aids and equipment were seen around the home that promoted independence or provided assistance with the management of care needs. The home was clean and free from offensive odours. One resident said, “It’s great here, my room is always clean and tidy”. Discussion with staff showed that they were familiar with infection control polices and procedures used at the home and most had received appropriate training. Some parts of the home were looking a little tired and shabby. Paintwork was chipped and some furniture dated. The manager was aware of this and a planned programme for maintenance and refurbishment was in place so that furnishings and fittings could be renewed and areas redecorated when needed. A number of radiators were unguarded and did not have a guaranteed low surface temperature. Unprotected radiators present a possible health and safety risk to residents and steps must be taken to remove or reduce this risk. Sue Ryder Care Centre Version 1.10 Page 18 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 34 & 35 The home had an effective staff team that was appropriately trained and had the skills and experience to manage and meet the needs of residents. The recruitment process was thorough enough to ensure the continued protection of residents. EVIDENCE: Staff rotas were in place, which showed the number of staff on duty and the capacity in which they were employed. Staffing levels were in excess of the minimum requirements of the previous regulatory body during the morning period when workloads were at their heaviest. Communication with some of the residents at Sue Ryder can be difficult due to the medical conditions from which they suffer. Staff were observed using a variety of methods developed to suit the individual, to communicate with residents. A lot of time had been spent getting to know residents and the ways in which they were able to express their needs. A member of staff was able to identify when a resident was becoming distressed because the resident was grinding their teeth. Residents said, “staff are great here”, “ I can do some things for myself and they help if needed, it’s great”. Sue Ryder Care Centre Version 1.10 Page 19 Comment cards received from relatives noted, “All the staff give 100 per cent, it is all the extra things they do that make the home so special”, “I find the staff very helpful and very good with my daughter”. The home had a training and development programme linked to the service provided and the needs of residents. Discussion with staff showed that they had received induction training and training specific to the work they were expected to carry out. Staff felt that training opportunities, both formal and informal were good. Comments included “I have discussed individual care with trained nursing staff, “If you want any information you just have to ask and they either have it or will find out”, “I had two full days induction went through all the procedures and watched a fire safety video”. “I have already discussed my training needs and would like to do an NVQ”. The recruitment process was thorough and took into account the need to protect residents. Personnel records of three newly appointed members of staff contained all the information required by the Care Home Regulations 2001. Staff discussed their experiences of the interview process. They said, “the interview was geared towards finding the right candidate for the position, it was a good interview”. “They used a new interview process with set questions to ensure they found the right person”. Sue Ryder Care Centre Version 1.10 Page 20 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 39, and 42 the key standards to be inspected at least once during a 12-month period. JUDGEMENT – we looked at outcomes for standard(s) 42 Health and safety issues were appropriately managed, thus providing a safe environment for people that lived at the home. EVIDENCE: Discussion with the manager and staff demonstrated a clear commitment to health and safety issues and a number safe working practices were verified at the time of inspection. Training in relation to health and safety issues had been provided for all staff so that they were able to promote the health, safety and welfare of the people they cared for. Certificates were inspected which confirmed that regular servicing had taken place in relation to systems and equipment used by the home. Comment cards received from residents showed that people living at the home felt safe. Sue Ryder Care Centre Version 1.10 Page 21 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. Where there is no score against a standard it has not been looked at during this inspection. 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x 3 x Standard No 22 23 ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x x x x 3 Standard No 11 12 13 x 3 x Standard No 31 32 33 34 35 Score x x 3 3 3 Page 22 Sue Ryder Care Centre Version 1.10 14 15 16 17 x 3 3 x 36 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score x x x x x x 3 Sue Ryder Care Centre Version 1.10 Page 23 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. 2 Standard 24 24 Regulation 13(4)(a) 23(b)(d) Requirement Radiators must be appropriately guarded or of a guaranteed low surface temperature. Worn furniture and fittings must be replaced. Damaged areas within the home must be redecorated and maintained to an appropriate standard. Timescale for action 30th September 2005. 30th September 2005. 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 Good Practice Recommendations Sue Ryder Care Centre Version 1.10 Page 24 Commission for Social Care Inspection Levens House Ackhurst Business Park Foxhole Road Chorley PR7 1NW 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 Sue Ryder Care Centre Version 1.10 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. 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