Inspection on 26/07/07 for Summerdyne Nursing Home

This inspection was carried out on 26th July 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

Summerdyne Nursing Home 16/06/09

Summerdyne Nursing Home 03/10/06

Summerdyne Nursing Home 10/10/05

Summerdyne Nursing Home 03/05/05

Summerdyne Nursing Home 21/10/04

Summerdyne Nursing Home 28/05/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

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

CARE HOMES FOR OLDER PEOPLE Summerdyne Nursing Home Cleobury Road Bewdley Worcestershire DY12 2QQ Lead Inspector Yvonne South Unannounced Inspection 26th July 2007 08.25 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 Summerdyne Nursing Home DS0000004147.V339978.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. Summerdyne Nursing Home DS0000004147.V339978.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Summerdyne Nursing Home Address Cleobury Road Bewdley Worcestershire DY12 2QQ 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) 01299 403260 01299 403174 tuulapage@heritagemanor.co.uk Heritage Manor Limited Mrs Tuula Anneli Page Care Home 27 Category(ies) of Dementia - over 65 years of age (19), Old age, registration, with number not falling within any other category (27), of places Physical disability over 65 years of age (27) Summerdyne Nursing Home DS0000004147.V339978.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. There are no more than twelve service users in the home with a primary diagnosis of dementia. 03.10.06 Date of last inspection Brief Description of the Service: Summerdyne Nursing Home is situated on the outskirts of Bewdley on a bus route. It is an adapted house with a purpose built extension. The service provides personal and nursing care for up to twenty-seven older residents of either sex who may have physical or mental frailty that requires continuing care. Accommodation is provided in seventeen single rooms, thirteen of which are ensuite. The remaining rooms are all ensuite double rooms. There is a shaft lift to facilitate movement between floors and there is a small garden and gazebo for the residents. In March of this year the registered providers who own the home changed their name from Frontsouth Ltd to Heritage Manor Ltd. The registered manager is Mrs Tuula Page. On 26.07.07 the registered manager stated that the current scale of charges were between £2160 and £2560 per month. Additional charges were made at retail costs for hairdressing, chiropody, personal toiletries and publications. Information regarding the home is available from the entrance area in copies of the Statement of Purpose, Service Users’ Guide and Inspection reports. Summerdyne Nursing Home DS0000004147.V339978.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection incorporates information received by the Commission for Social care Inspection since 03.10.06 and the information obtained during fieldwork on 27.07.07. The fieldwork extended over nine hours during which the inspector spoke to five residents, five staff and the manager. A partial tour of the premises was undertaken. Phone discussions also took place with a relative. Prior to the fieldwork the Commission for Social Care Inspection (CSCI) sent questionnaires to ten residents, their relatives and their GPs. These sought opinions on the quality of the service provided. Three responses were received from residents and five from relatives. One was received from a GP. An Annual Quality Assurance Assessment (AQAA) document was sent to the registered persons to complete and return to the CSCI. This was returned on 27.06.07. This was a key inspection which focused on the key National Minimum Standards and the requirements and recommendations that arose out of the previous inspection. What the service does well: The home provides a warm welcome for everyone. The atmosphere is calm, friendly and homely A person seeking a home for a relative said that she had received a wonderful impression. Another person said that the door was always opened with a smile. The home is attractive and well maintained and decorated. It is clean and there are no bad odours. A relative described it as spotless and residents say it is always fresh and clean. Another comment was that the bedrooms are decorated with thought and co-ordinated bed linen, no nasty smells, well aired and fresh. Staff are well recruited and training is provided. A relative said that ‘They always have a welcome for us when we arrive –often a cup of tea. They always treat us friendly and kind’. Residents said that the staff were kind and they were well looked after. Summerdyne Nursing Home DS0000004147.V339978.R01.S.doc Version 5.2 Page 6 The health and personal care is very good and the home contacts different specialist for advice when needed. A trained nurse is on duty at all times. Medication is well managed for those who are unable or do not wish to manage their own. A range of in house activities is provided in which residents can participate if they wish. If they prefer they can stay in their rooms and the social carer will visit them there. Entertainers visit the home each month and when the social carer takes residents to keep their appointments they frequently enjoy tea in the community before they return. Thus turning the occasion into a social outing. Faith is respected and people from different religions visit the home as required by the different residents. What has improved since the last inspection? What they could do better: The recommendations to improve the laundry facilities and lower the risks of cross infection had not been addressed. It is acknowledged that this will be a large and expensive task. However the risks to health and safety are high. Summerdyne Nursing Home DS0000004147.V339978.R01.S.doc Version 5.2 Page 7 Appropriate locks had not been fitted to bedroom, ensuite, bathroom and toilet doors in the home. These are necessary so that people can obtain privacy when they want it, without fear or risk of entrapment. Space is limited for storage, and in the lounge and dining room. Thought should be given as to how these facilities can be improved so that moving around the home is easier for those who use wheelchairs and walking frames and the staff who need to use the hoists. 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. Summerdyne Nursing Home DS0000004147.V339978.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Summerdyne Nursing Home DS0000004147.V339978.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3. Standard 6 was not assessed, as an intermediate service is not provided by this home. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Information is readily available in the Statement of Purpose, the Service Users’ Guide and the home’s brochure as well as through personal contact, to support and enable people to make a decision regarding admission to the home. Assessments are made before a place is offered to ensure the needs of people can be met by the service. EVIDENCE: The manager stated in the Annual Quality Assurance Assessment (AQAA) that prior to admission, each potential resident was assessed to establish their care needs, taking into consideration the home’s staffing levels and the expertise needed to provide the individual’s care needs. Their families were consulted and invited to view the home, as was the potential resident if possible. Summerdyne Nursing Home DS0000004147.V339978.R01.S.doc Version 5.2 Page 10 This gave them the opportunity to make an informed choice as to whether or not they felt the environment was suitable for them. Visits to the home would enable them to meet and talk to staff, which in turn made transition easier. Opportunity was given to the potential resident and their family and friends to spend a day in the home prior to admission. Lunch was provided thus giving them time to socialise with residents in the home. In the questionnaires, completed and returned by residents and their relatives, everyone agreed that they had received all the information they needed to help them make a decision. In a telephone call from a relative to the Commission for Social Care Inspection (CSCI) it was stated that they had received a wonderful impression when they had entered the home and they had felt very happy about it. All information needed was provided. Everyone was extremely efficient whilst maintaining a ‘human face’. Everyone agreed in the questionnaires that the residents received the care and support that they needed and the residents in the home told the inspector that they were well cared for. Three care records were assessed and these indicated that everyone’s care needs had been ascertained before a place was offered in the home. Two of the assessments had been carried out in 2005 and the third in 2007. The standard of these records had improved so that the amount of detailed gathered, provided staff with more guidance to enable them to provide the care needed as soon as the person arrived in the home. It was suggested that when information was not available during the initial assessment a note be made to this effect so that it could be gathered at a later date and so not omitted from the care plans. The Statement of Purpose and Service Users’ Guide were readily available and had been updated to reflect the name change of the registered provider. Summerdyne Nursing Home DS0000004147.V339978.R01.S.doc Version 5.2 Page 11 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. This judgement has been made using available evidence including a visit to this service. Information is available that informs and guides staff, enabling them to provide each resident with the personal and health care they need according to their wishes The staff treat people with kindness and respect for their privacy and dignity. However environmentally there are weaknesses in relation to the provision of suitable door locks. EVIDENCE: Following the last inspection requirements were made that; Care plans must be drawn up with the involvement of the resident or their representative and signed wherever possible. The resident’s wishes regarding terminal care and arrangements after death must be discussed and recorded in order that they can be carried out. Summerdyne Nursing Home DS0000004147.V339978.R01.S.doc Version 5.2 Page 12 There had been some compliance with the first requirement. It was observed that there were signatures agreeing to the initial care plan of a person recently admitted to the home and there were records of contact with relatives and representatives. It was acknowledged that the home maintained a friendly and approachable ethos that enabled visitors to talk to any of the staff and discuss matters with the senior nurses whenever they wished. A relative stated in a questionnaire response that; ‘If meetings are taking place about Mrs X and her medication and extra needs an invite to meetings is always given.’ It was agreed that the majority of residents, or with their consent their representatives, would not be able or wish to read through, review and sign each of their care plans each month. Therefore it was suggested that for those people who did not wish to do this, each month contact be made with each person to ensure that they were aware of any changes and check that they were happy with the care provided. This should be recorded. It was observed in the records that there had been a major improvement in gathering information relating to end of life care wishes. Staff now had the information they required to enable them to provide the care each person needed and wanted when their life came to and end. The manager stated in the AQAA that residents and their families were consulted and involved in drawing up the plans as to how they wish to be cared for. No restrictions were put on residents as regards the time they got out of bed or went to bed. They had the freedom to go out with family and friends and there were no limits to visiting times. With the information collected on assessment and upon admission, they started to collect data to enable them to build up an individual care plan. This would state clearly how they were planning to meet health and personal care needs. Care plans were very user friendly, which helped the nursing staff to communicate any changes in a resident’s care needs. It was felt that they were able to meet and treat residents as individuals and listen to their wishes and concerns. Staff understood how to respect resident’s privacy and dignity, and end of life issues were also taken into account in care planning. The home had a good quantity of pressure relief equipment and could access quickly any more that was required. Summerdyne Nursing Home DS0000004147.V339978.R01.S.doc Version 5.2 Page 13 The questionnaire responses indicated that people believed the care and support was generally what had been agreed and was needed. One person stated; ‘If it were possible to give more than 100 to this care service I would. Another person felt that she needed more information regarding the care her relative was receiving. The three care records that were assessed during the field work contained informative assessments and care plans. These had been regularly evaluated and updated. Some of the changes had been absorbed in the evaluation records and this made locating the most up to date information more difficult. This was especially so when the care and nursing needs were complex and changing. It was suggested that out of date documents be archived and new care plans be drawn up when the number and degree of amendments made the original plan incorrect. This would simplify the records and make the retrieval of information easier. Consent forms had been signed for the use of bedrails but these needed to be fully completed, and risk assessments had been carried out. It was suggested that the justification and use of bedrails should be included in the ‘sleeping’ care plan. Wound care was well planned, implemented and monitored with very good results. However there were no photographs that demonstrated the lack or progress of healing. This is considered to be good practice and the manager was urged to obtain either a Polaroid camera or a digital camera that could be linked to a computer programme for obtaining prints. This would ensure privacy and dignity was respected through the developing process which would be difficult to ensure in a commercial premises. Although the information was available it was suggested that care plans specifically for pressure care and diabetes would clarify matters. There was good evidence that other health care professions were consulted when necessary, such as speech therapists, homeward nurses, district nurses, physiotherapists, chiropodists, diabetic specialists, continence specialists, social workers and specialist doctors. The advice and guidance given was well documented. The questionnaire responses received from a GP were positive. It was observed that changes to medication were documented and the management of medication was good. Storage was well maintained and security was acceptable. Summerdyne Nursing Home DS0000004147.V339978.R01.S.doc Version 5.2 Page 14 Stock control was appropriate and the records were well maintained with appropriate signatures and entries demonstrating stock received, administered and disposed of. A sample check of controlled drugs balanced with the controlled drugs register. It was observed that the staff related to the residents with kindness and sensitivity. They demonstrated a respect for privacy and dignity. However there were some shortfalls in the environment that had the potential to compromise privacy. For example, although all doors in the home were not checked, it was observed that the shower room on the top floor lacked a door latch and lock, ensuite facilities were not fitted with locks and the locks on the bedroom doors did not meet the criteria agreed with the fire authority. It is considered to be good practice that approved locks should be fitted to all communal bathroom and toilet facilities, ensuites and bedroom doors. For health and safety reasons these locks should meet the agreed criteria and enable emergency access and protect residents from entrapment. A recommendation was made to this effect in the report following the last inspection in October 2006. No action had been taken. Summerdyne Nursing Home DS0000004147.V339978.R01.S.doc Version 5.2 Page 15 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. This judgement has been made using available evidence including a visit to this service. Residents are offered opportunities in the home and the community that provide stimulation and interest. Group and individual support is given. Support is also given when required to maintain links with family and faiths. Visits are always welcome and enjoyed by the residents in the lounge or their bedroom. However a second quiet lounge would improve the facilities for residents and visitors. A choice of good quality nutritious meals is provided that the residents enjoy. EVIDENCE: In the AQAA the manager stated that meal times were a pleasant social activity and they endeavoured to create a calm unhurried atmosphere. A choice of menus was provided and meals were nutritious, well presented and varied. The nursing staff sat with residents and assisted those who needed help. Several family members had enjoyed meals in the home on occasions. Summerdyne Nursing Home DS0000004147.V339978.R01.S.doc Version 5.2 Page 16 Imaginative cooks were employed and a new chef had been appointed who had brought more appetising and creative menus, thus enhancing residents’ choice and enjoyment at meal times. The social carer organised activities on group or one to one basis. She took residents to any appointments and when possible used this occasion to take them out for a coffee and change of environment. Relatives and friends were always welcome and made to feel part of the ‘family’. Local churches make regular visits and held communion/mass services for those who wish to participate. Visits from different musicians were hired to cater for all tastes. There was a cordless ‘phone and the ability to have ‘phones – landlines or mobiles, in residents’ bedrooms. The documents indicated that the social carer was employed to work 21 hours each week. A programme of activities was displayed on the wall outside of the lounge. In-house activities included bingo, cards, television, reading, and the external entertainers who visited the home each month. A manual indicated that visits had been received from an organist, a keyboard / vocalist, a singer, a therapist providing hand, foot and back treatments, music for health and a comedian / magician. Records were maintained that indicated which residents had attended and participated, and how successful the event had been. It was recommended that individual records were also maintained that demonstrated opportunities each person had to participate in other events that were stimulating and interesting according to their tastes and wishes. On the day of the fieldwork a resident was accompanied to keep an appointment and then proceeded to enjoy a social outing with the social carer. It was observed in the care documents that the religion of residents was identified and links to their churches were established and supported as they wished. The new chef demonstrated that a record was maintained of all food provided for residents. He confirmed that each day the residents were informed of the menu for the day and asked if they wanted an alternative. Due to the small numbers alternatives were easily accommodated. Although he had not been in post long he said that he was already becoming aware of individual preferences. Special diets were provided for those people who were diabetics and those who needed a soft or liquidised diet. The residents said that they enjoyed the food and they were well fed. A relative stated in the questionnaire response that the food smelt delicious and was well presented. Summerdyne Nursing Home DS0000004147.V339978.R01.S.doc Version 5.2 Page 17 The residents’ records indicated that the advice of a nutritionist was sought when necessary and weights of residents able to use the scales were monitored. Visitors were always welcome and the visitors’ book indicated that a steady stream had come to the home during the day the fieldwork took place. The questionnaire responses stated that the majority of respondents considered that they were kept up to date with important issues, and were made to feel welcome when they visited. One person said that he regularly phoned the home to speak to his wife and others said that they visited on a regular basis. It was observed that both the lounge and dining room were small and of an awkward shape. A respondent stated in the questionnaire that there was a need; ‘to have a quiet calm room for the residents that don’t enjoy TV or radio and to give them a little more space. Only having one lounge it gets very hot and crowded.’ This view was observed and endorsed by staff and the manager. A conservatory would be a great asset. Summerdyne Nursing Home DS0000004147.V339978.R01.S.doc Version 5.2 Page 18 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. This judgement has been made using available evidence including a visit to this service. Information, guidance and support are available and people voice their concerns as they arise. There is a good rapport between residents, relatives and staff, which ensures that matters are addressed before they escalate. Staff are well-recruited and appropriate checks and training are undertaken to ensure residents are not put at risk. However evidence must be retained that two references, including one from the previous employer, have been obtained before a place is offered. EVIDENCE: The manager stated in the AQAA that every new resident and their family received details of the complaints procedure, which stated clearly the stages and timescales for the process. They were also encouraged to talk to her and the staff, thus creating an atmosphere of openness and trust. Prior to employment, all staff were checked by the Criminal Records Bureau (CRB) and references were sought from previous employers. Summerdyne Nursing Home DS0000004147.V339978.R01.S.doc Version 5.2 Page 19 Training related to the protection of vulnerable adults (PoVA) was provided to all staff to increase their knowledge of the rights’ of the residents and what constituted abuse. There had been no verbal or written complaints during the past year. The manager considered that this proved that attention was given to concerns and the need to make any complaints had not arisen. It was observed that the complaint procedure was available in the Statement of Purpose and the Service Users’ Guide. The residents stated in the questionnaire responses that they knew how to make a complaint and who to speak to. Two relatives said that they knew how to make a complaint and two people said that they didn’t. However one relative confirmed in the questionnaire response that ‘Information is available at the desk in the hall of the Nursing Home and in our contract.’ Other comments made included; ‘ I have never ever felt the need to complain.’ ‘I have never had to raise concerns as we regularly talk with the staff about Mrs X needs, and adjustments are on going.’ ‘I am always contacted immediately if there is a problem.’ One relative was unhappy how a concern had been handled over a year ago. However she acknowledged that the matter had been resolved. The inspector spoke to five staff and checked three staff records. It was observed that there was only one reference available for a person recently recruited to the home. This person was well known to the manager as a former colleague and although the reference had been requested its nonreceipt had been overlooked. The manager undertook to ‘chase it up’ immediately and it has since been received. Checks had been undertaken for each person through the Criminal Records Bureau (CRB), and of the Protection of Vulnerable Adults (PoVA) list since its inception. The staff indicated that they had a good general idea of how to respond to issues of abuse and the training records indicated that some staff had received training. The manager confirmed that training was planned for the remainder of the staff and new staff received training as part of their induction. Summerdyne Nursing Home DS0000004147.V339978.R01.S.doc Version 5.2 Page 20 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 adequate. This judgement has been made using available evidence including a visit to this service. The improvements to the home, internally and externally, have made it a more pleasant place in which to live. It is well maintained and clean. Infection control is generally well addressed but the laundry arrangements increase the risks of cross infection to residents and staff. The lack of storage for large items of equipment results in the availability of some facilities such as bathrooms, being compromised. Summerdyne Nursing Home DS0000004147.V339978.R01.S.doc Version 5.2 Page 21 EVIDENCE: Following the last inspection two requirements were made that; ‘The programme of routine maintenance and renewal of fabric and decoration must be implemented to ensure the home is safe and well maintained.’ and ‘The outside window frames must be attended to and repainted. The timescale for this requirement had previously been set as 30/09/05 and had not been met.’ The manager stated in the AQAA that in the past 12 months the following work had been completed; • Re-carpeted stairs and corridors • Redecorated and re-carpeted the dining room, • Introduced a separate manager’s office. One of the garages had been converted into a manager’s office, which had provided better facilities for meeting staff and visitors. This was separate from the care office itself. • Up-graded several rooms. Redecorated the exterior. • Several bedrooms had been redecorated, some bedroom furniture been replaced and two bedrooms had been re-carpeted. • Steps have been taken to improve the pond and surrounding areas. • The windowpane cracked in one bedroom had been replaced with a double glazed unit. The manager further stated that Summerdyne offered a welcoming and homely atmosphere and the home was clean and free from offensive odours. Each room was personalised with different décor, and residents and their families had been invited to choose the colour scheme when their rooms were redecorated. Residents were also encourage to bring in personal items or pieces of furniture to make their room personal and family pictures which would add character to their rooms. During the fieldwork a partial tour of the home was conducted. The improvements internally and externally were observed and had benefited the residents and staff. Most of the residents used either a wheelchair or a walking frame. This caused difficulties in the lounge and dining room, as space was limited. Social grouping of furniture was not possible and many of the dining tables could only be large enough to seat two people. Summerdyne Nursing Home DS0000004147.V339978.R01.S.doc Version 5.2 Page 22 The location of the laundry was not convenient as access was via the kitchen or an exterior door. Access via the kitchen was banned for hygiene reasons and laundry transported via the other route necessitated staff going in and out of the front door and across the front path before re-entering the home via an external door. There was no shelter to this area. The manager said that there had been plans at one time to construct a covered walk way but nothing had come of the idea. The laundry was in a cluster of three small areas. There was no hand basin or sink. Personal protective equipment was provided and the staff confirmed that this was always available. However the lack of hand washing facilities increased the risks of cross infection. Overall the laundry was badly designed and located, and increased the risk to health and safety. Liquid soap and disposable towels were appropriately available elsewhere for use in the home. The cleanliness of the home was appreciated by residents and relatives who commented favourably in the questionnaire responses. A sample of bedrooms was seen. They were clean and attractive. Personal items decorated each room giving it individuality. Special beds had been obtained when there was a need and pressure care equipment was in use. There were two standing hoists but only one full hoist. This caused some difficulty, as it needed to be taken from floor to floor. A second full hoist would be useful. Storage space was limited for large items of equipment such as commodes, hoists and wheel chairs. In the lobby area outside of the new office packages of continence products were stored as there was no space elsewhere. Two recommendations were made in the previous report that consideration should be given as to how the access and laundry facilities could be improved and a programme should be drawn up and implemented for the fitting of approved bedroom door and ensuite door locks that provided privacy and safety for residents. Neither of these recommendations had been addressed. Summerdyne Nursing Home DS0000004147.V339978.R01.S.doc Version 5.2 Page 23 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 good. This judgement has been made using available evidence including a visit to this service. Well-recruited and trained staff ensure the residents receive the care and attention they need and are protected. However there is great dependency on the good will and health of the staff considering their low remuneration. EVIDENCE: In the AQAA the manager said that staff were paid to attend training and training costs were met by the company. Staff stability was high – 50 of the staff had at least 2 years service, most had more. 60 of the nurses had at least 4 years services and 50 of carers had National Vocational Qualifications (NVQ) to level 2. Twenty nursing/care staff, some full time and some part time, and five ancillary staff were employed. No agency staff had been used in the past 3 months. Five full time staff had left in the past twelve months. The ages of care staff ranged between 25 years and 64 years, with one person being over 65 years, and all care staff were female. All catering staff and 60 of care staff had received training in safe food handling. Summerdyne Nursing Home DS0000004147.V339978.R01.S.doc Version 5.2 Page 24 There was a diverse mix of staff; twelve people were white British, five staff were from India and eight staff came from the Philippines. The inspector spoke to five staff and assessed three sets of staff records. Application forms, references (Only one reference was available for the most recent recruit but this situation has since been addressed.), the results of checks undertaken by the CRB, training certificates and contracts were seen. The inspector was told that some staff were contracted to work 44.75 hours a week, which necessitated them working long days. It was clear that the staff were loyal to the home and committed to providing good care for the residents. They commented on the strength of the team and how well they got along together. The questionnaire responses from residents stated that the staff listened and acted on what they said and they were usually available when needed. However a relative said that more care staff were needed as they were usually short staffed. A member of staff endorsed this and the manager said that currently staff needed to work extra hours to cover the shifts in the home. The AQAA identified that five staff had left the home since the last inspection and the manager said that currently there were two full time care vacancies. A detailed ‘handover’ took place at the start of each shift during which the care and changes experienced by each resident were considered and discussed. One of the nurses confirmed that everyone was involved and she worked closely with the staff and received continual feedback during the shift from them. At the end of each shift all care staff reported to the nurse and the records were brought up to date. Most relatives considered the communication to be very good although one person had concerns that she had not been kept up to date with matters regarding her relative. The training matrix demonstrated that training was on going. All staff had received health and safety training and fire safety training since the last inspection and other topics had been addressed by some staff. The manager confirmed that courses relating to infection control and the Protection of Vulnerable Adults had been booked. A recommendation had been made following the last inspection that the induction training programme should be updated in line with the standards listed by Skills for Care. The manager said that this recommendation had been accepted and new staff now undertook this course. Summerdyne Nursing Home DS0000004147.V339978.R01.S.doc Version 5.2 Page 25 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, 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed and due attention is given to health and safety to safeguard the well being of everyone. EVIDENCE: The home was well managed by a well-trained, competent and pleasant person who was respected by staff, residents and relatives. A questionnaire response stated that ‘Summerdyne is spotless and runs very well in the capable hands of Sister Page’. Summerdyne Nursing Home DS0000004147.V339978.R01.S.doc Version 5.2 Page 26 Following the last inspection a requirement had been made that the quality assurance system must be implemented to ensure the service develops and improves. This requirement had been outstanding for some time. The previous timescale of 30/03/06 had not been met. However on this occasion the inspector was shown a quality assurance manual that demonstrated an audit of the service had been undertaken and action plans were being drawn up and implemented where areas for improvement and development had been identified. The manager said that residents’ monies held in safe keeping were stored securely with access limited to herself and one of the trained nurses. Records were maintained and two signatures were required for each entry. Receipts were given for all income and retained for all expenditure. A second requirement that staff must receive training in the full range of health and safety topics had been outstanding, as the previous timescale of 10/10/05 had not been met. The training matrix demonstrated that all staff had now received training in health and safety and fire safety. Courses in moving and handling and infection control were arranged. Information in the AQAA indicated that appropriate maintenance and servicing of equipment and systems had been carried out and health and safety matters were being addressed. Appropriate policies and procedures were in place and had been reviewed last year or this. Manuals containing records of water safety checks, maintenance checks and fire safety checks were seen. A fire risk assessment had been carried out in May 2007 by the registered manager assisted by one of the trained nurses. Staff had received regular fire safety training and participated in fire drills. Accident records were well maintained. Summerdyne Nursing Home DS0000004147.V339978.R01.S.doc Version 5.2 Page 27 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 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 2 X X X X X X 2 STAFFING Standard No Score 27 2 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Summerdyne Nursing Home DS0000004147.V339978.R01.S.doc Version 5.2 Page 28 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. Standard Regulation Requirement Timescale for action 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 OP7 Good Practice Recommendations A camera should be available so that changes in the care of wounds can be monitored and responded to. However rights, privacy and dignity must be safe guarded. Consideration should be given as to how access to the laundry and the facilities provided, can be improved so that health and safety is safeguarded. 3. OP38 A programme should be drawn up and implemented for the fitting of approved bedroom door and ensuite door locks that provide privacy and safety for residents. Appropriate locks should also be fitted to all communal bathroom and toilet facilities. 2. OP26 Summerdyne Nursing Home DS0000004147.V339978.R01.S.doc Version 5.2 Page 29 4 OP22 Thought should be given as to how the storage facilities can be improved so that the space available to residents’ is not compromised and everyone can use the home safely. Summerdyne Nursing Home DS0000004147.V339978.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection Worcester Local Office Commission for Social Care Inspection The Coach House John Comyn Drive Perdiswell Park, Droitwich Road Worcester WR3 7NW 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 Summerdyne Nursing Home DS0000004147.V339978.R01.S.doc Version 5.2 Page 31 - 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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