CARE HOMES FOR OLDER PEOPLE
Summerfields House Rest Home 12 Burton Road Branston Burton On Trent Staffordshire DE14 3DN Lead Inspector
Rachel Davis Unannounced Inspection 8 March 2006 10:30 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 Summerfields House Rest Home DS0000005009.V284799.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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. Summerfields House Rest Home DS0000005009.V284799.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Summerfields House Rest Home Address 12 Burton Road Branston Burton On Trent Staffordshire DE14 3DN 01283 540766 01283 540766 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) Mrs Annette Gilliland Mr Mark Gilliland Mrs Annette Gilliland Care Home 21 Category(ies) of Dementia - over 65 years of age (7), Old age, registration, with number not falling within any other category (21), of places Physical disability over 65 years of age (3) Summerfields House Rest Home DS0000005009.V284799.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 23rd August 2005 Brief Description of the Service: Summerfields care home is a privately owned large Victorian detached house that has been extended to provide accommodation for 21 older people with needs associated with old age, seven of which may have dementia care needs and three of who may have physical disability. The home is not registered for service users with nursing needs. Health service professionals such as district nurse, community psychiatric nurse, and physiotherapist are accessed when required and local GPs and a pharmacist service the home. The home is situated on a main road in a residential area of Burton on Trent, within a short distance of the town centre with all its amenities, a bus route passes the door and parking is available. Accommodation is provided on two floors the first floor being accessible by shaft lift as well as a staircase that is fitted with a stair chair lift. On the ground floor there are ten single bedrooms and one double bedroom, and on the first floor there are seven single and one double bedroom. Three of the single bedrooms on the ground floor have en-suite facilities. There are two assisted bathrooms, one on each floor, plus a domestic style bathroom and seven separate toilets located throughout the premises. Communal facilities consist of two lounge areas and a dining room. Externally there are secure garden areas to the rear that include a pleasant patio area that has been fitted with garden furniture. There was one vacancy in a shared facility on the day of inspection. Summerfields House Rest Home DS0000005009.V284799.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was carried out over four hours by one inspector who used the National Minimum Standards for Older People as the basis for the inspection. This visit only covered a small number of the national minimum standards, to ascertain a full picture this report should be read alongside the unannounced inspection held on 23rd August 2005. The inspection included an examination of records, indirect observation, and discussions with service users, visitors, the proprietor and staff. The home continues to meet the majority of national minimum standards; one requirement was made as a result of this visit. What the service does well:
Staff at the home generate a friendly, professional and consistent approach, this is both comforting for the service users and welcoming for visitors. Comments included: “I am happy and well looked after” “They are lovely people, they treat you well” “My relative is happy here, I can visit whenever I please” A menu is available every day and those service users asked said that the food provided was very good. The management team work in partnership with other professional bodies to ensure the best outcome for the service users. Summerfields has the appropriate Protection of Vulnerable Adults policy and procedure in place, training in the recognition of abuse has also been provided. Staff supervision is regular and recorded. The establishment places strong emphasis on Health and Safety. Summerfields House Rest Home DS0000005009.V284799.R01.S.doc Version 5.1 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 report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Summerfields House Rest Home DS0000005009.V284799.R01.S.doc Version 5.1 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 Summerfields House Rest Home DS0000005009.V284799.R01.S.doc Version 5.1 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1 The statement of purpose and service user guide provide adequate information for permanent and prospective users to enable them to make an informed decision about the suitability of the home. EVIDENCE: The revised Statement of Purpose was examined and it was clear that further work had been undertaken to provide an informative and detailed document that would assist potential service users when considering moving into the home. A copy of the new Statement of Purpose has been sent to the Commissions’ area office as required. Summerfields House Rest Home DS0000005009.V284799.R01.S.doc Version 5.1 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not inspected on this occasion. Please refer to the last inspection report. EVIDENCE: Summerfields House Rest Home DS0000005009.V284799.R01.S.doc Version 5.1 Page 10 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 and 13 There is a range of activities open to the service users to meet their needs, family and friends are encouraged to visit. EVIDENCE: Summerfields ensures that the service users differing expectations and preferences to lifestyle are met. Some service users choose to become actively involved with the running of the home; others go to out to lunch twice weekly, some service users visit the local shops, others are encouraged to partake in activities organised within the home. These include baking, card making, reminiscence sessions, bingo and cards for example. Others were receiving visitors in their rooms or reading, knitting, talking or watching television. “The activities coordinator is very good, I am very impressed.” “I like to help with the chores, I vacuum, peel the vegetables and help with the dishes.” “I enjoy what goes on, we are a happy household.”
Summerfields House Rest Home DS0000005009.V284799.R01.S.doc Version 5.1 Page 11 A relaxed and informal impression was apparent. The Commission talked about diversity with the proprietor on this occasion. It was evident that individuals’ needs would be well researched. Considerations were dealt with as the need arose, the staff were enthusiastic on receiving specialist training and understood the needs of the resident group well. Further support is offered from visiting professionals as and when required. Summerfields House Rest Home DS0000005009.V284799.R01.S.doc Version 5.1 Page 12 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Service users were aware of how and who to complain to, they were protected from abuse by the home’s adult protection procedure and their on-going training programme. EVIDENCE: The home has an appropriate complaints procedure and each service user had a copy of this within the Service User Guide. Service users spoken with knew that if they wanted to complain they could speak with the manager or a member of staff. A complaints book was in place, this record includes the nature of the complaint, when and by whom (if known) the complaint was made, how the complaint was dealt with, including the outcome. No entries have been added since the last inspection. The proprietor ensures that complaints issues are also continually monitored through the homes quality assurance process. Summerfields has introduced a ‘comments and compliments’ book to enable individuals to informally pass comment if they so wish. Summerfields House Rest Home DS0000005009.V284799.R01.S.doc Version 5.1 Page 13 Remarks within this included: Please provide signage for the toilets and also add the service users name to their bedroom door, the proprietor assured the Commission that these requests have been actioned. One protection of vulnerable adults referral has been made to the Commission since the last inspection, it was unfounded. Summerfields has an Adult Protection procedure and a handbook on what constitutes abuse is available for all staff. All new members of staff receive various types of training as part of their induction and this includes training on how to protect service users from abuse. Summerfields House Rest Home DS0000005009.V284799.R01.S.doc Version 5.1 Page 14 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not inspected on this occasion. Please refer to the last inspection report. EVIDENCE: Summerfields House Rest Home DS0000005009.V284799.R01.S.doc Version 5.1 Page 15 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 All staff are suitably trained to carry out their duties, the homes recruitment practices are, in the majority of instances, in line with the National Minimum Standards. EVIDENCE: Summerfields has a robust recruitment procedure that ensures that their staff are suitable to work with vulnerable people. Staff files examined showed that they were well ordered and evidenced that thorough pre employment checks were carried out. One file seen that did not contain the required, Protection Of Vulnerable Adults (POVA) check. This must be initiated and is a requirement of this report. The home also ensures there is evidence to confirm that the staff are both physically and mentally fit for purpose. Discussions with the service users and relatives revealed that “The staff are very caring” and
Summerfields House Rest Home DS0000005009.V284799.R01.S.doc Version 5.1 Page 16 “Regular staff are in place that are very approachable.” Staff also confirmed that: “They get on, communicate well and are a really good team.” The staff compliment and their deployment were discussed with the service users; it was considered that there were generally sufficient levels available to meet their needs. Evidence was available to support the fact that the staff were well trained and were offered continual professional development opportunities. Summerfields House Rest Home DS0000005009.V284799.R01.S.doc Version 5.1 Page 17 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 and 38 Robust recording systems are in place within the home. Structured and methodical processes ensure procedures are completed safely and are well documented. EVIDENCE: Service users spoken to were aware of who the manager and proprietor were and were positive in their responses. Staff too felt that the management team “respond well.” and that “ team work was good.” Comments also included: “The proprietor is always available, she will always ring the home when she is not on duty to make sure everything is ok”
Summerfields House Rest Home DS0000005009.V284799.R01.S.doc Version 5.1 Page 18 The home could further improve systems by reintroducing resident/ relative meetings; the proprietor will investigate whether this would be well received by incorporating this thought within the homes questionnaires. The proprietor ensures the service users control their own money except where they choose not to. The records of financial involvement were scrutinised on this occasion. Where the money of an individual was handled, appropriate recording and receipts were kept. Not all monies checked were as recorded, a recommendation to further tighten their system was made. The inspector examined a range of records and service documentation which evidenced that the health, safety and welfare of service users and staff were protected: Fire extinguishers and fire alarm tests, emergency lighting, staff drills and training were all in date. Legionella information and water outlet recordings were in place. Portable Appliance Testing (PAT) had been undertaken in January 2006. Building and fire risk assessments were in date. The registered manager, proprietor and staff team are committed to ensuring that the best quality of care is offered to each individual, this was a positive inspection. Summerfields House Rest Home DS0000005009.V284799.R01.S.doc Version 5.1 Page 19 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 3 X X X X X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 X X X X X X X X STAFFING Standard No Score 27 3 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Summerfields House Rest Home DS0000005009.V284799.R01.S.doc Version 5.1 Page 20 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP29 Regulation Schedule 2 (7) Requirement The registered person must ensure all members of staff are in receipt of all pre employment checks. Timescale for action 17/03/06 19(1)(b)(i) 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. 2. Refer to Standard OP33 OP35 Good Practice Recommendations Following consultation the registered manager should consider reintroducing relative/resident meetings. The registered manager should consider strengthening their financial transaction records. Summerfields House Rest Home DS0000005009.V284799.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Stafford Office Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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