Inspection on 19/08/08 for Summerhill

This inspection was carried out on 19th August 2008.

CSCI found this care home to be providing an Good service.

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

Summerhill 29/04/09

Summerhill 29/08/07

Summerhill 02/05/06

Summerhill 12/10/05

Summerhill 15/04/05

Summerhill 29/11/04

Summerhill 12/07/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 19/12/2008.

CARE HOMES FOR OLDER PEOPLE Summerhill 46 Glenwood Road West Moors Ferndown Dorset BH22 0ER Lead Inspector Martin Bayne Unannounced Inspection 19th August 2008 10:00 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 Summerhill DS0000026878.V367882.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. Summerhill DS0000026878.V367882.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Summerhill Address 46 Glenwood Road West Moors Ferndown Dorset BH22 0ER 01202 870935 NONE summerhillwestmoors@hotmail.com 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 D K Farrar Manager post vacant Care Home 15 Category(ies) of Old age, not falling within any other category registration, with number (15) of places Summerhill DS0000026878.V367882.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 29th August 2007 Brief Description of the Service: Summerhill residential home is registered to provide personal care and accommodation to 15 people with frailty of old age. The home is situated in a quiet residential area of West Moors with a level walk to the local shops and bus routes to the nearby towns of Poole and Bournemouth. The home is a detached property with a car park to the front and a wellmaintained secluded garden to the rear. All of the bedrooms are for single occupancy and are provided with en-suite WC facilities. A passenger lift provides access to the first floor. Residents share communal areas of a large lounge that leads to the garden, a small conservatory and a separate dining room. Mr & Mrs Farrar, the registered providers live in a property adjacent to the home and are actively involved in the management of the service. In August 2007, the weekly fees were between £438 - £500. Additional charges were made for hairdressing, chiropody, etc. See the following website for further guidance on fees and contracts: http:/www.csci.org.uk/about_csci/press_releases/better_advice_for_people_ choos.aspx Summerhill DS0000026878.V367882.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. We, the Commission, carried out an unannounced key inspection of Summerhill on the 19th of August 2008 between 9:15am and 1:30pm. The aim of this inspection was to evaluate the home against the key National Minimum Standards for older people and to follow up on the four requirements and four recommendations made at the last key inspection in August 2007. Mrs Farrar, the registered provider, and the staff on duty assisted us throughout the inspection, providing us with information and records about how the care and support of residents was managed at the home. During the inspection we spoke with eight of the residents accommodated at the home, two relatives of residents, two members of staff and with one district nurse who was visiting the home on that day. Information was also gathered from the returned Annual Quality Assurance Assessment document, AQAA, to help form the judgement s contained within this report. We also carried out a tour of the premises. What the service does well: The home ensures that it can meet the needs of people accommodated at the home through carrying out a full pre-admission assessment of their needs. When a person is admitted to the home, a care plan is developed with them to ensure that their health and social care needs are met. We found that residents’ social and health needs were being met through the care planning system. Medicines are administered safely in the home. Residents are well supported by a long-standing and caring staff team. Summerhill DS0000026878.V367882.R01.S.doc Version 5.2 Page 6 Residents’ leisure and recreational needs are addressed through a programme of individual and group activities. The home provides a good standard of food with nutritional assessments being carried out when required. Residents and relatives of fully informed of how to make complaints. Staff are recruited in line with the regulations. The staff are trained and are competent to carry out their job descriptions. Summerhill provides a ‘homely’, clean and safe environment. Generally the home is well managed and run in the interests of the residents. What has improved since the last inspection? What they could do better: Medication administration procedures could be improved by maintaining a sample of staff signatures of those staff who administer medication, and through a checking mechanism to ensure that hand entries on medication administration records are made correctly. Summerhill DS0000026878.V367882.R01.S.doc Version 5.2 Page 7 Although moving and handling and adult protection training is provided to staff, we recommend that an accredited training provider carry out this training. A duty staff roster is maintained but action should be taken to ensure that this is kept up to date. 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. Summerhill DS0000026878.V367882.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 Summerhill DS0000026878.V367882.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): 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from their needs being assessed prior to being offered a place at the home, ensuring that Summerhill is suitable placement. EVIDENCE: Throughout the inspection we looked at the personal files for two residents admitted to the home since August 2007 to track record keeping that the home is required to keep by Regulation. We found that in the case of both residents, they had been given the opportunity to visit the home together with their relatives to assist in their choosing a suitable placement. We were told that at the time of visiting, residents and relatives are given copies of the home’s brochure and Service User Guide to assist them in making the decision Summerhill DS0000026878.V367882.R01.S.doc Version 5.2 Page 10 as to whether to move to the home. We saw that Mrs Farrar had also carried out an assessment of both residents’ needs to ensure that the home was able to meet these. Following the pre-admission assessment of need, a letter had informed the residents that their needs could be met with a formal offer of a placement at the home. The report of August 2007 recommended that the admission assessment process could be improved by the pre-admission assessment of need form being signed and dated. We saw on this occasion that both assessment documents had been signed and dated. One resident told us, ‘ I felt at ease as soon as I came here’. The home does not provide an intermediate care service. Summerhill DS0000026878.V367882.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. Residents benefit from their health and care needs being met through the care planning system, through their privacy and dignity being respected and through medication being administered safely. EVIDENCE: We looked at the care plans for both residents tracked through the inspection that had been developed from the assessment of need. We saw that the residents concerned had signed their care plan, indicating that they had been involved in their development. Both residents had relatively low care needs and the care plans were adequate in informing staff how they should assist the residents. Mrs Farrar told us that she was aware that residents with higher Summerhill DS0000026878.V367882.R01.S.doc Version 5.2 Page 12 needs would require more in-depth care plans. The residents we spoke with told us that the staff were very supportive and that their care needs were being met. The entries within the daily recording notes provided further evidence to this effect. The residents we spoke with said that their needs were being met. We saw that for each resident a moving and handling assessment had been completed and where there were concerns about a resident’s weight, a nutritional assessment had also been carried out. We saw that for one resident a risk assessment had been carried out concerning the risks posed by an uncovered radiator. Skin care risk assessments are completed as required. We found that the health needs of residents were being met at the home. The district nurse we spoke to told us that the home made referrals appropriately should residents have nursing care needs. We saw within the care plans and daily records that all residents were registered with a GP, and that needs concerning dentistry, eye care needs and chiropody were also being attended to. We observed the interaction between staff and residents and it was evident that there were good relationships between the two. Residents we spoke with told us that they were treated with respect and their right to privacy was upheld. We looked at how medication administration was managed within the home. We found that the medication administration records had a photograph of each resident at the front of their medication records, so that a new member of staff could easily identify them. We saw that residents with any known allergies have these recorded at the top of their medication records, as recommended at the last inspection. Medication administration records were being completed correctly with no gaps in the recording. We recommend that where hand entries have to be made to the medication records, a second person checks the record and signs that medications have been entered correctly. We also recommend that a sample of staff signatures of those staff trained to administer medication be maintained, so that it is possible to determine from the records which member of staff administered medication. We saw the medicines were being stored correctly and that systems would allow a full audit of medication entering the home. Summerhill DS0000026878.V367882.R01.S.doc Version 5.2 Page 13 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 benefit from their social and recreational needs being met and through being provided with a good standard of food. EVIDENCE: The residents we spoke with told us that they were satisfied with the activities and mental stimulation provided at the home. We saw that residents were informed for the week ahead of activities that had been planned. These included a session of exercises, escorted walks, quizzes, and a ‘legs and feet pampering’ session. We were also told that the occasional outing is arranged, as the home has a minibus for taking residents on outings. Residents recently went to Exbury Gardens and also to a variety show in Christchurch. Oneperson told us that they go out to attend day-care. Residents told us that a hairdresser visits the home as well as the visiting library. One resident described to us their view of the home, saying, ‘It is heaven on earth’. Summerhill DS0000026878.V367882.R01.S.doc Version 5.2 Page 14 Another resident said, ‘ I was so scared but so glad that I came to Summerhill’. One relative told us that they were very happy with the way their mother was looked after. Another relative told us that their relative had been very afraid of losing their independence but found that the home had given them a role and allowed them to be as independent as possible. We were told that residents are supported concerning spiritual needs and we saw that these needs are addressed at the time of assessment. One resident attends a local church. We asked residents about the standard of food provided in the home. In general the feedback was positive with residents telling us that the staff knew of their likes and dislikes. At the last inspection it was recommended that more detailed records be kept of the food provided, to include alternative meals provided to some residents. We saw the records of food provided and these now informed of what each resident had been provided with. We saw that nutritional assessment tools were being used to monitor residents where there were concerns regarding loss of weight. We also saw that within care plans there were instructions for staff and residents who needed assistance with eating. Summerhill DS0000026878.V367882.R01.S.doc Version 5.2 Page 15 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. Residents benefit from being informed of how to make complaints and through staff being trained in adult protection, although we recommend that an outside trainer give this training. EVIDENCE: Relatives and residents are informed of how to make a formal complaint, as the complaints procedure is detailed within the Service User Guide and also the terms and conditions of residence. We saw that the complaints procedure includes contact details for the Commission. We saw that staff are trained in-house in adult protection. We were told through the AQAA that training through an external provider was being arranged. This will be followed up at future inspections. The home has policies and procedures relevant to ensuring safety of residents. Summerhill DS0000026878.V367882.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from a well-maintained and homely environment. EVIDENCE: Since the last inspection the front drive has been tarmaced and provides a safer surface to the gravel drive it replaced. The front gardens have also been re-landscaped making a more welcoming entrance to the home. We were told through the AQAA that five bedrooms have been redecorated with residents being involved in choosing curtains and colours. The downstairs bathroom has also been refurbished with a new bath, and bath hoist being fitted. On the day of inspection we found the home to be clean, free from unpleasant odours and Summerhill DS0000026878.V367882.R01.S.doc Version 5.2 Page 17 in good decorative order. The home has a garden and patio area leading from the lounge. We were told that there were plans to have the back garden relandscaped with residents being involved in choosing the layout. Risk assessments have been carried out concerning uncovered radiators and those deemed a high risk have been covered. The home has thermostatic mixer valves installed to hot water outlets of baths and showers to protect residents from scalding water. The home has a dedicated laundry area that is suitable for the needs of the home and is sited away from food preparation areas and has washable walls and floors to aid cleaning and infection control. Gloves and protective clothing are made available to staff. Summerhill DS0000026878.V367882.R01.S.doc Version 5.2 Page 18 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 adequate. This judgement has been made using available evidence including a visit to this service. Residents benefit from there being sufficient staff employed to meet their needs and the staff being trained and recruited in line with the Regulations. EVIDENCE: The residents we spoke with told us that the staff were caring and there were sufficient numbers of staff to meet their care needs. During the daytime, from 8 a.m. to 10 p.m. there are always two carers on duty as well as domestic staff. During the night-time period there is one awake member of staff on duty and one person who carries out a sleep-in duty. The record of staff who had covered each shift is detailed within the daily diary. We saw a staff duty roster. The staff work to a fixed shift pattern so that generally the same staff work the same shifts each week. We recommend that this be kept under review as the duty roster we saw detailed a member of staff who had now ceased working at home, so the roster was not accurate. We looked at the recruitment records for one member of staff who had been employed to the staff team since the last key inspection. We found that all the Summerhill DS0000026878.V367882.R01.S.doc Version 5.2 Page 19 recruitment checks and records required under Schedule 2 of the regulations had been complied with. At the last key inspection a recommendation was made that the recruitment process be made more thorough. We found that this recommendation had been complied with and the recruitment process was clearly recorded. The returned AQAA informed us that home had reached a level of 50 of the staff team being trained to NVQ level 2 or above. We looked at a sample of staff training records and saw that staff receive core mandatory training. We recommend that manual handling training be provided through an accredited trainer. Summerhill DS0000026878.V367882.R01.S.doc Version 5.2 Page 20 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. Residents benefit from a well managed home. EVIDENCE: Mrs Farrar, the registered provider has the required qualifications and many years experience of running Summerhill. In general we found that the home was well managed with records being kept up to date, staff being supervised and the premises being maintained. We saw that equipment used in the home was being serviced to required timescales and looking at the fire logbook, we Summerhill DS0000026878.V367882.R01.S.doc Version 5.2 Page 21 saw that required tests and inspections to the fire safety system were being carried out as required. At the last inspection it was recommended that the accident recording be maintained in line with data protection legislation. We found at this inspection that this recommendation had been complied with. At the last inspection a recommendation was made concerning window restrictors, as some windows opened wider than the recommended gap. We found this inspection that Mrs Farrar had seen to this matter. Summerhill DS0000026878.V367882.R01.S.doc Version 5.2 Page 22 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 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 2 11 X 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 3 X X X X X X 3 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Summerhill DS0000026878.V367882.R01.S.doc Version 5.2 Page 23 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 OP9 Good Practice Recommendations We recommend that: • A sample of signature be maintained of those staff trained to administer medication to residents. • That where hand entries have to be made to the medication administration records, a second member of staff checks and signs that the record has been completed correctly. We recommend that action is taken to ensure that the staff duty roster is kept up to date so inform who is to work each shift. We recommend external training for staff be provided by an outside trainer in adult protection and moving and handling. 2. 3. OP27 OP30 Summerhill DS0000026878.V367882.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection South West Colston 33 33 Colston Avenue Bristol BS1 4UA 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 Summerhill DS0000026878.V367882.R01.S.doc Version 5.2 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!