Inspection on 02/05/06 for Summerhill

This inspection was carried out on 2nd May 2006.

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

Summerhill 29/04/09

Summerhill 19/08/08

Summerhill 29/08/07

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 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Summerhill 46 Glenwood Road West Moors Ferndown Dorset BH22 0ER Lead Inspector Martin Bayne Key Unannounced Inspection 09:00 2nd May 2006 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 DS0000026878.V293385.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. DS0000026878.V293385.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Summerhill Address 46 Glenwood Road West Moors Ferndown Dorset BH22 0ER 01202 870935 NONE 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 Care Home 15 Category(ies) of Old age, not falling within any other category registration, with number (15) of places DS0000026878.V293385.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12th October 2005 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. DS0000026878.V293385.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The key inspection was unannounced and took place between 9am and 4.30pm. Mrs Farrar, the Registered Person assisted throughout the inspection. Five of the residents were spoken with about their experience of living at the home as part of the inspection. Two staff were spoken with and the rest of the time was spent discussing with Mrs Farrar how the service was run. Records required to be maintained at the home were viewed. What the service does well: What has improved since the last inspection? What they could do better: It is recommended that the home should have a controlled drugs cupboard that complies with Misuse of Drugs (Safe Custody) Regulations 1973. Recruitment procedures must be improved, ensuring that all of the records are in place and checks carried out in respect of new staff appointed to work in the home, as detailed within Schedule 2 of the Care Homes Regulations 2001. Adult protection policies and procedures must be updated to include POVA (Protection of vulnerable adults) and ‘No Secrets’. DS0000026878.V293385.R01.S.doc Version 5.1 Page 6 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. DS0000026878.V293385.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 DS0000026878.V293385.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): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A full assessment of need is carried out prior to a person being admitted to the home to ensure that their needs can be met. EVIDENCE: Since the last inspection of Oct 2005 there has been one resident who has been admitted to the home. This resident was admitted to the home for respite care, but then decided to move into the home permanently. The deputy manager had carried out a care needs assessment and in addition a copy of the care management assessment had also been obtained. Mrs Farrar informed that policy was for an assessment to be carried out by either herself or the deputy before a person is admitted to the home. Ideally she prefers the person to visit the home, but if needs be they are visited in their home or in hospital. The home does not provide an intermediate care service. DS0000026878.V293385.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): 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. Resident’s benefit from their care needs being set out in a plan of care, medication being administered in line with good practice and their health needs met. Resident’s privacy and dignity is respected at the home. EVIDENCE: Throughout the inspection three service user files were used to track records that are required to be kept on behalf of residents. For each person, a full care plan had been developed from the assessment process. The plans were typed and had been reviewed each month to ensure that they are kept up to date. Mrs Farrar informed that the plans are developed in consultation with residents and in some occasions, their relatives. The forms have a space in which residents are invited to sign, however Mrs Farrar said that many of the residents are not interested in signing these documents. The plans provided sufficient information for a new member of staff to provided care to that individual. DS0000026878.V293385.R01.S.doc Version 5.1 Page 10 With regards to their health care needs, residents spoken with said that the staff and Mrs Farrar were very helpful and would arrange for a doctor to visit should they request. There was also information recorded in the care plans and daily recording sheets that demonstrated that health care needs were met. The records also provided evidence that other health needs, such as dentistry; eye care, chiropody and hearing were arranged through staff at the home. At the last inspection a requirement was made concerning the administration of medicines at the home. A subsequent full pharmacy inspection found additional issues that required addressing. Mrs Farrar informed that the practice found at the pharmacy inspection of decanting medications into pots and then subsequently administered by another member of staff had stopped. Practice now is for one member of staff to take medication directly from the container supplied by the pharmacist, administered to the appropriate resident and then recorded on the medication administration record. Mrs Farrar also informed that the home was changing in May to having medicines delivered to the home in a unit dosage system. A maximum/minimum thermometer had also been ordered to ensure that medicines that require refrigeration are kept at optimum temperature. The two storage cabinets in the kitchen were inspected and it was found that medicines were being stored correctly. The medication administration records were seen and these were being completed correctly with no gaps in the record. It was reported that all of the staff who administer medications were to receive training through the pharmacist on medication administration. The district nurse has also been into the home and provided training for the staff on how to drawn up insulin for a resident who requires assistance with administration of insulin for diabetes. The requirements made at both inspections had been complied with. The residents spoken with said that the staff were kind, courteous and respectful of their privacy and dignity. They informed that they received their mail unopened and should a doctor visit receive treatment in their own room. DS0000026878.V293385.R01.S.doc Version 5.1 Page 11 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, 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 spiritual and recreational needs being met at the home and being able to receive visitors. Personal choice of residents is respected within the home. Residents are provided with choice of food catering to specialist diets. EVIDENCE: On arrival at the home at 9am the residents were congregating in the lounge prior to their breakfast being served in the dining room. There were recorded entries in the daily recording sheets seen, that residents are able to get up and go to bed when they chose. One resident informed that they had not gone to bed until late the evening before as they were watching the final of the snooker championships on the television. After lunch one of the staff assisted in a group game for all of the residents in the main lounge. The daily diary gave space for recording what activities take place in the home. It was seen that some form of activity takes place each afternoon in the home. Within the last weeks prior to the inspection all of the residents had been taken out to see DS0000026878.V293385.R01.S.doc Version 5.1 Page 12 a visiting circus. One resident informed that enjoyed the garden, another said that liked to read and that the visiting library calls at the home. Mrs Farrar informed that the spiritual needs of residents are catered for, with a catholic priest visiting the home each week. Due to a change of local Church of England minister, there was currently no Church of England service being held in the home. Mrs Farrar informed that two residents choose to go out each week to a local Sunday service. Through discussions with residents it was found that visitors are welcome at the home at any time, but are encouraged not to visit during mealtimes. The inspector was able to speak with two friends of one resident, who were visiting at the time of the inspection and they informed that they were made welcome at the home and were impressed with its cleanliness. From the records of one of the residents tracked through the inspection, it was evident that residents are able to bring their possessions and a record is maintained of all furniture brought into the home. Mrs Farrar informed that residents have access to their personal files should they so request. The residents spoken had differing views on the standard of food provided in the home, but overall their judgements were that the food was of a reasonable standard. There was evidence through the care planning system that likes, dislikes of residents are known and that at the time of inspection specialist diets were catered to in respect of diabetes and a gluten allergy. The daily diary is where a record is maintained of food provided to residents and this reflected that there was a varied and wholesome menu served to the residents. It was agreed that a fuller record would be maintained in future, naming those residents who had differing options. Mrs Farrar explained that being a small home there was no set rotation of menus and that residents are consulted each week before the weekly shop on choices for meals the week ahead. The home does not employ a cook, with carers doing separate shifts when they are on duty to cook the midday meal. All of the staff who work in the kitchen have had Basic Food Hygiene training. DS0000026878.V293385.R01.S.doc Version 5.1 Page 13 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 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents benefit from having a full and well publicised complaints procedure being available to them, however better protection to residents would be afforded if all current policies and procedures be available to the staff at the home. EVIDENCE: The complaints procedure is detailed within the Service User Guide and the Terms and Conditions of residence. Each resident is given a copy of these documents on entering the home and are therefore informed of the complaints procedures. Mrs Farrar also informed that residents are often told through the residents meetings on how to complain. The home maintains a log of complaints, however none have been made to Mrs Farrar since the time of the last inspection. There have been no complaints brought to the attention of CSCI. The complaints procedure of the home conforms to the guidance set out in the Standards for older people. At the last inspection it was agreed that the internal adult protection policies and procedures would be updated to include the introduction of POVA and ‘No Secrets’. It was found at this inspection that this is yet to be done. It is required that these policies and procedures are updated as they form part of the package to keep staff informed on adult protection matters. The situation remains the same as at the time of the last inspection with the staff receiving cascade training form Mrs Farrar on adult protection. DS0000026878.V293385.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): 19 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s benefit from a safe well maintained environment where infection control standards are maintained. EVIDENCE: On the day of inspection the home was clean, in good decorative order and there were no adverse odours. Summerhill provides a homely and comfortable environment for the residents and there is a mature garden to the rear of the home that has ramps to provide a level access for the residents. At the last inspection it was reported that the radiators in the home had been risk assessed as to the hazard that they posed to residents in respect of burns and one radiator has been covered. It was strongly recommended that the home develop a plan for the covering of radiators. It was found at this inspection that one further radiator had been covered after a risk assessment was carried out resulting from a deterioration in this person’s health. The DS0000026878.V293385.R01.S.doc Version 5.1 Page 15 recommendation remains that safety of residents would be promoted with a plan to cover all of the radiators. With regards to infection control, the home has policies and procedures in line with best practice. Gloves and protective clothing are provided to the staff to minimise cross infection. The home has a laundry area that complies with the standards. The home also provides a sluicing sink for the cleaning of commodes, although it was reported that these are rarely used in the home. DS0000026878.V293385.R01.S.doc Version 5.1 Page 16 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 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents needs are met at the home through adequate staffing levels and appropriate training, however safety of residents could be compromised by failure to undertake criminal records bureau checks on all of the staff. EVIDENCE: The recommendation made at the last inspection in relation to staffing has been adopted and a cleaner has been added to the staffing compliment. In other respects the staffing levels remain the same as at the time of the last inspection with two care staff on duty throughout the daytime and either Mrs Farrar or the deputy manager additionally on duty. The cooking is carried out by one of the carers who unless an emergency situation prevails, is not on care duties when cooking. The residents spoken informed that staffing levels were satisfactory. A standing rota was seen, reflecting the above staffing levels. A record is maintained in the daily diary of who has worked which shift each day. It was found at this inspection that all of the staff have now received mandatory training in moving and handling. The home has a longstanding staff team who have all received core training for caring for older people. 50 of the staff team have achieved NVQ level 2, thus meeting the standard. Since the time of the last inspection there has been one new member of staff who has started working at the home. This person and two other members of DS0000026878.V293385.R01.S.doc Version 5.1 Page 17 staffs’ records were used to track through the home’s recruitment procedures. A CRB had not been taken up with respect to the new member of staff as Mrs Farrar was under the misapprehension that being a cleaner, a CRB was not required. CRB forms had been received in respect of all staff. A requirement was made that all staff who work in the home have a CRB check. DS0000026878.V293385.R01.S.doc Version 5.1 Page 18 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 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 the home being well managed with health and safety of staff and residents promoted and their best interests being served. EVIDENCE: Mrs Farrar is responsible for the management of the home and has a deputy who is currently undertaking training in NVQ level 4. The staff spoken with said that Mrs Farrar was approachable and that there was an open and transparent management of the home. Mrs Farrar does not hold or take responsibility for any residents’ finances. Relatives taking on this responsibility should it be required. DS0000026878.V293385.R01.S.doc Version 5.1 Page 19 The fire logbook was inspected and it was found that tests and inspections had been carried out to the required timescales. Certificates were also seen for the maintenance of the lift. There were no hazards identified during the inspection. The accident book was seen and provides a record of accidents in the home. The home carries out an annual survey of residents and relatives views that forms part of the quality audit of the home. Mrs Farrar also keeps letters received from relatives about the performance of the home. DS0000026878.V293385.R01.S.doc Version 5.1 Page 20 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 2 10 3 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 2 X X X X X X 3 STAFFING Standard No Score 27 3 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 DS0000026878.V293385.R01.S.doc Version 5.1 Page 21 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. 2. Standard OP29 OP18 Regulation Schedule 2 13 (6) Requirement You are required to carry out CRB checks on all staff who work at the home. You are required to obtain copies of local adult protection policies and procedures. Timescale for action 24/05/06 10/06/06 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 OP19 Good Practice Recommendations It is recommended that the risk assessments of the radiators be updated and any radiators that pose any risk to residents be covered. The home should have a CD cupboard that complies with the Misuse of Drugs (Safe custody) Regulations 1973. If the dose on the medicine label is incomplete, or differs from the MAR chart, the doctor should be asked to clarify and update the next repeat prescription. 2. OP9 DS0000026878.V293385.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI DS0000026878.V293385.R01.S.doc Version 5.1 Page 23 - 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!