Inspection on 29/08/07 for Summerhill

This inspection was carried out on 29th August 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Summerhill 29/04/09

Summerhill 19/08/08

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 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Summerhill 46 Glenwood Road West Moors Ferndown Dorset BH22 0ER Lead Inspector Trevor Julian Key Unannounced Inspection 29th August 2007 09:45 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.V349492.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.V349492.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 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 Summerhill DS0000026878.V349492.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 2nd May 2006 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 £430 - £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.V349492.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place on the 29th August 2007 between 09:45 and 15:15. The purpose of the visit was to monitor progress with issues identified previously and to check the home against the National Minimum Standards. Before the inspection, Mrs Farrar had provided an Annual Quality Assurance Assessment of the home. This gave general information on the management systems and basic needs of the residents. Residents and visitors were invited to give their view on the home by returning comment cards nine were received from residents, one from a relative and one from a community nurse. During the visit, information was gathered through discussion with the residents, staff and Mrs Farrar, case tracking, review of records and a tour of the premises. Since the last key inspection in May 2006, the home had been visited twice once to follow up on the inspection and the other occasion to follow up on concerns that had been passed to the Commission. What the service does well: The records seen showed that there was a pre – admission assessment carried out before a place at the home was offered to prospective residents. There was evidence that following the assessment the home informed the person that they had the capacity to meet the identified care needs. One person recalled visiting the home before deciding to accept the accommodation. Care records were clear and showed how identified needs were met. There was evidence of a basic nutritional assessment. There was also evidence that the home involved healthcare professionals to address any health needs. Residents said the home contacted their GP as needed and that the staff managed medication sensitively. The mini bus had recently been returned to service and several people were looking forward to a trip out during the afternoon. There was no compulsion and some residents had decided not to go out. Another person appreciated the help that Mrs Farrar had given in arranging home visits. Two people regularly attended a local church and a priest visits one person for communion. Residents enjoyed the visiting library service. The residents described the food as very good. The meals were served in an unhurried manner; some residents were still eating breakfast at 10:00. Summerhill DS0000026878.V349492.R01.S.doc Version 5.2 Page 6 Residents comment card showed that they were able to raise concerns about the home. The home was clean and well aired. The rear garden provided a secluded seating area, which was used by several of the residents. Alterations had improved access to the garden. Comment cards and discussion with the residents showed that the staff were highly regarded by the residents. The majority of the staff had worked in the home for several years and provided good continuity of care. There was evidence that safety equipment was checked and serviced. Records also showed that fire safety checks and training was up to date. What has improved since the last inspection? What they could do better: The files of two people employed in the past year showed that recruitment practice still needed attention. Staff had started work without a Protection of Vulnerable Adults check being completed and the Criminal Records Bureau checks applied for late. There were unexplained gaps in employment history and there was significant information not disclosed on the application form. Significant events affecting the well being of the residents had not been reported to the commission. Mrs Farrar informed the inspector that the first floor windows had restricted openings however the ones checked during the visit were not restricted and posed a risk to the residents. The home had started to cover the radiators to reduce the risk of burns from hot surfaces however one had not been fixed and could cause a fall if residents tried to use it to steady themselves. Summerhill DS0000026878.V349492.R01.S.doc Version 5.2 Page 7 The homes system for recording accidents did not conform to current data protection practice. The notice board gave information on who had contributed to the minibus restoration fund including names of residents and their individual contribution, this compromises the dignity and privacy of the individuals living in the home. 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.V349492.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.V349492.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home’s pre-admission assessment process helps to ensure that the home is suitable for the prospective resident. EVIDENCE: Three files were used for case tracking, there was clear evidence that an assessment of needs had been completed and on the most recent admission there was a copy of a letter which confirmed that the home had the skills and facilities to meet the persons assessed needs. The contract shows that the first six weeks of residence is a trial period. One person had visited the home before moving in and another, who moved from outside the area to be closer to her family and had asked their family visit the home to confirm suitability. Summerhill DS0000026878.V349492.R01.S.doc Version 5.2 Page 10 The process would be improved if the admission assessment was signed and dated by the person carrying out the assessment and who had been involved in the assessment process. Summerhill DS0000026878.V349492.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 adequate. This judgement has been made using available evidence including a visit to this service. The people living at Summerhill have their health and social care needs monitored and reviewed to help inform staff how those needs are to be met. Medication is safely managed for the benefit of the residents. EVIDENCE: The files seen contained care plans based on the pre-admission assessment and subsequent reviews. The identified needs had been detailed and how those needs were to be met. Daily records showed that the care tasks were being completed. There was information on the files showing involvement of healthcare professionals to meet the health needs of the residents; these included community nurses, chiropodists, opticians and dentist. There was a separate record of social activities offered. There was evidence of weight checks where concerns were noted. The files held an assessment of the persons’ mobility and detail of any equipment provided to assist that person. Summerhill DS0000026878.V349492.R01.S.doc Version 5.2 Page 12 There had been concerns for the mobility of one person and an Occupational Therapist referral had been made by the resident’s surgery. Most files contained a photograph to help identification for medication etc. One person who had recently moved into the home said that he was able to stay with his old GP surgery. The home had changed to a monitored dosage system to manage the medication of the residents. The stocks were safely stored and the records seen were up to date and allowed an audit trail for items coming into and leaving the home. The records would be improved if there was information recorded about allergies or the records marked as “none known” if appropriate. The home assisted several people with managing their diabetes the records were clear about who was able to assist. The residents said they could ask for a visit by their GP as needed. One person commented that the staff were kind and considerate when helping her to manage her medication. Throughout the visit, the staff were seen supporting and helping the residents in a friendly and relaxed manner. People said the staff were always polite and helpful. On the main notice board there was information about the funding arrangements for repairs to the minibus it included details of how much individual residents had contributed to the fund, this could compromise the privacy and dignity of those living in the home. Summerhill DS0000026878.V349492.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. People are able to make decisions about their daily lives with help and support from the home. EVIDENCE: The home records the activities offered in the home. On the day of the visit Mr & Mrs Farrar took most of the residents out to a local abbey and gardens in the home’s minibus. Residents said that the minibus had only recently been put back on the road following servicing and MOT. Two members of staff were left at the home with the few remaining residents. The residents said they were invited to join the trip but there was no compulsion. Mrs Farrar said that the minibus was starting to be used again after the service. During the period that the minibus was not available, Mrs Farrar had arranged for entertainers to visit the home. Several residents said that they went out shopping with Mrs Farrar. Summerhill DS0000026878.V349492.R01.S.doc Version 5.2 Page 14 Two people attend a local chapel with support from friends. A priest visits the home and offers communion to another resident. Mrs Farrar had tried to get the local Anglican vicar to offer a communion service in the home. Postal votes are arranged for those who require them others are assisted to the polling station. Residents had access to a visiting library service who provided a range of typefaces. Most people were finishing their breakfasts at 10 am. Residents said that they could get up when they liked and breakfast was then served at 09:30, they felt this allowed them to feel unrushed and meant they could take a later lunch. During the afternoon one of the carers was baking cakes for the next couple of days, care was taken to ensure that alternatives were made for people on special diets. There were records of the meals offered although they did not always record when people had taken alternatives. The menus were based on the known preferences of the residents who said if they didn’t fancy a particular item could request something else. The comments cards showed very high levels of satisfaction with the meals provided and this was confirmed in the discussions with residents during the visit. Summerhill DS0000026878.V349492.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are confident that they can raise concerns or issues with the home and that those concerns will responded to appropriately. EVIDENCE: The home had a procedure informing residents and visitors about how they could raise concerns. It included contact details for the Commission. The comment cards all showed that people felt able to approach the owner if they had any issues. The home was continuing to train the staff in procedures to follow in the event of signs or allegations of abuse. The staff on duty were aware of their responsibilities. Summerhill DS0000026878.V349492.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 adequate. This judgement has been made using available evidence including a visit to this service. The home generally provides a safe and homely environment for the residents however some areas need attention to remove unnecessary risks. EVIDENCE: The rooms visited were comfortable and clean. A programme of fitting radiator covers had started to help reduce the risk of burns from hot surface temperatures. In one room, the radiator cover was loose and could result in the resident falling if it was used for support. Mrs Farrar stated all rooms on the first floor had restricted window openings, on two which were tried both opened wider than the recommended gap. Mrs Farrar agreed to check all the windows and ensure the restrictors were operating correctly. Each of the rooms were en suite; the rooms had accessible call points to alert staff if an individual was having difficulties. The rooms had been personalised by the Summerhill DS0000026878.V349492.R01.S.doc Version 5.2 Page 17 occupants. There were bathrooms on the ground and first floor and they were fitted with lifting seats to aid access. The ground floor bathroom also had a shower offering residents a choice. The home was clean and odour free. There was a separate laundry which had washable walls and floors to aid with cleaning and infection control. Disposable gloves and aprons were available. To the front of the property, work had been started to improve access by replacing the gravel drive. To the rear of the premises, there was a paved seating area which was enjoyed by several residents. A path leads out to another gravel area. The area was planted with shrubs and trees these were being cut back improve access. Summerhill DS0000026878.V349492.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 poor. This judgement has been made using available evidence including a visit to this service. Staffing levels were appropriate for the level of care required. The home’s recruitment process is not robust and places residents at risk. EVIDENCE: The home was staffed by two carers during the daytime and one waking and one sleep in person at night. Additionally Mrs Farrar lives next door and is available on call as needed. There was a staffing roster with the actual hours worked recorded in the home’s diary. The recruitment process was checked. The two files both had a current Criminal Records Bureau check however they were not in place before the employment started nor had Protection of Vulnerable Adults First checks been obtained. The records also showed that gaps in employment history were not examined and one file only contained one reference. On another file, serious information had not been disclosed on the application form, which later became known. Issues around recruitment have previously been identified and poor recruitment practice places all residents at risk. Summerhill DS0000026878.V349492.R01.S.doc Version 5.2 Page 19 The home has an induction programme and several staff were working through their NVQ level 2 in Care and one was working on her NVQ level 3. The home has a generally stable workforce with many having worked in the home for a long time this helps to provided good continuity of care. None of the comment cards identified any concerns about the staff or staffing levels. All those spoken with during the visit were very positive about the whole staff team. Summerhill DS0000026878.V349492.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, 35, 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Issues around the management of the home were being addressed to improve the safety of the residents. Practical measures were in place to ensure safety equipment and procedures were up to date. EVIDENCE: Mrs Farrar has the required qualification and many years experience in running a care home. During the last year she had taken time away from the home, whilst away standards fell and are now being reapplied. However, during that time, the home did not inform the Commission of a significant event affecting the wellbeing of the residents and as stated previously recruitment practice had been poor. Summerhill DS0000026878.V349492.R01.S.doc Version 5.2 Page 21 The home looked after personal allowances for three people. The monies were used to pay for additional expenses e.g. private chiropody, hairdressing etc. The records showed income and expenditure and the two balances that were checked matched the transaction record, however there was not always receipts for expenditure. The home’s public liability insurance certificate was on display and there were records confirming equipment safety checks. Fire records were up to date and there was evidence of fire safety training being carried out monthly. The home had a system for recording accidents to employees and residents, however the method used did not meet with current data protection requirements and it is recommended that a suitable approved system is introduced. Summerhill DS0000026878.V349492.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 N/A 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 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 X X X 2 X X 3 Summerhill DS0000026878.V349492.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? YES 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 OP10 Regulation 12 (4) a Requirement The registered person must ensure the home is conducted in a manner to respect the privacy and dignity of the residents. You are required to undertake the required checks on all staff who work at the home to ensure that appropriate staff are recruited to care for residents in the home. This includes: Criminal Records Bureau and Protection of Vulnerable Adults checks plus two references including one from the last employer. This requirement is repeated from the key inspection of 02/05/06. The registered person must ensure that where there are gaps in the employment history a written explanation is obtained. The registered provider must inform the commission of significant events affecting the wellbeing of the residents. Timescale for action 31/10/07 2. OP29 19 31/10/07 3. OP29 19 Schedule 2 37 31/10/07 4. OP38 31/10/07 Summerhill DS0000026878.V349492.R01.S.doc Version 5.2 Page 24 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 OP15 OP25 Good Practice Recommendations The record of meals taken by the residents should include alternative meals taken. The home should ensure that control measures identified in risk assessment remain effective. a) radiator covers are secure. b) window restrictors function correctly. Additional care needs to be taken with recruitment records to show that there has been robust decision making around any significant issues with Criminal Record Bureau checks. The registered person should ensure that the home’s accident recording is in line with data protection legislation. 3 OP29 4 OP38 Summerhill DS0000026878.V349492.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF 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.V349492.R01.S.doc Version 5.2 Page 26 - 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!