Inspection on 03/10/06 for Sunbury Nursing Homes

This inspection was carried out on 3rd October 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

Sunbury Nursing Homes 24/02/09

Sunbury Nursing Homes 06/10/05

Sunbury Nursing Homes 11/10/04

Sunbury Nursing Homes 27/04/04

Similar services:

Springfield House

Sutton Lodge Nursing Home

The Shelley

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Sunbury Nursing Homes Thames Street Sunbury On Thames TW16 6AJ Lead Inspector Denise Debieux Key Unannounced Inspection 3rd October 2006 09:30 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 Sunbury Nursing Homes DS0000017645.V313440.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. Sunbury Nursing Homes DS0000017645.V313440.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Sunbury Nursing Homes Address Thames Street Sunbury On Thames TW16 6AJ 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) 01932 785414 snhltd@snh.demon.co.uk Sunbury Nursing Homes Limited Mrs Ellen White Care Home 87 Category(ies) of Dementia - over 65 years of age (87), Old age, registration, with number not falling within any other category (87) of places Sunbury Nursing Homes DS0000017645.V313440.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. In the case of this service, service users may be admitted from the age of 60. 6th October 2005 Date of last inspection Brief Description of the Service: Sunbury Nursing Home has been a family business for a number of years. The Manager and her four children are the Registered Persons who are involved in the day-to-day running of the business. The home consists of several buildings, which are set in well-maintained grounds. The main building comprises of West Lodge, a grade 2 listed building, to which further substantial wings were added in the 1960s. Administration buildings are situated between the main building and Weir House, which provides accommodation to a further 22 service users. Some staff accommodation is also located in Weir House and West Lodge. The majority of bedrooms are single and there are a total of 11 double bedrooms. The main communal areas consist of a conservatory at the front of West Lodge and the drawing room on the ground floor of Weir House. Several smaller communal areas are to be found elsewhere in the home. The home is located close to local amenities and an attractive stretch of the river Thames. Accommodation and services, including nursing care, are provided to a maximum of 87 older people and those with Dementia. Fees range from £565 - £617 per week. This fee does not include personal professional services e.g. hairdressing, manicures, chiropody etc; personal items e.g. toiletries, newspapers etc. or transport. This information was provided on 25/09/06. Sunbury Nursing Homes DS0000017645.V313440.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced visit took place over 7 hours and was carried out by Denise Débieux, Regulation Inspector. Mrs E White (Registered Manager), Mr J White (Responsible Individual), Miss N. White, Mrs J. Hartland and Mr C. White were present as representatives for the establishment. A tour of the premises took place. Ten of the eighty-five service users and eight on-duty staff were spoken with during the visit. In addition, eighteen service user survey forms, eleven relatives/visitors survey forms and seventeen care worker’s survey forms were completed and handed in to the inspector on the day of this visit. Some of the comments made to the inspector and made on the survey forms are quoted in this report. The home had completed a pre-inspection questionnaire and service user care plans, staff recruitment and training records, health and safety check lists, menus, medication records and storage were all sampled. The lunchtime meal was observed and the home was toured. The inspector would like to thank the service users and staff for their time, assistance and hospitality during this visit. What the service does well: What has improved since the last inspection? Sunbury Nursing Homes DS0000017645.V313440.R01.S.doc Version 5.2 Page 6 The ongoing maintenance and redecoration of the home and gardens provide the service users with homely and comfortable surroundings in which to live. Staff starting work prior to receipt of a satisfactory Criminal Records Bureau certificate are now allocated a named member of staff as a supervisor. 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. Sunbury Nursing Homes DS0000017645.V313440.R01.S.doc Version 5.2 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 Sunbury Nursing Homes DS0000017645.V313440.R01.S.doc Version 5.2 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 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Each service user is only admitted to the home following a comprehensive needs assessment to ensure that the home can meet the service user’s identified needs. The home does not offer intermediate care. EVIDENCE: Six care plans were sampled during this visit. In each case comprehensive pre-admission assessments had been carried out prior to admission to ensure that the home could meet the service users’ identified needs. Thirteen of the eighteen service users surveyed felt they had received enough information prior to moving to the home and all relatives surveyed stated that they were satisfied with the overall care provided. Sunbury Nursing Homes DS0000017645.V313440.R01.S.doc Version 5.2 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 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Personal care and healthcare support and assistance is planned and was seen to be provided, where needed, in a respectful and sensitive manner. Policies, procedures and practices are in place to ensure the safe administration of medication. EVIDENCE: The care plans sampled during this visit were all based on pre-admission assessments and had been drawn up shortly after the service users’ admission to the home. Care plans sampled were comprehensive and set out actions which need to be taken by care staff to ensure that all aspects of the health and personal care needs of the service users are met. The staff carry out individual risk assessments covering the risk of falls, skin breakdown and the use of bed rails. Care plans are reviewed on a monthly basis and daily notes are kept that reflect the care given. These daily notes Sunbury Nursing Homes DS0000017645.V313440.R01.S.doc Version 5.2 Page 10 demonstrated that any changes or new concerns are recorded and promptly acted upon. The home is in the process of reviewing their care planning system. This was discussed during this visit and a recommendation has been made that the home develop and implement a nutritional risk assessment, include activities/social care as part of the service user’s care plan and that service users or their representatives sign the care plans to signify their involvement and agreement to the contents. It is also recommended that the care plans are expanded further to include more detail of individual service users’ preferences as to how their care is carried out. Of the eighteen service users who returned comment cards, fourteen stated that they always received the care and support they need, three answered ‘usually’ and one answered ‘sometimes’. One service user added that they ‘Couldn’t ask for better’ and one visiting relative said that ‘My mother is very well cared for at Sunbury Nursing Home and is very happy with her care.’ The lunchtime medication round was observed and the medication administration records, medication storage, policies and procedures were all sampled and found to be in order. During the tour of the home staff were observed to always knock before entering the service users’ bedrooms and all interactions observed between staff and service users were seen to be caring and respectful. Sunbury Nursing Homes DS0000017645.V313440.R01.S.doc Version 5.2 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 and 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The recent development of the home’s activity provision is leading to a more varied and individualised activity programme and includes contact with the local community both within and outside the home. Contacts with family and friends are encouraged. Meals are well-balanced and varied with individual choices and preferences catered for. EVIDENCE: Planned activities take place in the main part of the building, in the conservatory. Weir House service users have their own drawing room with activities and can also join the other service users in the main house. Service users are able to choose which activities they attend or participate in. One service user commented on how much she was looking forward to meeting the animals later this week (the home have arranged for a ‘mobile farm’ to visit for an afternoon). During a recent survey (two weeks ago) of service users carried out by the home, a number of service users had expressed some dissatisfaction about the activity provision at the home. The home identified that this is mostly related Sunbury Nursing Homes DS0000017645.V313440.R01.S.doc Version 5.2 Page 12 to service users who either are not able to or do not wish to join group activities. This was also reflected in the responses received by the inspector on the day of this visit. Of the eighteen service users who returned comment cards four said that there were always activities arranged by the home that they can take part in, five answered ‘usually’, three answered ‘sometimes’ and two answered ‘never’. The inspector notes that the home has already instituted positive measures to provide additional social interaction with the service users who responded to the home’s survey. This now needs to be taken forward to ensure that all service users have a wider choice and the opportunity to participate in social and recreational activities which suit their needs, preferences and capabilities. A requirement has been made. There are no restrictions to visiting times and staff support and encourage service users to maintain family links and friendships inside and outside the home. Menus were sampled and seen to be varied and well-balanced. The lunchtime meal was taking place during the visit and the food was presented in an appetising manner. Ample staff were present and offered help or assistance where needed in a discreet and sensitive way. The atmosphere in the conservatory on the day of this visit was convivial and unhurried. Of the eighteen service users who returned comment cards, ten said that they always liked the meals at the home, five answered ‘usually’ and two answered ‘sometimes’. One service user commented there is a ‘good choice of meals’. Sunbury Nursing Homes DS0000017645.V313440.R01.S.doc Version 5.2 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 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a simple, clear and accessible complaints procedure which includes timescales for the process. All required policies and procedures are in place to ensure that service users are safeguarded from harm or abuse. EVIDENCE: The home has a complaint’s procedure in place that is available to all service users and their relatives and is also included in the service users’ guide. There have been no complaints made to CSCI in the past 12 months. The home also has a ‘Whistle Blowing’ policy in place and basic awareness of the protection of vulnerable adults is included in the home’s induction training. A copy of the latest ‘Surrey Multi-agency Procedure for the Protection of Vulnerable Adults’ is available in the office. Five of the seventeen care staff surveyed were unclear of the correct procedure to follow if they suspected abuse and a recommendation has been made that the correct procedure is reviewed with all staff. All service users spoken with and surveyed told the inspector that they felt safe at the home. Sunbury Nursing Homes DS0000017645.V313440.R01.S.doc Version 5.2 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 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The location and layout of the home and gardens are suitable for their stated purpose. An ongoing maintenance and redecoration programme provides the service users with clean, pleasant and homely surroundings in which to live. EVIDENCE: Service users spoken with expressed their satisfaction with the accommodation provided at the home. Fifteen of the eighteen service users surveyed stated that the home was always fresh and clean, with two answering ‘usually’ and one answering ‘sometimes’. During the tour of the home the premises were seen to be well maintained with service users able to freely access all areas. All personal rooms seen were individualised to the service users’ wishes and were seen to contain personal items and mementos. Sunbury Nursing Homes DS0000017645.V313440.R01.S.doc Version 5.2 Page 15 The gardens are well kept, with many separate seating areas provided for the use of service users and their visitors in warmer weather. Laundry facilities are sited on the ground floor with washing machines appropriate for the needs of the service users at the home. On the day of inspection the home was found to be warm and bright with a homely atmosphere and a good standard of housekeeping apparent. Sunbury Nursing Homes DS0000017645.V313440.R01.S.doc Version 5.2 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 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The numbers and skill mix of the staff meets service users needs. Action must be taken to improve the staff recruitment procedures to ensure that service users’ safety is protected. The home has a comprehensive staff training programme which is designed to ensure, as far as reasonably possible, that service users are in safe hands at all times. EVIDENCE: The staff rota evidenced that staff are provided in sufficient numbers to meet the needs of the service users at the home. The home has been working towards achieving the minimum level of 50 of care workers qualified to National Vocational Qualification (NVQ) level 2 in care. Of the eighty-three carers currently employed at the home, eighteen have achieved NVQ level 2 in care, ten are due to complete the course in the near future and a further ten are in progress. During this visit the files of six recently recruited members of staff were sampled. All files were seen to contain the required checks, documents and information. However, at present the home has only been asking for employment histories for the last ten years and this needs to be amended to a full employment history, ensuring that any gaps in employment are fully explored. Sunbury Nursing Homes DS0000017645.V313440.R01.S.doc Version 5.2 Page 17 All staff starting work on a POVAfirst check, are now allocated to a named staff member for supervision pending the return of a satisfactory Criminal Records Bureau (CRB) certificate. The amended Schedule 2 of The Care Homes Regulations 2001 was reviewed with the management and requirements have been made. Sunbury Nursing Homes has a comprehensive induction and ongoing training programme and are in the process of ensuring that their training meets all areas required by the Skills for Care organisation (previously TOPSS) in their new induction standards. The training logs seen at this visit evidenced that all mandatory training and updates are provided promptly and the training records were well maintained and easy to follow. Additional training is provided that is relevant to the needs of the individual service users at the home. Service users spoken with were complimentary about the staff at the home. Of the eighteen service users surveyed, twelve stated that staff always listen and act on what they say, three answered ‘usually’ and one answered ‘sometimes’. One service user commented ‘I have only been at the home a short while but I feel very happy’. All relatives surveyed stated that they felt there were always enough staff on duty and that they felt welcome at the home at any time. All interactions observed between the staff and service users were caring and respectful. Sunbury Nursing Homes DS0000017645.V313440.R01.S.doc Version 5.2 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 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from the clear management approach at the home providing an open, positive and inclusive atmosphere. The home has an effective quality assurance and monitoring system in place that is based on seeking the views of the service users. Policies and procedures are in place to protect service users’ financial interests. All policies, procedures and practices are in place to ensure, so far as is reasonably practicable, the health safety and welfare of service users and staff. EVIDENCE: A total of seventeen care staff questionnaires were returned to the inspector on the day of this visit. From observations made on the day and from comments made on the staff questionnaire it is clear that the home have a close and happy staff team. To the question ‘What is the best thing about working here?’ answers included: ‘The training, care for service users and Sunbury Nursing Homes DS0000017645.V313440.R01.S.doc Version 5.2 Page 19 staff’, ‘Working together as a team’ and ‘The friendly atmosphere. It’s a rewarding job and to know each service user is happy and well cared for makes me happy.’ The home has an effective quality assurance and monitoring system in place that is based on seeking the views of the service users. The registered manager routinely tours the home and talks with service users and their visitors. In addition the home have now fully implemented regular quality assurance reviews (Regulation 26 visits). These reviews are comprehensive and take place every one-two months with service user surveys and views forming the central core of the system. The report for September this year had just been produced and provided to the inspector at the time of this visit. This report clearly shows that any issues raised during the service user surveys are acted upon and prompt action taken to resolve any concerns that may be raised. The home do not handle financial affairs for service users. However, on occasions when service users want valuables stored securely for a short period of time, the home has a safe which can be used. Any items stored in this way are recorded in the service users’ files and signed for. All required safety monitoring checks, fire drills and safe working practice training and updates have been carried out. Staff were observed to be following appropriate health and safety practices as they went about their work. All interactions observed between the staff and service users were inclusive, caring and respectful. Sunbury Nursing Homes DS0000017645.V313440.R01.S.doc Version 5.2 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 2 8 2 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 2 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 Sunbury Nursing Homes DS0000017645.V313440.R01.S.doc Version 5.2 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 Standard OP12 OP14 Regulation 16(1) (m)(n) Requirement The registered person must consult with individual service users about their social interests and the programme of activities provided by the home. All service users must be given the opportunity to participate in social and recreational activities which suit their needs, preferences and capabilities. Particular consideration to be given to those service users with dementia/confusion, sensory impairments and physical disabilities. The registered person must not employ a person to work at the care home unless he/she is fit to work at the care home and the registered person has obtained the information and documents specified in paragraphs 1-9 of Schedule 2 of The Care Homes Regulations 2001 (as amended by The Care Standards Act 2000 (Establishments and Agencies) (Miscellaneous Amendments) Regulations 2004). Timescale for action 03/01/07 2 OP29 19(1)(b) Schedule2 03/10/06 Sunbury Nursing Homes DS0000017645.V313440.R01.S.doc Version 5.2 Page 22 3 OP29 19(1)(b) Schedule2 The registered person must check all staff files and obtain the information and documents specified in paragraphs 1-9 of Schedule 2 of The Care Homes Regulations 2001 (as amended by The Care Standards Act 2000 (Establishments and Agencies) (Miscellaneous Amendments) Regulations 2004) retrospectively for all staff employed since 26th July 2004. 17/12/06 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 OP7 OP8 Good Practice Recommendations It is recommended that the registered person expand the service user care plans to include: • Nutritional risk assessments • Social care/activity plans • More in depth details of service users’ preferences • Service user/representative signature to indicate their involvement and agreement with the care plan. It is recommended that the registered person review, with all staff, the correct procedure to follow in relation to The Surrey Multi-agency Procedure for the Protection of Vulnerable Adults and any reports or suspicions of abuse. 2 OP18 Sunbury Nursing Homes DS0000017645.V313440.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Surrey Area Office The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN 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. 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