Inspection on 11/11/08 for Sundial Cottage

This inspection was carried out on 11th November 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

Sundial Cottage 07/12/06

Sundial Cottage 08/11/05

Sundial Cottage 02/06/05

Sundial Cottage 03/02/05

Sundial Cottage 09/12/04

Sundial Cottage 03/02/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

Extracts from inspection reports are licensed from CQC, this page was updated on 30/01/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Sundial Cottage Badminston Drove Fawley Southampton Hampshire SO45 1BW     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Patricia Trim     Date: 1 1 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Sundial Cottage Badminston Drove Fawley Southampton Hampshire SO45 1BW 02380891031 02380891031 sundialcottage@hotmail.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Gillian Elizabeth Veal Type of registration: Number of places registered: Mr N Sykes,Mrs L Beale care home 22 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Sundial Cottage is registered to provide personal care and accommodation for 22 older people who may, or may not, have dementia. The home is privately owned. The home has 17 bedrooms, 5 of which are doubles, and offers a separate dining room and two lounges, one with a conservatory that overlooks the garden. Accommodation is arranged over two floors, with a passenger lift providing easy access between floors. The fees given at the time of the visit are from 415 to 585 pounds per week. There are additional charges for hairdressing, chiropody, newspapers, and toiletries and for hospital visits, where the person is accompanied by a staff member. Care Homes for Older People Page 4 of 28 Over 65 22 22 22 0 0 0 Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The information used to write this report was obtained in the following ways. We looked to see if we had received any complaints about the home and saw that we had not. We also looked at any information the home had given us about what might have happened since we visited. We used some of the information the provider gave us about the home in a form called the Annual Quality Assurance Assessment (AQAA). This is a form the home has to fill out every year to tell us what they are doing to make sure the home gives the people who have used the service the care that they want. Care Homes for Older People Page 6 of 28 We also used information we received from surveys. We sent 5 surveys to people who use the service to ask what they thought about it and received five surveys back. We also sent 4 surveys to health care professionals and received 2 back. We sent 5 staff surveys to the home and asked they be distributed to staff. We received 5 surveys back. A 6 hour visit was made to the home by one inspector to carry out a key unannounced inspection. During the visit 3 of the people who use the service were spoken with to get their views about the care they receive. Time was spent observing staff practice and interactions between people who use the service and staff. There was also an opportunity to speak with 3 visitors. Time was spent discussing the service provided and any future plans with the registered manager and provider. A partial tour of the home was carried out and a random selection of records viewed. 3 people who use the service were case tracked. This means their records were looked at to see how the provider identified their needs and made sure they were met. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 28 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service get enough information about it to make a decision about whether they wish to move in. Detailed pre admission assessments enable the registered manager to be sure the service can meet the persons needs before offering them a place. Evidence: The statement of purpose and service user guide give good information about the service and are available in large print and photographic formats which ensures they are accessible to people with differing needs. Five people who use the service said they had sufficient information to enable them to decide whether to move in, although one person felt they could have asked more questions. One person wrote I spoke to Jill and Lorraine. They showed me this room and said it would be mine. I like my room. Care Homes for Older People Page 10 of 28 Evidence: The AQAA recorded that detailed pre admission assessments are completed before someone moves in and people are invited to visit the service before reaching a decision. Three people who have recently moved into the service were case tracked. Each of these had a detailed assessment completed, which recorded what they could do as well as what help they needed. For example, one recorded that the person was able to manage their personal care, but needed help in managing their medication. Further information had been gathered from care management assessments and from a personal history, completed with the person and their family. Where the person was in hospital, or living in another care home, a transfer sheet had been obtained to give further information. Care Homes for Older People Page 11 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Detailed care plans ensure people consistently receive their personal care in the way they like it. People who use the service have access to a wide range of health care services which makes sure their health care needs are monitored and met. Staff have the training and guidance they need to manage medication safely. Evidence: Three care plans were viewed. These showed that information obtained through the assessment is used to provide a care plan for each person who uses the service that enables them to maintain their independence and dignity. Plans recorded what someone could do for themselves, for example, wash their face and hands, together with what staff needed to do to help. This might be prompting or giving physical assistance. Comments from people who use the service showed that staff gave them care as recorded in the care plans. One person said The girls always help me. I like to do it for myself, but I know they are there for me, whilst another commented they always Care Homes for Older People Page 12 of 28 Evidence: chose what they wore each day. Feedback from surveys completed by people who use the service showed they felt they were always offered the care they needed and that staff always listened to and acted on what they said. Risk assessments were completed for any area of concern, such as nutrition, manual handing or going out independently. These are monitored and reviewed on a monthly basis, together with mental health needs, social and emotional needs and dependency levels. This information is used to identify whether any aspect of the care plan needs to be amended. Records showed that people who use the service have access to a wide range of health care services and the home works closely with other health care professionals. Feedback from two health care professionals showed they felt staff were alert to health care needs and made relevant referrals. People who use the service were supported to regularly see the chiropodist, optician, primary health care team and specialist services such as community psychiatric nurses and diabetic specialist nurses. The majority of medication was provided by the local pharmacist in a monitored dosage system on a monthly basis. The medication was checked into the home and kept locked in a metal cabinet for storage. Staff said they were not permitted to give out medication until they had completed an accredited training course. Recently 7 staff had attended a course. Staff were observed giving medication, following good practice guidance. Medication administration records were completed immediately after the member of staff had given the medication to the person, using the recommended codes. This included a recorded of any medication given as required. A record was kept of any medication returned to the pharmacist for disposal. The AQAA recorded that staff are required to complete a Skills for Care induction course that includes discussing core values such as privacy and dignity and the rights of people who use services. A relatives survey, carried out in October by the management of the home, showed that 58 felt staff attitude was excellent and 42 felt it was good. People who use the service, spoken with during the visit, said staff were very kind and patient. Staff were observed throughout the day giving assistance to people, quietly and sensitively. A member of staff, assisting one person in eating the main meal was seen to help them at the persons own pace. Staff always knocked on bedroom doors and waited until permission was given to enter. The registered manager was seen giving Care Homes for Older People Page 13 of 28 Evidence: unopened post directly to the person it was addressed to. Care Homes for Older People Page 14 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are able to make choices about how they spend their time. They are offered a range of activities that provide mental stimulation and that they enjoy. Well balanced meals are provided that give people some choice and that the majority of people enjoy. Evidence: People who use the service are able to make choices about how they spend their day. Care plans record their preferred daily routine. At 9 a.m. some people were up and dressed, having breakfast, whilst others came down later in their dressing gowns to have theirs. Staff said the number of people who needed help from the day staff each morning varied, as people chose when they wanted to get up on a daily basis and night staff assisted those who wished to get up early. People were seen during the day, moving freely around the home, spending time in the variety of communal areas provided, or their rooms. They read their papers or books, watched television or listened to music. A wide range of organised and informal activities are provided which include helping Care Homes for Older People Page 15 of 28 Evidence: staff with daily tasks such as folding linen or joining in flower arranging and playing board games. Staff spend time talking with people on a one to one basis or helping them with simple memory games. People who use the service said they liked the activities provided, and although some chose not to join in, they were always invited to. Social events are celebrated, such as peoples birthdays and Armistice Day was remembered on the day of the visit, with everyone marking the two minute silence and staff sitting with people talking about their memories. A summer and Christmas party are held and families said they enjoyed attending these. Regular trips out are organised. The registered manager is good at finding suitable transport and had arranged a meal out for everyone and a theatre trip to a band concert in the next few weeks. Entertainers also visit the home regularly. Peoples religious needs are recorded on admission and relatives said a minister visits the home to give communion to those who wish to receive it. Feedback from three relatives visiting the home showed they felt they were always made welcome. They said they were given information about their relative and contacted when there was a concern. Families are asked to help complete a personal history for each person who uses the service and information about family contact is included in the assessment. Information in the surveys completed by 5 people who use the service showed the majority of them liked the food provided. Two people spoken with during the visit said the enjoyed their meals, but one did not. This was discussed with the registered manager who said she would speak with the person concerned to see what changes could be made. Staff take it in turns to cook the main meal and to make cakes. On the day they cook they are not included in the care hours. The home has a four week menu plan. On the day of the visit the main meal comprised honey and mustard chicken with crispy or mashed potatoes, peas, cauliflower and broccoli. On some days there is a choice of main meal, but the registered manager said people could always have an alternative any time they wished. Nutritional assessments are completed for people who use the service, which identify any dietary problems, such as difficulty in swallowing. The staff cooking on the day of the visit said two people had diabetes. They did not have any special diet, but were encouraged to eat sensibly. Care Homes for Older People Page 16 of 28 Evidence: The AQAA identified planned improvements for the next year includes continuing to develop staffs understanding of dementia and nutritional training for staff. People who used the service were sensitively assisted to eat their meals independently. For example, plate guards were used and one person always had their meal on a white plate to help them see the food more clearly. Those that needed assistance with eating were helped discreetly and at their own pace. Care Homes for Older People Page 17 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have the information they need to make a complaint and are confident they will be listened to. Staff have the training and guidance they need about safeguarding to minimise the risk to people who use the service. Evidence: The 5 people who completed survey forms felt they knew how to make complaints and were confident their concerns would be addressed. Relatives said they also had information on how to complain and felt that concerns raised with the provider were quickly resolved. Information about the complaints procedure is given to eveyone who moves into the home. The AQAA stated that no complaints had been received by the service since the last inspection, neither had the commission received any. The home had a policy and procedure in respect of safeguarding and staff spoken with demonstrated a good understanding of it. The AQAA recorded that one member of staff had completed a Train the Trainer course in safeguarding and had given staff refresher training in September. Part of the improvements planned for the next year included making sure all staff have a good understanding of safeguarding and the Mental Capacity Act. The provider and registered manager have both had experience of working with the safeguarding procedures and have worked with Adult Services to ensure the safety of Care Homes for Older People Page 18 of 28 Evidence: people who use the service. Care Homes for Older People Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are able to live in a clean, comfortable environment that meets their needs. Staff have the information and training they need to minimise the risk of infection for people who use the service. Evidence: People who use the service said they liked their environment and thought the home was kept clean. The home employs a cleaner and there is a cleaning schedule to make sure all areas are cleaned regularly. The AQAA recorded that there was a programme of renewal and renovation and a number of bedrooms had recently been redecorated. The home employs a handyman to carry out minor repairs and a record is kept of anything staff need him to do. The home has a large lounge, dining room and quiet lounge. There are also a number of areas provided with seating so people have choice about where they spend their time. There is also a garden and patio area that people said they liked spending time in when the weather was good. Staff had completed training in respect of infection control, the safe handling of cleaning products and had written guidance about dealing with clinical waste. There Care Homes for Older People Page 20 of 28 Evidence: was a laundry procedure so staff had the information they needed to deal with soiled linen safely and the washing machine had a disinfection programme. The home had a contract for the removal of clinical waste. Care Homes for Older People Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are supported by well trained staff, in sufficient numbers to meet their needs. Evidence: Feedback from people who use the service showed they felt staff were always available to meet their needs. Comments included They come as soon as I need them. Staff also felt the staffing levels were sufficient to meet the needs of people who use the service. The staff rota showed there were 3 staff on duty during the day. They were complemented by a cook, cleaner, handyman and administration assistant. The registered managers hours were allocated for her management role, although she occasionally worked a shift to monitor practice in the home. The providers also visited the home regularly. Feedback from the 5 staff surveys and from talking to 2 care staff during the visit showed they felt their recruitment had been thorough and fair. The registered manager had a checklist to enable her to monitor the recruitment procedure. The records for 2 staff, recently recruited, demonstrated the procedure had been followed. Both staff had completed all the relevant checks, such as providing information about Care Homes for Older People Page 22 of 28 Evidence: previous employment, proof of identity and qualifications. The provider had obtained 2 references and a Criminal Records Bureau (CRB) and Protection of Vulnerable Adults (POVA)check before making an offer of employment. Staff said they thought they had good induction and training. The registered manager used a training matrix to monitor training needs and arranged a wide variety of training. All staff were required to complete a Skills for Care induction programme and were encouraged to continue their development by completing National Vocational Qualifications (NVQ). The AQAA recorded that 11 out of 21 staff had completed this qualification and the registered manager said more staff were currently undertaking it. Recent courses included training that enabled staff to support people with specific needs, such as sensory deprivation, palliative care and challenging behaviour. All staff are supported to have on going training in respect of dementia care. Care Homes for Older People Page 23 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed for the benefit of the people who use the service and people are able to give feedback about the service they receive. Regular staff training and the regular maintenance of equipment minimises the risk of accidents to people who use the service. Evidence: The registered manager has worked at the home for many years and had completed her management qualifications. She continues to develop her practice by attending relevant training courses and researching developments in dementia care. The AQAA recorded there was an open door management style and people who use the service felt the management listened to any concerns they might have. Feedback from staff showed they felt the home was well managed. Comments included The manager is extremely thorough and there is good communication and relationships are good between staff and manager. Care Homes for Older People Page 24 of 28 Evidence: Relatives spoken with felt involved in supporting people who use the service, commenting that communication was good and that they were always contacted if there was anything they needed to know. The home has organised relative meetings and sends out an annual questionnaire. A summary of the results was displayed in the home so people could see what issues had been raised and how the management had resolved them. The registered manager said she was trying to find more ways of getting feedback from people who used the service. A pictorial survey was being developed. The AQAA recorded that staff received regular supervision. Staff confirmed this and said it was used to discuss practice issues and training needs. The registered manager said people were encouraged to manage their own money or to appoint someone to do it on their behalf. Families are invoiced for any expenditure. The registered manager has a system for monitoring staff training needs in respect of health and safety. Records showed that regular training and refresher training is provided in all aspects of health and safety such as first aid, infection control and moving and handling. Records are kept of any accidents or injuries to people who use the service. Notifications of these are sent to the commission when necessary. The AQAA gave information about the servicing of equipment and a random selection of service contracts seen confirmed these had been carried out. Records also showed that staff receive regular fire safety training and in house fire safety checks are completed. Care Homes for Older People Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 27 of 28 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 28 of 28 - 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. 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