Inspection on 10/03/09 for Sundial Lodge

This inspection was carried out on 10th March 2009.

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

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

Sundial Lodge 15/11/06

Sundial Lodge 16/02/06

Sundial Lodge 20/08/05

Sundial Lodge 09/02/05

Sundial Lodge 22/09/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Sundial Lodge Sundial Lodge Park Hill Road Torquay Devon TQ1 2EA     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: Caroline Rowland-Lapwood     Date: 1 0 0 3 2 0 0 9 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. that people have said are important to them: They reflect the things 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 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) 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.cqc.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Sundial Lodge Sundial Lodge Park Hill Road Torquay Devon TQ1 2EA 01803292889 01803291483 sundial.lodge@eclipse.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Sundial Lodge Ltd care home 48 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Sundial Lodge is registered to provide accommodation and care for a maximum of 48 people in the registration category of `Old Age?. The Home is situated in a residential area of Torquay and is less than a mile from the town centre. The Home has private transport facilities and is also on a public bus route. Information about the service is available from the service provider in the form of a Statement of Purpose and a Service Users? Guide. Copies of inspection reports are kept in the communal lounge and in the office and will be made available on request. Copies of reports can also be obtained from the CSCI Website. 0 Over 65 48 Care Homes for Older People Page 4 of 27 Brief description of the care home At the time of the inspection the fees ranged from #360 to #480 a week. Additional charges are made for providing meals and/or overnight accommodation for resident?s guests, professional manicures, pedicures and hairdressing, private telephone lines, magazines and newspapers and other items of a personal nature. Care Homes for Older People Page 5 of 27 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 quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This key unannounced inspection consisted of a visit to the home on Tuesday 10th March 2009. One inspector performed this inspection. During this time we spoke to the owner, the registered manager who is the person with day to day responsibility for the service, the administrator, the deputy manager , the chef and several care and ancillary staff. We spoke to 11 people who live in the home. We case tracked three people who use the service. Case tracking means we looked in detail at the care three people receive. We spoke to staff about their care, looked at records that related to them and made observations if they were unable to speak to us. Care Homes for Older People Page 6 of 27 We looked at three staff recruitment records, induction and training records and policies and procedures. We did this because we wanted to understand how well the systems work and what this means for people who use the service. All this information helps us to develop a picture of how the home is managed and what it is like to live at Sundial Lodge. What the care home does well: What has improved since the last inspection? What they could do better: Some further improvements to care planning will ensure that the people living at the home always get the care they need in a safe and consistent way. Care Homes for Older People Page 8 of 27 People that need a liquidized diet should have it presented in a way that is attractive and appetizing. Regular checks on the hot water must be done to ensure peoples safety. 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.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 27 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 10 of 27 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. The information provided means that people and their relatives have accurate information to decide whether Sindial Lodge is the home for them to be in. The admission procedure is good and means that staff have enough information to decide whether they are able to meet the needs of the person. Evidence: The Statement of Purpose and Service User guide are found in the reception area of the home. Both documents include the information that is needed for people to decide whether the home is the right place for them to be. Each document reflects the services that are provided. Surveys informed us that people had enough information given to them prior to moving into the home. Care Homes for Older People Page 11 of 27 Evidence: Each person is admitted following an assessment performed by the manager at the home. This assessment is used alongside assessments made by other health care professionals. Together this information is used to make an initial plan of care. Evidence was also seen of involvement of the person and their family. Care Homes for Older People Page 12 of 27 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. The health and personal care people receive is provided in a respectful and person centered way. The care planning systems at the home are generally good and reflect how health and personal care needs are identified and met in a safe way. However some improvements are needed to ensure staff know how to care for the individual properly. The management of medicines is good and helps protect people from risk. Evidence: Twelve surveys were sent out to people living at the home 7 said they always get the care and support they need and 5 said they usually do. Health care professionals who visit the home are largely satisfied with the standard of health care provided. One health care professional comments that the home Cares for patients in a caring and supportive environment Care Homes for Older People Page 13 of 27 Evidence: When we looked at the care of the three people we found that their health care needs are generally met. These people are registered with a doctor and see the chiropodist and optician when needed. Referrals are made to the district nurse and to the community psychiatric nurse. We looked at these peoples care plans and found that some were relevant and contained the information needed to care for the person properly whilst others were not totally up to date for example one said feisty today yet there was no instruction or guidance for staff with regard to challenging behavior and how best to manage it , another said needs help with feeding but there were no clear action to support this for instance, needing a soft diet. One person we visited had very specific needs with regard to hydration, moving & handling and pressure area care these were not documented fully in the care plans. However, staff were able to describe how individual care is delivered and had a good knowledge of the individual needs of each person. The management of medications is performed well at the home. We looked at where medications are stored in trolleys or locked cupboards. The senior care staff are responsible for management of the medication from receipt to disposal. Medicines are supplied mainly in a monitored dose system. The medication trolleys were clean, tidy and securely stored. A spot check of controlled drugs was performed and found to be correct and managed well. The records of administration were clear. To aid identification of the person to receive medication the records have photographs of each individual person living at the home who were in receipt of medication. All medications for disposal are recorded and signed for on collection as per the company and government policy. We received feedback from some health care professionals it said people are always treated with respect. We saw evidence of this, for example, staff were heard to talking to people in a kind and sensitive way and were seen knocking on bedroom doors before entering. During the inspection people looked cared with the finer details such as eye care, nail care and appropriate foot wear present. People told us that they were pleased with the attention they received from the majority of the staff. One person said I get on very well with the girls , they are very nice, polite, kind and helpful. Surveys showed that people and their relatives were also pleased with the care. Care Homes for Older People Page 14 of 27 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. The varied, well organised social and therapeutic activities provided for people is excellent. People also benefit from a wholesome balanced diet. Evidence: It is the stated philosophy of Sundial Lodge to provide the people living there with a home within a home. Most people have an apartment comprising of a bedroom and small kitchen and living area, they are encouraged to determine their own routines for daily living where possible. A programme of social activities arranged by the Home is given to each of the service users and includes three regular weekly shopping trips, one to the town centre, one to The Willows and one to St Marychurch. Other trips out are arranged in the summer months. Guest speakers are invited into the home to provide talks on a variety of topics and musical entertainers regularly visit the home. In addition to this bingo and armchair exercise sessions and coffee mornings are arranged. Holy communion is carried out at the home monthly and residents will be transported Care Homes for Older People Page 15 of 27 Evidence: to Churches of their choice if required. The home has library facilities and a tuck/essentials shop. Visitors are welcome at any time and, with prior notice and for a small charge, arrangements can be made for them to share a meal or to stay overnight in the guest suite. Transport is provided to enable people to attend local clubs and/or to visit friends in the community if they wish to do so. People who can and want to prepare their own breakfasts, afternoon tea and supper, they are provided with the groceries they need to do so and have their own kitchen facilities within their apartments. If people cannot use these facilities safely they are disconnected and all meals will be provided. If people do not wish to prepare their own light meals they will be provided for them. Lunch is the main meal of the day. This is a three-course meal and people living at the home are given a weekly menu plan to complete and return to the kitchen with their choices of starter, main course and dessert. Vegetarian options are always available. Special diets are catered for included soft and pureed meals, on this day the chef prepared a pureed meal but instead of serving each component of the meal separately on the plate it was served all together, this is poor practice. Records of meetings showed that the people living at the home have an input into menu planning. Most people eat their meals in their apartments, although some of the more dependent people use the communal rooms. Care Homes for Older People Page 16 of 27 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 who use the service and their relatives can be confident that their complaints and concerns will be listened to and acted on. The knowledge procedures and training in place for the Protection of Vulnerable Adults help to protect people. Evidence: People said they felt able to complain to staff and the manager in the home. Surveys also told us that people were able to complain. Comments included Yes I do know how to complain but have not needed to do so. and We have never needed to complain.The home has a record which is organised and clearly shows any complaints in along with the outcomes following an investigation. The CSCI has not received any complaints since the last time we inspected ( March 2007). We did not see anyone who was unnecessarily restrained in the home. Everyone we spoke with, without hesitation said they felt safe living at the home. Staff we spoke to said they felt able to talk to the manager about any worries or concerns. The home also operates a supervision and appraisal system in which staff Care Homes for Older People Page 17 of 27 Evidence: raised concerns that are discussed, recorded and acted upon. Staff told us they would have no hesitation to complain if the situation arose and would certainly report poor practice. Staff said they had attended Protection of vulnerable adult (POVA) training and had been informed of the different types of abuse and how to report them. All staff were aware they could speak with the CSCI if they were concerned about abuse. All staff have a criminal records bureau police check and a POVA register check performed before they are able to work. Care Homes for Older People Page 18 of 27 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. The individual apartments, with private bath/shower room and kitchenette facilities, enable the people living there to maintain their independence within this well maintained home. Evidence: Sundial Lodge is a listed Georgian mansion set in a large landscaped garden. Any renovations carried out on the building have been done sympathetically and the building retains much of its original charm. The people living at the home have private accommodation which is made up of apartments and each apartment contains a bed-sitting room or a sitting room with a separate sleeping area, an en-suite bath/shower room and a kitchenette. Most of the apartments are single but a small number of double apartments are available to accommodate couples. There is a very spacious communal lounge, which is ideal for large social events and small social meetings. Although people have their own private bath/shower facilities there is a communal bathroom and this has been fitted out to provide safe bathing facilities for people with physical disabilities. The bathroom, which is opposite the lounge, contains the only Care Homes for Older People Page 19 of 27 Evidence: shared toilet. A team of housekeepers and maintenance/gardeners/decorators are employed to keep the apartments, communal areas and office accommodation clean and in a good state of repair. A partial inspection of the premises showed that they are carrying out their duties efficiently and conscientiously as all parts of the home that were seen and the gardens were very clean and well maintained. The laundry facilities are located away from areas where food is stored and prepared and feedback from service users indicates that their laundry is done quickly and efficiently. Care Homes for Older People Page 20 of 27 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 are cared for by a stable well trained staff group who have had sufficient pre employment checks carried out. Evidence: Without exception, comments regarding staff were very positive. People and relatives used descriptions such as really very good, you cant ask for better and they will do anything for me. Off duty records are maintained and show that staffing levels are stable and supplied in sufficient numbers to meet the complex needs of people who use the service. In addition to the care staff, additional ancillary staff to clean, cook and attend to the laundry. The manager told us that staff at the home continue to cover shortages themselves whenever possible but also use an agency if necessary. Comments on call bell response times were, quick, within 5 minutes, 5 to 10 minutes. The care staff have received training in both general care duties such as manual handling, food hygiene, fire safety, health and safety and infection control. Some care staff have had additional training to understand the more complex needs of mental health problems including dementia. Staff told us that many care staff have an NVQ in Care Homes for Older People Page 21 of 27 Evidence: care at level 2 or above. Surveys read Courses are always on offer and we are encouraged to attend them and through induction and training I feel confident. Recruitment is well managed at the home. The administrator processes the actual application and chases CRB and references, whilst the manager interviews potential staff. Staff recruitment folders showed that the recruitment process is consistent with all staff being interviewed following completion of an application form. Applicants are asked to complete a criminal declaration and health questionnaire. Staff files also contained CRB and POVA recording information two written references and proof of identity including photograph from the driving license or passport. All staff files showed evidence that staff had completed an induction programme and had had a recent supervision session. Care Homes for Older People Page 22 of 27 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 competent Manager and staff at the home manage the home in an effective and efficient way. Evidence: The registered manager is Sonja Brotherton, she has over twenty years experience of managing a care service, is a Registered General Nurse and has completed her Registered Managers Award. She is also a qualified National Vocational Qualification Assessor. The registered provider is Steven Vans-Colina, he works at the home on a daily basis attends the business side of running the home, including finances. The Home has a quality assurance/quality monitoring system, using questionnaires to gain feedback from the service users, their friends and families. The information received had been analysis and areas for improvement had been identified. There is also a residents association and records of meetings with the management were seen. Care Homes for Older People Page 23 of 27 Evidence: These very clearly showed that the service users views, as expressed through their representatives, are listened to and acted upon. Most of the people living at the home are able to handle their own financial affairs or to gain the help they need from their families or a legal representative. Those that are assisted by the home have clear and up to date records kept of all transactions. The Annual Quality Assurance Assessment (AQAA) completed by the registered manager identified that all of the required and recommended policies and procedures are kept and are regularly reviewed. Copies are kept in the staff room to enable the staff to access them. The premises are very well maintained and recommendations from the most recent inspection by the Fire Safety Service had been dealt with quickly and efficiently. On the day of the inspection the water temperature was checked and found to be far too hot; this was immediately looked at by the manager and measures taken to rectify the problem. Records of staff training were seen to demonstrate that staff training is provided in health and safety related areas. Staff told us there are clear lines of management at the home. Staff said they felt the home was well organised and appreciated the open door policy of the manager and the owner at the home. Staff said the manager is very approachable, supportive and maintained confidentiality when personal issues are shared. Staff said they could come and discuss issues at any time. Staff told us there are staff meetings where new information is shared and is also an opportunity for staff to share ideas and concerns. All staff we spoke with told us they had receive mandatory training within the last year. Care Homes for Older People Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes R No £ 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 1 7 14, 15, 17, 24 The registered persons must 15/02/2007 ensure that detailed reviews of the services users needs and care plans are carried out and recorded. 18 The registered persons must 15/01/2007 review the day care staffing levels to ensure that sufficient staff are employed to provide care for the residents and to keep the residents needs assessments and care plans up to date. 2 27 Care Homes for Older People Page 25 of 27 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 1 2 7 15 Care plans should be kept up to date and contain only current information that is relevant. All pureed meals should be presented in a way which is attractive and appealing. Care Homes for Older People Page 26 of 27 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.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 © (2009) 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 27 of 27 - 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!