Inspection on 21/07/05 for Sunflowers

This inspection was carried out on 21st July 2005.

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

Sunflowers 04/04/07

Sunflowers 27/01/06

Sunflowers 22/02/05

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

CARE HOME ADULTS 18-65 Sunflowers 37 Pembury Road Westcliff-on-Sea Essex SS0 8DU Lead Inspector Helen Laker Unannounced Thursday 21st July 2005 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 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. Sunflowers I56 S49075 Sunflowers V233806 210705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Sunflowers Address 37 Pembury Road Westcliff-On-Sea Essex SS0 8DU 01702 434943 01702 434943 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Summer Care Homes Ltd Miss Susan Helen Bray CRH Care Home 6 Category(ies) of LD Learning Disability (6) registration, with number of places Sunflowers I56 S49075 Sunflowers V233806 210705 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. Personal care to be provided to 6 residents with a learning disability. 2. Maximun number to be cared 6 (six). 3. The age of the service users will be between 18 to 65 years. Date of last inspection 22nd Feburary 2005 Brief Description of the Service: Sunflowers provides residential accommodation for six adults with learning disabilities.The home is situated in residential area of Westcliff on Sea close to the sea front, shops and local facilities. The homes facilities include five single bedrooms, four with ensuite facilities, a large lounge, a dining room, and a kitchen with access to a garden at the rear.There is off street parking at the front, with room for two vehicles. Sunflowers I56 S49075 Sunflowers V233806 210705 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a routine, unannounced inspection which took place over four hours with one inspector in the home. There was a tour of the premises and grounds and an inspection of records and documentation. Time was spent discussing the care of the six service users, as all were out on the day of inspection. The manager and one member of staff were spoken with. Twenty seven National Minimum Standards were inspected on this occasion, twenty seven overall outcomes were met and one minor recommendation detailed in the full report. Discussion of the inspection findings took place with the manager at the end and throughout the inspection and guidance was given. What the service does well: What has improved since the last inspection? What they could do better: Records and care documentation in the home have improved and the staff are provided with essential information to assist them in understanding the needs and wishes of the service users. The manager informed the inspector that care plans now document physical care needs and associated goals and interventions. Please contact the provider for advice of actions taken in response to this Sunflowers I56 S49075 Sunflowers V233806 210705 Stage 4.doc Version 1.30 Page 6 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Sunflowers I56 S49075 Sunflowers V233806 210705 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Sunflowers I56 S49075 Sunflowers V233806 210705 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2 Each service user has a contract directly with the home if privately placed or a statement of terms and conditions if funded by social services. EVIDENCE: Examination of the file of the last service user admitted to the home revealed that a full assessment was provided by the social worker and a pre assessment carried out by the manager. This was evidenced at the last inspection also. Sunflowers I56 S49075 Sunflowers V233806 210705 Stage 4.doc Version 1.30 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7,9 Service users know their assessed and changing needs, they can make decisions and participate in all aspects of the home. Each service user has an individual plan and service users are supported to take risks as part of an independent lifestyle via a process of assessment EVIDENCE: Service users care plans examined were found to be comprehensive and covered all service users assessed needs. The home uses the Person Centred Planning system to ensure service users needs are met. Service users are involved in the formation and review of their care plans. Care notes sampled evidenced service users choices in respect of daily activities of living. Where choices were restricted this was recorded and risk assessments were in place to support the decision made. There was evidence of service user involvement in the risk assessments sampled, which evidences good practice. At the homes previous inspection, service users were noted to be encouraged and supported wherever appropriate in making decisions in respect of their daily lives and risks are managed through a system of assessment with the involvement of service users. Sunflowers I56 S49075 Sunflowers V233806 210705 Stage 4.doc Version 1.30 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,15,16,17 Service users are encouraged and supported with opportunities for personal development by way of access to a wide variety of training and educational colleges, day centres and overall their rights and responsibilities are recognised in their daily lives. EVIDENCE: This standard remains unchanged since the last inspection. Service users attend day centres and local education and training facilities and partake in a wide variety of practical and leisure activities, details of which are recorded in care notes. All service users were out on the day of inspection. Staff encourage and support service users to access all the local community facilities. Service users are included in the local voters register, they are supported and encouraged to maintain links with family and friends. Daily routines were noted to still be flexible and influenced by service users choice wherever it is appropriate. Service users are encouraged to maintain and develop independence according to their assessed capabilities. One service user chose not to attend college at the time of this inspection. Where service users capabilities impede or pose risk, this is now facilitated by way of an assessment of associated risks. Sunflowers I56 S49075 Sunflowers V233806 210705 Stage 4.doc Version 1.30 Page 11 The home’s menus are discussed at service users meetings. Service users assist with shopping and participate in food preparation according to their assessed capabilities. Nutrition assessments are carried out on admission and individual nutrition records maintained. Sunflowers I56 S49075 Sunflowers V233806 210705 Stage 4.doc Version 1.30 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18,19,20 Good arrangements are in place to ensure that the health care needs of service users are identified and met. EVIDENCE: The home has a key worker system. Personal care is provided in service users bedrooms and bathrooms. All service users in the home are fully mobile and are able to manage their personal care with supervision. Care plans evidenced that service users health care needs are regularly assessed and appropriate measures taken, including referral to health care professionals. The home uses a pre-dispensed system for the administration of tablet medication. Staff receive training in house and by the local pharmacist. Protocols were seen for medication prescribed as and when required (PRN) and risk assessment were in place for self-medication. Medication administration records (MAR) were seen to be appropriately completed. Medication was stored securely in the office. Sunflowers I56 S49075 Sunflowers V233806 210705 Stage 4.doc Version 1.30 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22,23 The home has effective procedures in place to ensure that service users are protected from abuse, neglect and self-harm. EVIDENCE: There had been no complaints received by the home since the previous inspection. The home has an appropriate complaints policy and procedure which has been developed in a pictorial format for the service users and included in the service users guide. The home has a clear policy for recognising and managing issues around the protection of vulnerable adults. The manager and deputy manager have attended Adult Protection Training. The home has policies and procedures regarding managing aggression and difficult behaviour which is covered upon staff induction and through ongoing training. Sunflowers I56 S49075 Sunflowers V233806 210705 Stage 4.doc Version 1.30 Page 14 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,25,26,27,28,29,30 Sunflowers was clean, bright and well maintained and provided the service users with homely and comfortable surroundings. Noticeable improvements have been made to the décor of the home internally and externally. EVIDENCE: The home is a large semi detached house close to the seafront and local shops. It continues to offer a good standard of accommodation for the service users. The carpet in the corridors and on the staircase has been renewed along with one ceiling due to an unfortunate collapse and decorating was evident. The accommodation in terms of space remains unchanged and continues to meet the standard. Service users bedrooms viewed were noted to be of a good size, well furnished and decorated and personalised to each individual service users taste. Only one of the service users have a lock to their bedroom door. The home has sufficient bathroom and toilet facilities and provides sufficient communal space for its service users. This includes a large well furnished lounge and a separate dinning room. There is a medium size garden to the rear of the house in which the paving slabs were being evened and hanging baskets being made with the service users help. Sunflowers I56 S49075 Sunflowers V233806 210705 Stage 4.doc Version 1.30 Page 15 The manager previously informed that all the service users are fully mobile and do not require any adaptations to the premises and that these would be provided if necessary. The home was seen to be clean and tidy throughout. Both the kitchen and laundry were to a good domestic standard. COSHH materials are stored in the laundry and service users have access through the home risk assessment procedures. Sunflowers I56 S49075 Sunflowers V233806 210705 Stage 4.doc Version 1.30 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 34,35,36 The procedures for the recruitment and training of staff have safeguards in place to offer protection to people living in the home. The home has an effective and competent staff team. EVIDENCE: No new staff have been recruited since the last inspection. Staff files examined show that appropriate procedures were in place for recruitment and contained all the information to meet this standard. The manager informed previously that the proprietors develop the Groups training programme centrally. All mandatory training requiring renewal has been planned for 2006. Staff files evidenced staff receive individual supervision every two months. A schedule for this was seen and the format was seen to be appropriate. Annual appraisals have now been developed and are being done. Sunflowers I56 S49075 Sunflowers V233806 210705 Stage 4.doc Version 1.30 Page 17 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,39,42 There is leadership, guidance and direction to staff and the home has in place practices that promote and safeguard the health, safety and welfare of the people using the service. EVIDENCE: The registered manager has worked at Sunflowers since the home opened and has over 20 years experience in working with the client group. The manager demonstrated that she had the qualifications, competencies and experience to ensure that the home is managed in a manner which promotes the aims and objectives of the home. The manager holds NVQ level 4 in care and has completed the registered managers award and is awaiting certification. The proprietors have achieved “ Investors in People” award. Quality questionnaires have been issued to service users and relatives. The proprietors have organised the group’s managers to meet on a regular basis to look at quality issues throughout all the homes in the group. Regulation 26 visits are being made on a monthly basis and submitted to the Commission. Sunflowers I56 S49075 Sunflowers V233806 210705 Stage 4.doc Version 1.30 Page 18 The manager was aware of her duties under Health and Safety. Policies and practices are in place for ensuring Health and Safety in the home. Some staff are awaiting a refresher courses in Health and Safety which have been booked for 2005/6. Up to date safety certificates were seen for services and equipment. Regular weekly checks are carried out on the fire alarm emergency lighting and hot water temperatures. Regular fire safety drills are carried out. A monthly health and safety inspection is carried out and results submitted to the groups head office. Sunflowers I56 S49075 Sunflowers V233806 210705 Stage 4.doc Version 1.30 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 x 3 3 x 3 3 3 Standard No 31 32 33 34 35 36 Score x x x 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Sunflowers Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 x 3 x x 3 x I56 S49075 Sunflowers V233806 210705 Stage 4.doc Version 1.30 Page 20 No Are there any outstanding requirements from the last inspection? 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 Regulation Requirement Timescale for action 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 20 Good Practice Recommendations It is recommended that any transcribed medication have two signatorys Sunflowers I56 S49075 Sunflowers V233806 210705 Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection Kingswood House Baxter Avenue Southend-on-Sea Essex, SS0 8DU National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Sunflowers I56 S49075 Sunflowers V233806 210705 Stage 4.doc Version 1.30 Page 22 - 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!