Inspection on 04/04/07 for Sunflowers

This inspection was carried out on 4th April 2007.

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 27/01/06

Sunflowers 21/07/05

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 Inspection 4th April 2007 10:00 Sunflowers DS0000049075.V326705.R01.S.doc Version 5.2 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 Sunflowers DS0000049075.V326705.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 Adults 18-65. 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. Sunflowers DS0000049075.V326705.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Sunflowers Address 37 Pembury Road Westcliff On Sea Essex SS0 8DU 01702 434943 01702 434943 bray67@blueyonder.co.uk 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) SummerCare Homes Ltd Miss Susan Helen Bray Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Sunflowers DS0000049075.V326705.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Personal care to be provided to 6 residents with a learning disability. Maximum number to be cared for 6 (six). The age of the service users will be between 18 and 65 years. Date of last inspection 27th January 2006 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. The home was first registered in August 2002 The Service User Guide and Statement of Purpose are available and are updated as required. The residents and their representatives are provided with this information and it is displayed for reference along with current Commission for Social Care Inspection reports too. At the time of this report the homes fees for current service users ranged from £490.21 to £603.26 per week but are variable as an increase of approximately 2.5 is applied annually. Sunflowers DS0000049075.V326705.R01.S.doc Version 5.2 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 one day 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. Twenty two National Minimum Standards were inspected on this occasion, Twenty one overall outcomes were met and one 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. Further feedback was also received from service users and staff through survey and discussion. Responses have been included in the relevant sections of the report. A pre-inspection questionnaire was not provided on this occasion and other reports and correspondence provided by the staff on duty were used as evidence to inform this report. What the service does well: What has improved since the last inspection? What they could do better: Staff are provided with essential information to assist them in understanding the needs and wishes of the service users via a process of assessment and planning. Transcribed medication where it is required should have two signatures evident. Sunflowers DS0000049075.V326705.R01.S.doc Version 5.2 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Sunflowers DS0000049075.V326705.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Sunflowers DS0000049075.V326705.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. 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: There have been no new admissions to the home since 2003 Examination of the file of the last service user admitted to the home at the previous inspection revealed that a full assessment was provided by the social worker and a pre assessment carried out by the manager. This file has since been archived. Sunflowers DS0000049075.V326705.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. 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 Sunflowers DS0000049075.V326705.R01.S.doc Version 5.2 Page 10 daily lives and risks are managed through a system of assessment with the involvement of service users. Sunflowers DS0000049075.V326705.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13,15,16 & 17 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. 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 Sunflowers DS0000049075.V326705.R01.S.doc Version 5.2 Page 12 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. 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 DS0000049075.V326705.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 & 20 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Arrangements are generally in place to ensure that the health care needs of service users are identified and met. Some minor omissions and recording issues with reference to medication recording were evident. 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. Any transcribed medication should have two signatories. Some minor omissions and recording issues with reference to medication recording were evident. Medication was stored securely in the office. Sunflowers DS0000049075.V326705.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. 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 acting 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 DS0000049075.V326705.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Sunflowers was clean, bright and generally well maintained and provided the service users with homely and comfortable surroundings. Future improvements are planned and some have already been made to the décor of the home. 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 previously been renewed along with one ceiling due to an unfortunate collapse and decorating was evident at the last inspection. 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. Sunflowers DS0000049075.V326705.R01.S.doc Version 5.2 Page 16 There is a medium size garden to the rear of the house in which the paving slabs are to be evened and a shed has been removed creating more space. The proprietor is currently having all homes in the group surveyed with a view to fully refurbishing the same. 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 DS0000049075.V326705.R01.S.doc Version 5.2 Page 17 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 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 & 35 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. 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 2007. Staff files evidenced staff receive individual supervision approximately every two months. A schedule for this was previously seen and the format was seen to be appropriate. Annual appraisals have been developed and are being done. Sunflowers DS0000049075.V326705.R01.S.doc Version 5.2 Page 18 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 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. 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 previous registered manager has worked at Sunflowers since the home opened and has over 20 years experience in working with the client group. She has now attained internal promotion within the company. She does however still oversee the running of Sunflowers. The present acting manager was not present on the day of inspection and has applied for registration. This has been delayed process but is now underway. She has 10 years experience in appropriate care settings and is working towards her NVQ level four in care with integrated management modules. The present registered manager said that she had the qualifications, competencies and experience to ensure that Sunflowers DS0000049075.V326705.R01.S.doc Version 5.2 Page 19 the home is managed in a manner which promotes the aims and objectives of the home. The manager overseeing the home whilst a new manager application is processed holds NVQ level 4 in care and has completed the registered managers award. 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. The locality manager present on the day of inspection 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 2006/7. 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 DS0000049075.V326705.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 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 Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 3 X X 3 X Sunflowers DS0000049075.V326705.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. 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 YA20 Good Practice Recommendations It is recommended that any transcribed medication have two signatories Sunflowers DS0000049075.V326705.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Sunflowers DS0000049075.V326705.R01.S.doc Version 5.2 Page 23 - 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!