Inspection on 10/09/08 for Sunhill Court

This inspection was carried out on 10th September 2008.

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

Sunhill Court 03/03/08

Sunhill Court 02/10/07

Sunhill Court 29/11/06

Sunhill Court 22/11/05

Sunhill Court 04/08/05

Sunhill Court 21/10/04

Sunhill Court 07/08/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

Extracts from inspection reports are licensed from CQC, this page was updated on 27/02/2009.

CARE HOMES FOR OLDER PEOPLE Sunhill Court Mill Lane High Salvington Worthing West Sussex BN13 3DF Lead Inspector Jo Hartley Unannounced Inspection 10th September 2008 10:10 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Sunhill Court DS0000024220.V372123.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Sunhill Court DS0000024220.V372123.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Sunhill Court Address Mill Lane High Salvington Worthing West Sussex BN13 3DF 01903 261563 01903 261563 sunhillcourt@btinternet.com 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) Woodean Ltd Post Vacant Care Home 40 Category(ies) of Dementia (0), Old age, not falling within any registration, with number other category (0) of places Sunhill Court DS0000024220.V372123.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home with nursing - (N) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (OP) 2. Dementia (DE). The maximum number of service users to be accommodated is 40. Date of last inspection 16th June 2008 Brief Description of the Service: Sunhill Court is a care home able to provide nursing care to forty older people. Thirteen people living at the home may have dementia and other related mental disorders and it is also registered to accommodate three service users in the category physical disability between the ages of fifty-five and sixty-five. The home is located in a very quiet residential area in the north of Worthing. The access to the main road is via a partly unmade road, which does not have street lighting. The home has thirty-two single rooms and four doubles. There are three levels all accessible by a vertical lift. The home has a sunroom built on the ground level and commands views over the Findon Valley. The current scale of fees being charged at the home is from £499 to £700 per week. Sunhill Court DS0000024220.V372123.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people that use this service experience adequate quality outcomes. The purpose of the inspection was to assess how well the home is doing in meeting the key National Minimum Standards and Regulations. It was carried out by Jo Hartley and Annie Taggart. The findings of this report are based on several different sources of evidence. These include: previous reports of visits to the home, the Annual Quality Assurance Assessment (AQAA) completed by the home, surveys received from residents and staff, an unannounced visit to the home, which was carried out on the 3rd March 2008 and a random inspection of the home carried out on the 16th June 2008. During the visit we looked around the inside and outside of the home, which included a sample of bedrooms and bathrooms. Staff and care records were sampled and in addition to speaking with staff, people who live at the home, relatives and nurses, their day-to-day interaction was observed. All regulatory activity since the last inspection was reviewed and taken into account including notifications sent to the Commission for Social Care Inspection. What the service does well: Sunhill Court offers a comfortable, homely and attractive environment for the people who live there who say they are happy with the facilities provided. People have specialist equipment provided as required and receive the medical attention they need. The home provides a variety of fresh home cooked meals and people can choose where they wish to eat. Families and friends can visit at any time and people are encouraged to keep in touch. Many individuals, who live at the home, have their own telephones. People who live at the home and visitors say that the staff team are kind and friendly. Sunhill Court DS0000024220.V372123.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Sunhill Court DS0000024220.V372123.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Sunhill Court DS0000024220.V372123.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People that use the service can feel assured that their needs will be assessed and that the home has an understanding of their needs using the assessment process The home does not provide intermediate care; therefore Standard Six does not apply. EVIDENCE: There have been no new service users admitted since the last inspection. The home has a new, more detailed, pre-admission assessment form in place to enable them to gather more information from prospective residents before they move into the home. Sunhill Court DS0000024220.V372123.R01.S.doc Version 5.2 Page 9 The provider, Mr Rajan, has decided not to admit any more residents until he is satisfied that the service is running properly. There are currently twenty-four residents living at Sunhill. Sunhill Court DS0000024220.V372123.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents receive the support they need to meet their health, personal and social care needs. Risks are identified and risk assessments are in place. They still need more detail regarding the action to be taken to minimise the identified risk. Residents are protected by the home’s medication procedures. Residents are treated with respect. EVIDENCE: During the visit we examined six care plans. They were found to be clear and concise and contained detailed information to enable the staff team to provide the care and support residents need. Evidence was seen that care plans had been discussed with the resident or their advocates. Care plans had been signed by the resident or a relative. Sunhill Court DS0000024220.V372123.R01.S.doc Version 5.2 Page 11 Risks are identified and risk assessments are in place. They still need more detail regarding the action to be taken to minimise the identified risk. Medical assistance is provided when needed. Records of all medical professional’s visits are recorded with the outcome and any action to be taken. Good detailed assessments are in place for pressure sores. They include a description, how they need to be dressed and when, and regular reviews. Risk assessments are in place for falls but there is not always a risk management plan detailing the action to be taken. The recording of the administration of medication is thorough. Medication Administration Recording sheets for all the residents were examined, they were all complete with no gaps. The list for medication administrators needs updating as the old manager is still recorded. Medication cabinets were clean and well managed. Medication training has been updated for all people who administer medication including RGN’s. Evidence was seen that where people have continually refused to take prescribed medication advice has been sought from a GP. Staff were observed knocking on doors before entering rooms. Staff were kind and patient in their dealings with people, and a friendly rapport between staff and service users was noted throughout the day. Sunhill Court DS0000024220.V372123.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home offers activities for residents, however their participation is not recorded so it is not possible to judge how many people take part in the activities and whether they are suitable. A requirement has been made regarding this. People are able to exercise choice in their lives. The residents enjoy the meals. EVIDENCE: There was a programme of activities in place and during the morning an entertainer came in to play an accordion and sing to people. In the afternoon staff were chatting to people and carrying out nail care. However although activities are happening they are not being recorded in the daily records or in a separate file. Service users told us that staff also come and chat to them in their rooms but these one to one times are not being recorded. A requirement has been made that the home reviews the activities programme to ensure that it is meeting the residents needs, and records who participates in the activities. Some residents said that they prefer not to join in with the Sunhill Court DS0000024220.V372123.R01.S.doc Version 5.2 Page 13 activities; another resident said more activities would be welcome. Social interests are now being recorded in care plans. Visitors are made welcome in the home at all reasonable times. Residents spoken with said they enjoyed the meals available to them. The home provides a choice of meals. Special diets are catered for. When meals need to be pureed, each item is pureed individually to retain taste. Staff were seen giving assistance with feeding to those residents who needed it. This was done in a sensitive, unhurried way. Sunhill Court DS0000024220.V372123.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and staff are protected by the policies, procedures and training regarding Adult Protection and the home’s complaints procedure. EVIDENCE: The home has a complaints procedure in place and a copy is displayed in the entrance hall of the home. Service users and two visitors to the home told us that they would feel comfortable in making a complaint and said that they felt it would be taken seriously and acted upon. We saw the complaints book and this showed us that three recent complaints had been recorded and investigated and the outcomes fed back to the complainant. There are policies and procedures in place regarding safeguarding service users from risk of abuse or harm and staff training records identified that the staff team have attended Safeguarding training. The staff on duty at the time of the visit told us that they would report any suspected abuse straight away to the manager or provider. There has been a safeguarding referral since the last inspection. The home co-operated fully in the investigation. Sunhill Court DS0000024220.V372123.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home offers a comfortable and attractive environment for the people who live there. People have the specialised equipment they need to provide their care. However some areas need redecorating and updating. EVIDENCE: Sunhill Court offers a homely and comfortable environment for the people who live there. Residents tell us that they are happy with the facilities on offer. Communal areas are comfortably furnished and attractively decorated. There is a large sun lounge overlooking the local countryside where people tell us they like to sit and watch the birds and gardens. Sunhill Court DS0000024220.V372123.R01.S.doc Version 5.2 Page 16 There is a programme of refurbishment and redecoration being carried out and we saw that some new carpets have been fitted and new beds and furniture purchased. People have the aids and adaptations they are assessed as needing including hoists, pressure relieving beds and mattresses. People’s private bedrooms have been personalised with their own furnishings and belongings and are bright, homely and comfortable. We saw that although some radiators in the home have “cool touch” surfaces others are not covered. We discussed this with the Provider Mr Rajan, who showed us that there is a computerised over ride on the home’s boiler system that stops the water temperatures and radiators being over a safe level and records showed us that regular checks are carried out and recorded. Although there have been a number of improvements made to the home, there are still some areas such as bathrooms and toilets that are in need of updating and some bedrooms still need redecoration. There was also a bare bulb above one service users bed and a toilet was broken in an unoccupied room. During the day an audit was being carried out by the maintenance person to identify areas still needing improvement. We saw a clinical waste bin that had no lid and the RGN on duty said that this would be put right straightaway. Protective clothing such as gloves and aprons was in use by the staff on duty and antiseptic hand gels were available for use. There was a housekeeper on duty who told us that she regularly cleans the carpets and the home was pleasant, clean and hygienic throughout. A service user told us, “ it is always lovely and clean here and always smells nice”. Sunhill Court DS0000024220.V372123.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents needs are met by the numbers and skills mix of staff. EVIDENCE: Six staff records were examined. The records of staff that have been recruited since the Care Homes Regulations were introduced have all the recruitment checks required including CRB, POVA and two written references. However, staff that were recruited prior to this do not all have two written references or application forms in their records. This was discussed with the manager and provider. The provider has implemented a full training plan and conducted an audit of the training needs of the staff team. The training plan includes all mandatory Health and Safety training and training specific to the needs of the residents. All four staff that we spoke with said that they had received good training. We looked at the staff duty rota and this showed us that there is enough staff cover to meet the needs of the current residents. Five staff are on duty all day, and one Registered Nurse and two carers are on duty at night. There has Sunhill Court DS0000024220.V372123.R01.S.doc Version 5.2 Page 18 been a reduction in the use of agency staff. Agency staff will provide only 4.5 hours in the current week. The home also employs an administrator, housekeeper, cook, kitchen assistant and maintenance man. Staff were kind and patient in their dealings with people. A friendly rapport between staff and residents was noted throughout the day. The provider is aware that staffing numbers will need to increase when more residents are admitted. Sunhill Court DS0000024220.V372123.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The previous manager of the home has resigned and the new manager is in the process of applying for registration with the Commission. The home is run in the best interest of residents. EVIDENCE: The previous manager of Sunhill Court has resigned her position. A new manager had just taken up this position at the start of the week that the inspection took place. She is in the process of applying for registration with the Commission. The new manager was organised and aware of the work she needs to do to continue the improvements that have started in the home. As Sunhill Court DS0000024220.V372123.R01.S.doc Version 5.2 Page 20 the manager is so new in post we were unable to evidence whether the improvements that have been made will be sustained. We spoke to four members of staff who said that there have been improvements in the home. They told us that there has been some confusion because they were getting conflicting messages about what they should be doing, but now that the new care plans are in place and there is a new manager they feel more confident. Another member of staff said there had been a lack of support and direction, but she felt there had now been many improvements, not least the investment in the home. A very detailed staff handover was observed. All residents were discussed with on coming staff and care plans updated as needed. Regulation 26 Registered Provider’s visits are carried out and recorded. The outcomes from these visits detail improvement plans for the future of the home. The people who use the service and their relatives or representatives, are able to discus all aspects of the running of the home generally or on a personal level. This opportunity is offered in questionnaires, which are sent out annually. Accidents and incidents in the home are recorded in an accident book. Sunhill Court DS0000024220.V372123.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X 3 X X 3 Sunhill Court DS0000024220.V372123.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 13 (4) Requirement Timescale for action 30/10/08 2. OP12 16 (n) Risk assessments need to be in more detail to ensure that individual needs are being met and the risks to service users are minimised. The home needs to review the 30/10/08 activities programme to ensure that it is meeting the residents needs. A record needs to be kept of who participates in the activities provided. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Sunhill Court DS0000024220.V372123.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Sunhill Court DS0000024220.V372123.R01.S.doc Version 5.2 Page 24 - 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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