Inspection on 22/11/05 for Sunhill Court

This inspection was carried out on 22nd November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Sunhill Court 10/09/08

Sunhill Court 03/03/08

Sunhill Court 02/10/07

Sunhill Court 29/11/06

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 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Sunhill Court Mill Lane High Salvington Worthing West Sussex BN13 3DF Lead Inspector Judith Farrell Unannounced Inspection 22nd November 2005 09:30 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.V256944.R01.S.doc Version 5.0 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.V256944.R01.S.doc Version 5.0 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 Limited Mrs Linda Kilgarriff Care Home 41 Category(ies) of Old age, not falling within any other category registration, with number (41), Physical disability (3), Physical disability of places over 65 years of age (3) Sunhill Court DS0000024220.V256944.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. A Maxium of 3 service users between 55 and 65 years with a Physical Disability (PD) may be accommodated. 4th August 2005 Date of last inspection Brief Description of the Service: Sunhill Court is a care home providing nursing care to forty-one service users in the category of older people. It also is registered to accommodate three service users in the category physical disability between the ages of fifty-five and sixty-five. (PD and PD) E)) The home can cater for both sexes. It is owned by Woodean Limited. The responsible individual is Mr Rajan. The home is located in a very quiet residential area in the north of Worthing, West Sussex. Access is via a partly unmade road that does not have street lighting. The home has thirty-two single rooms and four doubles. There are three levels all accessed by a vertical lift. The home has a sun room built on the ground level that commands views over the Findon Valley. Sunhill Court DS0000024220.V256944.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over six hours on 22 November 2005. This is the second statutory inspection of this year. The purpose of this inspection was to assess compliance with the requirements of the last inspection and to generally monitor care practices. This inspection report must be seen in conjunction with the 1st statutory report undertaken in August 2005. A tour of the premises took place, rotas and care records were inspected. Thirteen of the residents, four staff and the Manager were spoken with. The Inspectors observed the lunchtime meal being served. The home was decorated in a festive manor. What the service does well: What has improved since the last inspection? There is a new security system, which safeguards the residents. All residents are to be given the new Statement of Purpose and Service Users Guide. Sunhill Court DS0000024220.V256944.R01.S.doc Version 5.0 Page 6 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. Sunhill Court DS0000024220.V256944.R01.S.doc Version 5.0 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.V256944.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3, 4 There are systems in place to ensure residents and their representatives’ make an informed choice about the home. No resident moves into the home without having had a thorough assessment of their needs discussed with them. EVIDENCE: Ten residents and two relatives spoken with in private and in communal rooms were able to provide information and stated that they were to be given a copy of the homes Service Users Guide. They said they had visited the home prior to being admitted on a trial short stay. A review of their care needs was discussed with them during the first two days of their stay. One resident who had only been resident for a short while said she thought her health had considerably improved since entering the home. Residents said they found it particularly helpful to have met with the manager prior to entering the home. Sunhill Court DS0000024220.V256944.R01.S.doc Version 5.0 Page 9 The staff members on duty were aware of the assessments and were able to fully undertake the care needs. Staff interviewed stated that they would benefit from more training on meeting resident’s needs particularly in relation to dementia. Staff interviewed were not aware of what was written in the Statement of Purpose. In discussion with the nurse in charge and documental evidence no person is admitted to the home without a full assessment. In the event of an emergency the manager still goes to see and produces a written assessment before a potential resident is admitted. The Statement of Purpose states the qualification details of the staff. Sunhill Court DS0000024220.V256944.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 11 Residents should be activity involved in developing the plans in place to support them so that they can make informed choices about what they want to be included in these documents. Progress has been made on improving arrangements to ensure that health care needs of the residents are identified and met. Medication is generally managed well. EVIDENCE: Five care plans were examined and it was found that significant improvements had been made since the last inspection. The system of care planning now provides support plans to guide staff in the delivery of most identified care needs. However the plan should include how staff can support the resident’s wishes and their relatives in the event of the resident’s death. A nutritional assessment on admission must be undertaken and then subsequently on a periodic basis. Sunhill Court DS0000024220.V256944.R01.S.doc Version 5.0 Page 11 The inspector noted that in four out of the five care plans randomly selected there was mention of the resident having an underlying mental health problems. Though this might not present a problem staff must have sufficient training to meet these resident complex needs. Good practice must also be highlighted in the care plan. One member of staff in particular, has invested a lot of time reviewing and updating care plans. She acknowledges there is still work to be done and indeed it is required that all care plans provide a comprehensive plan of how residents should be supported. Residents who retain responsibility for some or all of their medicines did not have written risk assessments. Pain assessment charts could be considered to aid staff in managing pain. One resident informed the inspector that they often get into pain and they cannot always do what they want to which can be very frustrating. Sunhill Court DS0000024220.V256944.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 14, 15 Residents are encouraged to live healthy and fulfilling lives, although there is still a lack of daily planned activities. The manager meets the recommendations of this standard in enabling service users to exercise their personal autonomy and choice. The home ensures that a balanced and varied diet is provided and to ensure that those residents who are able to exercise choice and control over their diet and their daily living are assisted to do so. EVIDENCE: Information regarding Advocacy services is on display in the home. The service users statements of terms and conditions have information about access to personal records in accordance with the Data Protection Act 1998. A lunchtime meal was taken with four residents and it was evident that choice and flexibility are paramount. Residents are able to choose where to take their meals, for the residents spoken to this is seen as a social time. The dining room furniture is arranged into small groups and lots of positive interaction was noticed at this time. Sunhill Court DS0000024220.V256944.R01.S.doc Version 5.0 Page 13 The inspector noted that many residents chose not to eat in the dining room but prefer to eat in their bedrooms, one resident said ‘it was easier for staff’ and another stated it could be a problem if they wish to return to their rooms after lunch and staff were busy. Other comments were around that there was nothing to do in the lounge and therefore there was no reason to go to the lounge as the staff would always bring the food to them. The food itself was appetising and nicely presented. Most residents spoken with were highly complimentary of the meals at Sunhill Court. A drink is served to residents in the evening. Feedback indicated that biscuits are not always offered with this drink, when an evening snack is not provided, the time without food exceeds twelve hours. Sunhill Court DS0000024220.V256944.R01.S.doc Version 5.0 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 17, 18 Service users rights are protected by means of accessing and participating in the civic process if they wish. Service users and relatives are able to express their opinions, which they know will be listened to. Adequate systems are in place to protect service users from abuse. EVIDENCE: Postal voting is encouraged. Information about advocacy services is available in the home and assistance is given to access this service if necessary. All service users spoken with were able to explain what they would do if they were not happy about any aspect of their care. Similarly, the relatives expressed that should they wish to raise a complaint they would either inform care staff on duty or speak to the Manager. Staff were aware of the home’s complaints procedure and what to do if someone complained to them. There has been no complaint recorded since the last inspection. The staff interviewed were knowledgeable about the vulnerability of residents and the systems in place to protect them. Trained staff spoken with were less confident in describing the importance of the POVA (Protection of Vulnerable Adults) register introduced in July 2004. Sunhill Court DS0000024220.V256944.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 22, 23, 24, 25, 26 Residents benefit from an environment which provides choice of space, however, a number of safety, choice, maintenance and decorative issues make some areas less homely. Specialist equipment has been obtained to meet residents needs. More equipment could be provided to maximise resident’s independence. Bedrooms are furnished with some items of residents own belongings and meet their needs. The home is clean and hygienic. Sunhill Court DS0000024220.V256944.R01.S.doc Version 5.0 Page 16 EVIDENCE: Sunhill Court does have access difficulties as it is up an unmade road. There is an alternative route that is less problematic and Mr Rajan is seeking to tarmac an area of road to enable easier access. He also stated he hopes to install lights in the road outside the home. Since the last inspection the home has continued with the redecoration and refurbishment programme. There were numerous pleasant floral displays at the rear of the building. Residents and visitors were using a pleasant shaded conservatory on the day of the inspection. The home was clean and tidy and a resident commented on how often her room was being cleaned. She was pleased with her room, which has a window opening onto a very pleasant enclosed garden. Trained staff interviewed were clear on the guidelines for the control of infection. Though it was noted care staff were not as confident, and one member of staff was observed clearly not following these practice guidelines. The inspector recommended that health Protection is contacted to help the home meet the recommended guidelines on infection control. A number of areas require attention. This includes hot water problems. Residents stated that the water either runs cold or very hot. Tap water was spot-checked and in one part of the building was found to be running at well over the recommendations. Radiators in this part of the building were also found to be very hot to the touch. The bathrooms in some of the resident’s bedrooms were found to have green mould running along the exposed pipes. Similarly, a bath panels in one bathroom was broken and requires repairing. The hoist in the upstairs bathroom is rusty. Several tiles were missing from bathrooms and from splash backs in resident’s rooms. However, residents rooms have been made comfortable with their own belongings and residents who spoke with the inspectors were happy not to have a lock on their bedroom door, one resident said she was happy with the arrangements for respecting her privacy and dignity. Aids and equipment are in use in the home to aid independence and support staff with good moving and handling. However it was noted that there are no hand rails in corridors and one resident said she would like a grab rails in her bedroom, it would therefore be appropriate to have an assessment of the premises as recommended by the National Minimum Standards. The premises were clean and tidy on the day of the inspection. It was noted and brought to the registered manager’s attention that cleaning products are being stored in a bathroom and are not secured to ensure the health and safety of residents and staff. Sunhill Court DS0000024220.V256944.R01.S.doc Version 5.0 Page 17 Some residents at this home have the benefit of an adjustable bed. Sunhill Court DS0000024220.V256944.R01.S.doc Version 5.0 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 The deployment and number of staff is not sufficient to meet the needs of the residents. The procedures for recruitment of staff are robust and therefore the home provides the safeguards to offer protection to people living at the home. EVIDENCE: To adequately reflect the dependency of residents, particularly those with dementia who were observed to need more support during the afternoon and early evening, staffing levels should be reviewed. Most residents spend most of the daytime in their bedrooms and not all have access to a call bell during this time, a review of the deployment of staff should address this issue. Residents confirmed this stating that they never have to wait too long for the bells to be answered. All staff interviewed stated that at times when staff were on holiday or off sick there could be a real problem in giving the care needed. One member of staff described a day when a full complement of staff was present; they could undertake all the tasks needed without rushing the residents. New staff files were viewed and found to be in order and they meet the requirements to ensure that the residents are being safeguarded. There has been major improvement to the staff files. Sunhill Court DS0000024220.V256944.R01.S.doc Version 5.0 Page 19 A resident also talked about being put to bed at a very early hour because the home was short of staff. All residents and relatives spoken to said that staff at the home were kind, caring and committed but were always too busy and could spend little time with them. Sunhill Court DS0000024220.V256944.R01.S.doc Version 5.0 Page 20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36, 38 The manager has provided leadership; guidance and direction to staff to ensure residents receive a consistent quality of care. The outstanding issues regarding lack of supervision of staff could lead to poor practice and potentially put the resident at risk. The resident’s financial interests are safeguarded. The lack of quality assurance undertaken by the management at this home could lead to staff being unaware of residents wants and needs. EVIDENCE: Eight staff files randomly selected gave no indications of induction, supervision or any training and development staff had received. Sunhill Court DS0000024220.V256944.R01.S.doc Version 5.0 Page 21 One trained nurse interviewed talked about induction as being only two shifts with another trained nurse and then working on their own. Most staff interviewed reported to the Inspectors that they had had their entire mandatory training. The manager is very experienced having worked in nursing and residential homes for many years. Mrs Kilgarrif is a registered nurse, with a degree in nursing and is currently undertaking The City and Guilds Registered Managers Award, she is hoping to complete by April 2006. Residents said the home is now run efficiently and they said this they thought was down to strong leadership. Staff made positive comments about the management and gave good examples of best practice. Regulation 26 reports of these visits are sent to the Commission for Social Care Inspection as required. Residents and relatives interviewed were unable to confirm that they had any input into the quality assurance process. The manager advised that a quality questionnaire is available to residents and relatives for audit. The Inspector advised that it should be widened to include visiting professionals. Service users do not have regular meetings. Throughout the inspection, a number of issues in relation to health and safety were identified. Sunhill Court DS0000024220.V256944.R01.S.doc Version 5.0 Page 22 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 3 x 3 3 x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 x 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 x 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 1 3 x 3 3 2 3 2 STAFFING Standard No Score 27 3 28 2 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 1 x 3 2 x 1 Sunhill Court DS0000024220.V256944.R01.S.doc Version 5.0 Page 23 Are there any outstanding requirements from the last inspection? Yes 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 2 Standard OP36 OP38OP25 Regulation 18(a) 13(4)(c) Requirement That all care staff must receive formal supervision at least 6 times a year. All hot water must be distributed close to 43 degrees centigrade. All hot water pipework and radiators must be guarded or have guaranteed low temperature surfaces. That the health and safety issues identified on the inspection are improved to meet the requirements. That the home develop an effect quility asurance system. Timescale for action 01/02/06 01/12/05 3 OP38 12(a) 01/02/06 4 OP33 5 (a-b) 01/12/05 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 2 Refer to Standard OP1 OP1 Good Practice Recommendations Staff should read the Statement of Purpose. It is recommended that the care plan be drawn up with the involvement of the service user, agreed and signed by DS0000024220.V256944.R01.S.doc Version 5.0 Page 24 Sunhill Court the service user. 2 3 OP27 OP8 Staff would benifit from training in Dementia, other mental health issues and bereavement Good practice advice should be from outside profesionals regarding nutritional screening and tissue viability and health Proection. Sunhill Court DS0000024220.V256944.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection Worthing LO 2nd Floor, Ridgeworth House Liverpool Gardens Worthing West Sussex BN11 1RY 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 Sunhill Court DS0000024220.V256944.R01.S.doc Version 5.0 Page 26 - 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!