Inspection on 04/08/05 for Sunhill Court

This inspection was carried out on 4th August 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 22/11/05

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 Announced Thursday, 4 August 2005, 09.30am, V233780 th 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 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 H60-H11 S24220 Sunhill Court V233780 040805 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Sunhill Court Address Mill Lane, High Salvington, Worthing, West Sussex, BN13 3DF 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) 01903 261563 Mrs Linda Kilgarriff CRH 41 Category(ies) of PD-3, PD(E)-3, OP-41 registration, with number of places Sunhill Court H60-H11 S24220 Sunhill Court V233780 040805 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: A maximum of 3 service users between 55 and 65 years with a physical disability (PD) may be accommodated. Date of last inspection 21/10/04 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. Its 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 accessable by a vertical lift. The home has a sun room built on the ground level and commands views over the Findon Valley Sunhill Court H60-H11 S24220 Sunhill Court V233780 040805 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place on the 4th August 2005 and lasted seven hours. There were 33 residents living at the home at the time of inspection. The overall impression of this home is that there is normally a good level of knowledge and skills, enabling staff to care for the residents. A tour of the premises took place, rotas and care records were inspected. Seven residents, two relatives and seven staff members were spoken with. The Inspector received 4 relatives comment cards, which had positive comments about the home. The residents have different levels of communication ability and therefore it was difficult to ascertain all their views on how their needs are met. However some positive comments included ‘I feel I am always listened to’ ‘Staff are very kind and caring’. This is the first statutory inspection of this year. Two inspectors were involved in the inspection. Mrs Farrell who was the lead Inspector and Mrs Datoo was the second inspector. Mrs Datoo is a pharmacy inspector. She spent 3 hours examining medication procedures. Prior to the inspection the inspector read information held on the service file since the last inspection in October 2004, and read the previous two inspection reports. What the service does well: What has improved since the last inspection? There has been major improvement to the staff files. Several residents’ contracts were viewed and found to contain the relevant terms and conditions affecting their stay at Sunhill Court. At the time of this inspection the home was being efficiently managed. Systems are in place to ensure residents health and social care needs are being met. Sunhill Court H60-H11 S24220 Sunhill Court V233780 040805 Stage 4.doc Version 1.30 Page 6 A training programme introduced for aspects of care provided within the home has improved the outcomes for the residents. 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 H60-H11 S24220 Sunhill Court V233780 040805 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Sunhill Court H60-H11 S24220 Sunhill Court V233780 040805 Stage 4.doc Version 1.30 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 standard(s) 1,2,3,4 Prospective service users have the opportunity to see if the home will be able to meet their needs before they accept a permanent placement. Arrangements are in place to ensure that the health care needs of residents are identified and recorded. Staff have sufficient abilities to meet the needs of the residents admitted. However staff would like to have more training on particular mental health and bereavement needs of the residents. EVIDENCE: The residents spoken with were unable to confirm that they had received a copy of the Service User Guide. The Service User Guide is used to provide current and prospective residents with information about the services that Sunhill Court purports to provide. Several residents’ contracts were viewed and found to contain the relevant terms and conditions affecting their stay at Sunhill Court. A sample of recent pre-admission assessments were viewed and found that whilst there was evidence that most residents are not involved in their assessments, they contained sufficient information about the care needs of those residents. Sunhill Court H60-H11 S24220 Sunhill Court V233780 040805 Stage 4.doc Version 1.30 Page 9 At this home the residents have a variety of mental health issues. The inspector observed staff interact with a new resident to enable then to build a therapeutic relationship and gain a sense of what this gentleman required in his day-to-day life. Staff interviewed did however feel they would like some more training on dementia, other mental health and bereavement issues to improve their caring skills. The Statement of Purpose states the qualification details of the staff. There was evidence to demonstrate that residents are offered a trial period at the home, before a placement becomes permanent. This should be followed up by the home informing residents in writing that they are able to meet their needs at the end of the trial period. Sunhill Court H60-H11 S24220 Sunhill Court V233780 040805 Stage 4.doc Version 1.30 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 standard(s) 7,8,9,10,11 Progress has been made on identifying the health care needs and how these need to be met, there are shortfalls particularly in relation to written communication, staff supervision and training. These shortfalls could place residents at risk. The home demonstrated good medication handling. EVIDENCE: Five care plans were looked at in depth and it was noted that the positive outcomes observed for residents at this time are still dependent upon staff knowledge and memories, rather than full and detailed recording systems. The manager 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. There was evidence that care plans are starting to be reviewed. It was not possible to audit how advice from a range of healthcare professionals had been incorporated into care notes. This is particularly in relation to tissue viability, prevention or treatment of pressure sores, continence advice and nutritional screening. Risk assessments are currently inadequate. It is required that where risks are identified, they are followed through with an assessment of the controls in Sunhill Court H60-H11 S24220 Sunhill Court V233780 040805 Stage 4.doc Version 1.30 Page 11 place to minimise those risks. This is particularly important in respect of the residents who have dementia type conditions. The inspector observed staff members knocking on resident’s bedrooms and bathroom doors and waiting for permission before entering. However it was noted that at present there are no safety locks on any of the bathroom or toilet doors. The manager advised that there is a now a very good working relationship with the residents GPs, the district nurse service and specialist nurses. The resident’s can choose which GP they wish to register with, in the locality. Relatives spoken with discussed how their relatives are assisted to attend all hospital outpatients, dentist, eye, and hearing appointments. The medication policy and procedures were clear and comprehensive. Storage was tidy and well organised. Medication record charts sampled were accurate. A senior nurse refers health concerns to GP’s and requests a medication review for each resident, at a minimum of every six months. A risk assessment was recorded and reviewed for a resident wishing to retain partial responsibility for their medicines. Sunhill Court H60-H11 S24220 Sunhill Court V233780 040805 Stage 4.doc Version 1.30 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 standard(s) 12,13,15 Residents are encouraged to live healthy and fulfilling lives, although there are limited planned activities. 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: Conversations with residents highlighted that community presence and participation in social activities was varied across the home. Some residents are able to go out independently and do so frequently. For others, staff support is required and the frequency of their outings is dependent upon staff availability. Two residents informed one of the Inspectors that an activity programme had previously been in operation, but was no longer in place. Music in care Homes and a reminiscence activity leader visit each month, but staff confirmed that other activities were organised on an ad hoc basis. It was evident from the comments received that residents would benefit from a more robust plan of activities – which would take place both inside and outside the home. Sunhill Court promotes an open door policy during the day. Residents spoke of visitors they had received and the home maintains a record of the contact each resident has with his or her relatives and friends. Sunhill Court H60-H11 S24220 Sunhill Court V233780 040805 Stage 4.doc Version 1.30 Page 13 A lunchtime meal was observed and it was evident that choice and flexibility are paramount. Residents are able to choose where to take their meals, but for many this is seen as a social time. The dining room is arranged into small groups and lots of positive interaction was noticed at this time. The food itself was appetising and nicely presented. All residents spoken with were highly complimentary of the meals at Sunhill Court. Sunhill Court H60-H11 S24220 Sunhill Court V233780 040805 Stage 4.doc Version 1.30 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 standard(s) 16,18 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: 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. It was not possible to view the complaints file as this was locked in the Manager’s office, however, on previous inspections this has been viewed and found to be appropriately maintained. The staff interviewed were knowledgeable about the vulnerability of residents and the systems in place to protect them. Staff spoken with were less confident in describing the importance of the POVA (Protection of Vulnerable Adults) register introduced in July 2004. Sunhill Court H60-H11 S24220 Sunhill Court V233780 040805 Stage 4.doc Version 1.30 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 standard(s) 19,24,26 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. EVIDENCE: 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. A number of areas require attention. This includes the sluice areas, which are in need of up grading, particularly in relation to ventilation. Similarly, a bath panel in one bathroom was broken and requires repairing. Several tiles were missing from bathrooms and from splash backs in resident’s rooms. Sunhill Court H60-H11 S24220 Sunhill Court V233780 040805 Stage 4.doc Version 1.30 Page 16 It was noted that two residents were sharing a room. It was difficult to ascertain all their views on how their needs are met or if it is their choice to share a room due to communication difficulties. There was no evidence in any of the resident’s assessments or care planning documentation to suggest that there was any discussion prior to the second resident moving into the room. Some residents at this home have the benefit of an adjustable bed. Sunhill Court H60-H11 S24220 Sunhill Court V233780 040805 Stage 4.doc Version 1.30 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28,29,30 Residents are supported by a dedicated team of staff who are knowledgeable about their needs. EVIDENCE: On the day of inspection, there were sufficient staff to support the needs of residents as detailed in the care plans. Staff spoken with confirmed that staffing levels were adequate at this time. The residents who spoke with the Inspector commented how nice staff were and how they felt relaxed and happy to ask for help. The Inspectors observed lots of positive interaction between residents and staff. Staff spoken with confirmed that core training, such as first aid, infection control, adult protection, food hygiene for those who handle food, moving and handling is on schedule, and it is hoped that all staff will have had this training within the next few weeks. Staff training is ongoing, many staff are looking forward to starting their NVQ National Vocational Qualifications level 3 in care. New staff undertake an induction in line with the National Training Organisation. Staffs spoken with were very positive about the manager and how she has motivated them to undertake many different forms of education. On the day of inspection she was seen to be helping a member of care staff to gain information on good communication. 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 H60-H11 S24220 Sunhill Court V233780 040805 Stage 4.doc Version 1.30 Page 18 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,36,38 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 lack of quality assurance undertaken by the management at this home could lead to staff being unaware of residents needs. EVIDENCE: 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. Sunhill Court H60-H11 S24220 Sunhill Court V233780 040805 Stage 4.doc Version 1.30 Page 19 Staff confirmed that regular meeting handovers were held where the manager informed them of any changes in legislation. However there was insufficient evidence to prove that supervision was being undertaken six times a year. This standard will be assessed on the next inspection. 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, but are currently spoken with individually, and were aware in advance of the inspection. Throughout the inspection, a number of issues in relation to health and safety were identified. A fire exit was being blocked with a disused hoist, some fire doors would not close without being pushed, a residents en suit ventilation not working. Policies and procedures are in place to ensure the smooth running of the home. The staff on duty demonstrated that they were aware of their responsibilities under Health & Safety. A maintenance person is employed to undertake a variety of checks and audits and to keep the home in a good state of repair. Sunhill Court H60-H11 S24220 Sunhill Court V233780 040805 Stage 4.doc Version 1.30 Page 20 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 2 3 3 2 x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 2 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 1 x x x x 3 x 2 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 Standard No 16 17 18 Score 3 x 2 3 3 2 x 3 2 x 1 Sunhill Court H60-H11 S24220 Sunhill Court V233780 040805 Stage 4.doc Version 1.30 Page 21 yes 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. 2. Standard OP1 OP7and OP38 OP10 Regulation 5(2) 13(4) Requirement The registered person shall supply a copy of the service users guide to each service user Comprehensive risk assessments are carried out in respect of all areas of residents lives and the controls in place evaluated. Bathroom and toilets must have locks suited to service users capabilities and accessible to staff in emergencies. All staff are to receive training in relation to their roles, in this case Adult Protection. That the health and safety issues identified on the inspection are improved to meet the requirements. Timescale for action 01/10/05 01/10/05 3. 4(4) 01/10/05 4. 5. OP18 OP38 18 12(a) 01/10/05 01/10/05 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 OP4 OP8 Good Practice Recommendations Staff would benifit from training in Dementia, other mental health issues and bereavement Good practice advice should be from outside profesionals H60-H11 S24220 Sunhill Court V233780 040805 Stage 4.doc Version 1.30 Page 22 Sunhill Court 3. OP10 4. 5. OP26 and OP38 OP33 6. 7. OP36 OP12 regarding nutritional screening and tissue viability Doors to service users private accommodation are fitted with locks suited to service users capabilities and accessible to staff in emergencies. Service users are provided with a key unless risk assessment suggests otherwise. Staff need to have up-dated training on infection control issues. It is recommended that the manager have in place a quality assurance programme, which includes a systematic cycle of planning-action-review, reflecting aims and outcomes for service users. That care staff receive formal supervision at least 6 times a year. That a flexible and varied activity programme is introduced and made available to service users Sunhill Court H60-H11 S24220 Sunhill Court V233780 040805 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection 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. 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