Inspection on 24/05/05 for Sunkist

This inspection was carried out on 24th May 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 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

Sunkist 13/07/09

Sunkist 21/07/08

Sunkist 29/11/06

Sunkist 29/09/05

Sunkist 07/10/04

Sunkist 20/05/04

Similar services:

1 Marten Road

Daubeney House

Three Gables

Aldwick House

49 Glendale

The Springs Community

Crossways Community

Belle Vue Country House

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

CARE HOME ADULTS 18-65 Sunkist 14-16 Winchester Road Worthing West Sussex BN11 4DJ Lead Inspector Linda Riddle Announced Tuesday, 24th May 2005 V220339 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Sunkist H60 H11 S14752 Sunkist V220339 240505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Sunkist Address 16-16 Winchester Road, Worthing, West Sussex, BN11 4DJ 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 218908 Sunkist Homes Ltd Mrs Kate Brady Care Home 26 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (MD) 26 Both of places Sunkist H60 H11 S14752 Sunkist V220339 240505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 7th October 2005 Brief Description of the Service: Sunkist is a care home registered to provide accommodation and personal care for twenty-six people between the ages of eighteen and sixty-five who have mental disorders. It is owned by Sunkist Homes Ltd for whom Mr Belisario Schiavone is the responsible individual. The registered manager in charge of the day to day running of the home is Mrs Kate Brady. The premises consists of two large houses which have been linked to form one home. It is situated in a residential area within easy distance of Worthing town centre, with its shops and other amenities. Accommodation is provided in twent-three rooms, three of which are registered for double occupancy. Communal space consists of two lounges and a dining room/residents kitchenette. One of the lounges is designated for smoking. Sunkist H60 H11 S14752 Sunkist V220339 240505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This annual announced inspection was carried out over 8.25 hours by one inspector. A pre-inspection questionnaire sent out to the home was not received back by the Commission. The registered manager said that she had returned it. Twenty-three residents were being accommodated including two who were there for overnight stays as part of the pre-admission process. The home had one vacant room. Prior to the inspection the previous two inspection reports had been read along with other documentation held on file. Four completed comment cards and a letter from relatives/friends of residents had been received and one from a resident. These comments were taken into account during the inspection. Nine residents and two members of staff were spoken with at some length to find out what it is like to live and work in the home. Discussion took place with the registered manager at varying periods throughout the day. Records, policies and procedures were examined and a tour of the premises was undertaken, although not every private room was seen on this occasion. Residents generally made very positive comments about the home and the care they receive. Records relating to residents and to the running of the home were found to be well maintained and up to date. Areas of the premises seen were mainly in good order and an on-going maintenance programme was in place. What the service does well: What has improved since the last inspection? More efficient procedures and recording systems in respect of medication are now in place and staff have undertaken appropriate training. This provides safeguards both for residents and staff. Alterations and repairs to parts of the premises have resulted in more privacy, nicer facilities and greater safety for residents. New laundry equipment has been provided ensuring better hygiene and prevention of infection. Two members of staff are now on duty at weekends which means that one can accompany residents if they want company to go out. Sunkist H60 H11 S14752 Sunkist V220339 240505 Stage 4.doc Version 1.30 Page 6 Resident’s files with personal information have been upgraded and provide clear and concise information for each one, including care plans and reviews. 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. Sunkist H60 H11 S14752 Sunkist V220339 240505 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Sunkist H60 H11 S14752 Sunkist V220339 240505 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2, 3 Prospective resident’s individual needs and aspirations are carefully assessed. They know that the home will suit them, meet their needs and help them to achieve their goals. EVIDENCE: The four files examined contained detailed assessments of the individual’s needs and wishes. Two residents were having overnight stays in the home prior to any decision being made about their moving in. They had had previous stays and during each one continual assessment was taking place. There were records of this. One said “I am looking forward to coming here permanently, I’m quite confident the home is suitable for me and the staff will help me”. Care plans showed that support services such as the Community Mental Health Team are in place. Sunkist H60 H11 S14752 Sunkist V220339 240505 Stage 4.doc Version 1.30 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 9 Residents know their assessed and changing needs and personal goals are reflected in their individual care plans. They are helped to be as independent as possible and as part of this are supported to take risks. EVIDENCE: Individual Plans are drawn up and reviewed with the full involvement of the resident who signs his/her agreement to it. Each time it is reviewed the resident is given a copy which reflects any agreed changes. Residents confirmed this, one saying for example “we discuss my care plan and talk about goals”. Personal risks are identified in the care plans and were seen to show the action taken to minimise such risks. Some residents wanted to have control of their own medication and had been enabled to do so with certain safeguards put in place. Sunkist H60 H11 S14752 Sunkist V220339 240505 Stage 4.doc Version 1.30 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 16, 17 Residents have opportunities to develop through education and occupation and to be a part of the local community. The home helps residents to be as independent as possible and respects their rights. A healthy and varied diet is offered. EVIDENCE: Plans showed that some residents attend college courses and four go to various day centres on a part time basis. A resident said “they are trying to help each of us fill gaps in the week through activities, outings and things of interest”. Another said she is learning computing at college every Tuesday and doing English there on a Friday. One resident is hoping to start work in a kitchen near the home on Sunday mornings. Residents spoken with said they have keys to their rooms and to the front door of the home and come and go as they wish. Most said they have bank accounts and look after their own money. Copies of each resident’s terms and conditions of occupancy were held on their files and seen to be signed by them. Sunkist H60 H11 S14752 Sunkist V220339 240505 Stage 4.doc Version 1.30 Page 11 Everyone who commented on the food said how good it is. Menus are displayed in the resident’s kitchen/dining area and show a daily choice of two main meals and a vegetarian option. Facilities are available in this room for residents to make hot and cold drinks whenever they wish which they were observed doing. Sunkist H60 H11 S14752 Sunkist V220339 240505 Stage 4.doc Version 1.30 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20 Good arrangements are in place to ensure that the healthcare needs of residents are identified and met. Residents retain, administer and control their own medication where appropriate and are protected by the home’s policies and procedures for dealing with medicines. EVIDENCE: Resident’s physical and mental healthcare needs are assessed and recorded in their care plans. Records of appointments with healthcare practitioners are kept in the files with appropriate comments on any results or changes. Residents said they see their GPs when they wish, either making their own appointments or asking staff to do so on their behalf. A resident said “since I came in I’ve had my eyes tested and I’m going to get my teeth fixed soon” Another resident said he was off to see his dentist that afternoon. Several residents had control of their own medications and were seen to have lockable facilities in their rooms in which to store them safely. They were very aware of the need to do this. Medicines in the control of the home were seen to be securely stored, recorded and administered. Resident’s files contained their signed consents to taking medication. Sunkist H60 H11 S14752 Sunkist V220339 240505 Stage 4.doc Version 1.30 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22, 23 Residents know how and to whom to complain. They feel their view are listened to. The procedures for the protection of vulnerable adults are conflicting and could cause confusion for staff and a delay in obtaining the correct help and advice were it needed. This in turn could place residents at further risk. EVIDENCE: Residents said they have seen or had copies of the Service User Guide and know about the complaints procedure. They knew when asked, who they should go to and felt confident about being listened to. One said “ I know about the complaints procedure but I don’t need it because we discuss things and also have a suggestion box,” which he pointed out. Any complaints received are recorded as was seen but there had been none since the previous two inspections. A procedure for responding to allegations of abuse was available in the home and staff said they were aware of this. The homes own policy and procedure differed to some extent from the County Policy. A recommendation has been made in relation to this. Sunkist H60 H11 S14752 Sunkist V220339 240505 Stage 4.doc Version 1.30 Page 14 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 25 26, 27 Improvements to the décor, facilities and equipment have been made providing residents living in the home with greater comfort, more privacy and safer surroundings. The arrangement for two residents who are sharing a room is incompatible with their needs. This is causing both residents considerable stress. EVIDENCE: A planned maintenance and renewal programme was seen to now be in place. All areas are in suitable decorative order and an on-going programme of improvements is being undertaken. WC and bathroom facilities are now affording residents more privacy, for example a bathroom has been fitted with opaque covering to the glass in the door. An en-suite toilet has been properly enclosed. A new industrial washing machine with a sluicing programme was seen to have been installed along with a new tumble dryer. The room shared by two residents has only a curtain to divide the two ends of the room which each one occupies. One end is very limited for space and the other is not a great deal larger. When speaking to each resident the other could overhear what was being said. This was observed to cause each resident to be upset and made one very angry. Sunkist H60 H11 S14752 Sunkist V220339 240505 Stage 4.doc Version 1.30 Page 15 She said that she hated sharing the room and indicated that her privacy is being violated by the other resident. She said she was never given a choice about sharing a room. A requirement has been made relating to this situation. Sunkist H60 H11 S14752 Sunkist V220339 240505 Stage 4.doc Version 1.30 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, Service users are supported by an effective staff team. They know that there are sufficient numbers of staff with suitable skills to provide the support they need. EVIDENCE: Duty rotas showed that there is sufficient staff cover in the home at all times. Residents asked said that they are always available. They were seen to go in and out of the staff office areas chatting with staff as and when they pleased. One resident said “They are always available, I’m not aware of any time when they aren’t there for us”. Another said “yes, we can speak to them when we want”. Staff training records examined showed that training specific to caring for people with mental illness is provided. Sunkist H60 H11 S14752 Sunkist V220339 240505 Stage 4.doc Version 1.30 Page 17 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 41, 42 The current qualifications and experience of the manager enable her to understand the illnesses suffered by residents and to direct staff so that residents receive consistent quality care. The best interests and rights of residents are mainly safeguarded by the home’s record keeping, policies and procedures. However, the organisation has not yet arranged for unannounced monthly visits to be made to the home as required. This means that the home and it’s management are not being overseen and residents and staff do not have opportunities to speak with someone from the organisation on a regular basis. Policies, procedures and training promote and protect the health, welfare and safety of residents and staff. EVIDENCE: The manager is a registered mental nurse and worked in a senior management position in the NHS for more than two years before becoming the registered manager of Sunkist. There is documentation to support this. She said that she keeps her registration up to date by periodically working on hospital wards and attending training courses. Sunkist H60 H11 S14752 Sunkist V220339 240505 Stage 4.doc Version 1.30 Page 18 She has not as yet made any arrangements to undertake the Registered Managers Award and a recommendation has been made in this respect. Most essential records, policies and procedures are maintained up to date and in good order. There were no records of official monthly visits having been made and a requirement is made in respect of this. Personal information is securely stored and residents confirmed they are given access to their personal records if they want to read them. Policies, procedures and training records are in place showing that health and safety matters in the home are addressed. There are records of staff having training in topics such as first aid, fire safety and risk assessment. Facilities were seen to be in place to record and report accidents and incidents. Window restrictors are fitted to windows in rooms above ground floor level. Sunkist H60 H11 S14752 Sunkist V220339 240505 Stage 4.doc Version 1.30 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 3 x x Standard No 22 23 ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 x x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 1 3 3 x x x Standard No 11 12 13 14 15 16 17 x 3 3 x x 3 3 Standard No 31 32 33 34 35 36 Score x x 3 x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Sunkist Score x 3 3 x Standard No 37 38 39 40 41 42 43 Score 2 x x x 2 3 x H60 H11 S14752 Sunkist V220339 240505 Stage 4.doc Version 1.30 Page 20 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 25 Regulation 12(3)(4)( a) Requirement The registered person shall ascertain and take into account residents wishes and feelings and conduct the care home in a manner which respects the privacy and dignity of residents. The care home shall be visited in accordance with this regulation and a report be prepared on the conduct of the home. A copy of the report shall be supplied to the Commission. Timescale for action 7th June 2005 2. 41 26(2)(3)( 4)(5) 7th June 2005 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 23 37 Good Practice Recommendations There should be one clear policy and procedure in place for the Protection of vulnerable adults The registered manager should make arrangements to undertake the Registered Managers Award as soon as possible Sunkist H60 H11 S14752 Sunkist V220339 240505 Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection 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 Sunkist H60 H11 S14752 Sunkist V220339 240505 Stage 4.doc Version 1.30 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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