Inspection on 16/02/07 for Sunlight House

This inspection was carried out on 16th February 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 7 statutory requirements (actions the home must comply with) as a result of this inspection.

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

CARE HOME ADULTS 18-65 Sunlight House 412 Hill Cross Avenue Morden Surrey SM4 4EX Lead Inspector Adrian Gordon Unannounced Inspection 16 February 2007 10:00 th Sunlight House DS0000067655.V328819.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Sunlight House DS0000067655.V328819.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Sunlight House DS0000067655.V328819.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Sunlight House Address 412 Hill Cross Avenue Morden Surrey SM4 4EX 020 8715 4755 020 8715 4755 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) Mr Moonesswar Jingree Vishul Seewoolall Care Home 4 Category(ies) of Learning disability (4), Mental disorder, registration, with number excluding learning disability or dementia (4) of places Sunlight House DS0000067655.V328819.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection No previous inspection. Sunlight House was registered on 22/08/06. Brief Description of the Service: Sunlight House is registered with the CSCI to accommodate a maximum of four adults with mental health problems or a learning disability. The home is located in a residential road in Morden close to bus routes and local shops. Accommodation is over two floors, and includes a large kitchen, lounge and dining room. At the rear of the property is a large grassed area. The home is staffed twenty four hours a day. Further information about the service is available in the Statement of Purpose and Service User Guide. Sunlight House currently charges fees of £1000 per week, but fees vary according to the support required. Sunlight House DS0000067655.V328819.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over the course of one day and was carried out by one inspector. Evidence was obtained through examination of records, tour of the premises and observation of staff. The inspector had the opportunity to talk to residents, staff, the registered manager and the registered provider. Questionnaires were left for staff and residents but none were returned. What the service does well: What has improved since the last inspection? What they could do better: There must be an improvement in the support that is available for staff. This includes structured induction and formal supervision. Contracts and job descriptions must also be in place so that staff are clear about their responsibilities. Medication must be kept in suitable, secure storage to ensure the health and safety of residents and visitors. Residents must be given a contract for the provision of services so they are clear about their rights and responsibilities. Sunlight House DS0000067655.V328819.R01.S.doc Version 5.2 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Sunlight House DS0000067655.V328819.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Sunlight House DS0000067655.V328819.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 5 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Good assessments are in place to help staff to understand the needs of residents. A lack of written contracts for residents makes their rights and responsibilities unclear. EVIDENCE: A full needs assessment is kept in each residents file. The assessment gives a clear picture of the resident and their needs in areas such as physical health. Information from the referring authority is clear and detailed which makes sure that staff have a good overall understanding of each resident. This information is then used to make detailed care plans. Contracts and terms and conditions are not yet in place for residents. The manager said he was waiting for the contract to be returned from the placing authority. All residents must have a contract to make sure they know about their rights and responsibilities. Sunlight House DS0000067655.V328819.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Care plans are easy to understand and support residents in meeting their goals. EVIDENCE: Care plans are written as though from the resident’s point of view. A personal statement from the resident is included, as well as a list of people who contributed. The care plan is well written and sets out clear needs, goals, interventions and timescales for review. Areas covered include personal care, physical health and social wellbeing. Care plans are up to date and signed by the resident. Residents are able to make decisions about their lives, for example, what to do in the daytime, what to wear and what to eat at mealtimes. One resident said that there were some limits on what they could do, for example going on their Sunlight House DS0000067655.V328819.R01.S.doc Version 5.2 Page 10 own to church, but that they understood why this was necessary even though they did not like it. Risk assessments are specific to the resident and cover areas such as selfneglect, fire, medication and use of the kitchen. They are clearly written showing the level of risk and any action needed. A risk management plan is also in place. One resident confirmed they knew what was in their risk assessment. Written information held on residents is of a very good standard. It is clearly laid out and helps to give a good understanding of residents needs and goals, and how best to support them in achieving them. Sunlight House DS0000067655.V328819.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16, 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are able to take part in activities of their choice and are supported to take responsibility for their daily lives. EVIDENCE: One resident said they go to classes at a local Adult Education College to learn Maths, English and Cooking. Other activities they enjoy include walking, shopping and visiting the local library. The resident confirmed that they could go out alone, but that they need to have staff with them to go to church. Relatives are made welcome if they want to visit. Time is made each week for residents to get support in learning independent living skills with staff members, for example cooking or cleaning. A suggested menu is available but residents can have something different if they want. One resident said ‘the food is very nice’. There are a good variety of Sunlight House DS0000067655.V328819.R01.S.doc Version 5.2 Page 12 meals on offer and the menu book includes ideas for healthy eating and different recipes. A record of what residents choose to eat is maintained. Sunlight House DS0000067655.V328819.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are supported to understand their health needs and are encouraged to have a say about how they are met. EVIDENCE: Residents have a keyworker who meets with them regularly to discuss any issues in the home. The personal preferences of each resident are recorded in their file. This includes information on sexual awareness, religion and family relationships. To support one resident a member of staff was recruited from the same cultural background. Residents are registered with a doctor and receive additional support from a Community Mental Health Team and Community Psychiatric Nurse. Care plans include information on health needs, including personal hygiene. Resident files also contain descriptions of individual mental health problems and how these may affect the resident. Sunlight House DS0000067655.V328819.R01.S.doc Version 5.2 Page 14 Medication profiles are clearly written and include potential problems in giving out medicines. One resident has an agreed list of homely remedies to use, which is signed by a GP. A Community Psychiatric Nurse carries out any injections. Medication is currently stored in a filing cabinet drawer. This is not safe practice and suitable storage must be found in accordance with Pharmaceutical guidelines. Sunlight House DS0000067655.V328819.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Good procedures are made clear to staff, helping to prevent residents from abuse. EVIDENCE: Procedures for the Protection of Vulnerable Adults (POVA) are in place. Staff talked confidently about what they would do if they suspected any abuse. The procedures include local guidelines from the London Borough of Merton. A programme is in place to make sure all staff attend POVA training. A book is available to record any complaints. There have not been any since the home opened. The complaints procedure is included in the Service User Guide. Resident finances are recorded and checked each day. The financial procedures for one resident are included in their care planning information. Sunlight House DS0000067655.V328819.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 27, 28, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from living in a clean, comfortable home which meets their needs. EVIDENCE: Sunlight House is in a residential street in Morden and from the outside looks like other houses in the area. On the ground floor there is a lounge, dining room and large kitchen. The garage is being changed into a family room for visitors to meet residents if they want privacy. An extension from the dining room is being turned into a sun lounge. All shared areas were clean, tidy and well furnished. To the rear of the house is a large grassed area. There are four bedrooms on the first floor, two of which have ensuite bathrooms. The other two bedrooms share a toilet and separate bathroom. Bedrooms are spacious, bright and have been recently decorated. One resident said their bedroom is ‘big’ and ‘I can bring in my own things’. Sunlight House DS0000067655.V328819.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 34, 35, 36 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. A lack of formal induction and structured supervision does not support staff to develop as an effective team. EVIDENCE: The team has a mix of experienced and inexperienced staff. There is always a minimum of two staff on duty and this helps the inexperienced staff to learn and develop skills with the support of someone more experienced. Staff said that they did not have a written job description or signed contract of employment. These must be provided to make sure all staff are clear about their roles and responsibilities. Recruitment records for staff show that up to date Criminal Record Bureau disclosures are in place. One record did not contain a photo of the staff member. All staff had two references and proof of identification. However the manager should make sure that employment references are written on headed paper or stamped by the company. Sunlight House DS0000067655.V328819.R01.S.doc Version 5.2 Page 18 The manager said that the majority of staff are currently completing NVQ 2 or 3. Other training is usually carried out by a consultant who comes to the home. A programme of training is in place for the next three months and includes food hygiene, health and safety, medication administration and moving and handling. Training about managing challenging behaviour was taking place on the day of inspection. New staff have an induction form to complete but there is no formal structured period of induction. The manager meets staff regularly but formal supervisions are not yet happening. In order to support staff and monitor their progress, supervisions must take place regularly at least six times a year. Sunlight House DS0000067655.V328819.R01.S.doc Version 5.2 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well run by a competent manager, to the benefit of residents. EVIDENCE: The registered manager has experience in working with adults with learning disability and mental health problems. He is qualified as an NVQ assessor and is waiting to start the Registered Managers Award. He has a good understanding of all aspects of managing a home and has put in place clear policies and procedures to support staff in carrying out their roles. Monthly visits are carried out by the registered provider. Reports of these are kept at the home. The manager has developed a quality assurance monitoring form. This will be used to inform the provider about progress at the home each Sunlight House DS0000067655.V328819.R01.S.doc Version 5.2 Page 20 month. Information in files shows that residents are asked for feedback in meetings with keyworkers or at reviews The home met health and safety requirements when it was registered in August 2006. The manager completes a monthly health and safety monitoring form that includes checking the environment and fire safety. Health and safety checks are also carried out at each handover. Monthly fire drills are carried out and fire call points are tested each week. Sunlight House DS0000067655.V328819.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 Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 1 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 X 27 3 28 3 29 X 30 3 STAFFING Standard No Score 31 2 32 2 33 X 34 2 35 2 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 3 4 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 3 X X 3 X Sunlight House DS0000067655.V328819.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? N/A 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 YA5 Regulation 5(1) Requirement The registered persons must ensure that each resident has a contract for the provision of services, including terms and conditions. The registered persons must ensure that medication is kept in suitable storage. The registered persons must ensure that all staff have a written job description and signed contract of employment. The registered persons must ensure that employment records contain all the information required in Schedule 2 of the Regulations. The registered persons must ensure that all staff receive appropriate induction training when they start employment. The registered persons must ensure that all staff receive formal supervision at least six times a year. Timescale for action 15/04/07 2 YA20 12(2) 15/04/07 3 YA31 YA32 17(2), Sch 4(6) 19, Sch 2 15/04/07 4 YA34 15/04/07 5 YA35 18(1)(c), 18(2)(b) 18(2)(a) 15/04/07 6 YA36 15/04/07 Sunlight House DS0000067655.V328819.R01.S.doc Version 5.2 Page 23 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA34 Good Practice Recommendations The registered persons should ensure that previous employment references for staff are written on headed paper or stamped by the company concerned. 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