Inspection on 31/05/05 for Sunningdale

This inspection was carried out on 31st 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Sunningdale 23/04/09

Sunningdale 02/05/08

Sunningdale 03/05/06

Sunningdale 06/12/05

Sunningdale 14/10/04

Sunningdale 19/07/04

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

CARE HOMES FOR OLDER PEOPLE Lister Specialist Care Home 5 North Park Road Manningham Bradford BD9 4NB Lead Inspector Sue Dunn Unannounced 25 May 2005,31stMay 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. Lister Specialist Care Home J52 S60012 Lister Specialist Care V229521 250505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Lister Specialist Care Home Address 5 North Park Road, Manningham, Bradford, West Yorkshire, BD9 4NB 01274 510800 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) david.crabtree@lineone.net Crabtree Care Homes Mrs Georgina Melvin Care Home only 32 Category(ies) of Dementia (32), Dementia - over 65 years of age registration, with number (32) of places Lister Specialist Care Home J52 S60012 Lister Specialist Care V229521 250505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 14/10/05 Brief Description of the Service: Lister Specialist Care Home is a 32 bedded home which provides care for people with dementia, some of whom may be under 65. The home is owned and operated by Crabtree Care Homes who have other homes in the area.The home, originally two large Victorian semi detached family houses, has been extended in recent years to provide additional single bedrooms with en-suite facilities. The walled garden surrounding the property has a parking area and has been pleasantly landscaped to provide secure walking and sitting areas for service users. Access to the property is through electric gates which are controlled from inside the house by staff, with the help of a CCTV camera.The house is situated in the Manningham area of Bradford overlooking the park. It is within a short walk of a main bus route into the city and a small parade of shops.Accommodation is on two floors with access to the first floor by a wide staircases and a passenger lift. Lister Specialist Care Home J52 S60012 Lister Specialist Care V229521 250505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection, carried out by two inspectors was unannounced and spanned a period of 8 hours on the first day (25th May) followed by a four hour visit on 31st May which included feedback to the manager and proprietor. The purpose of the inspection was to ensure the home was operating and being managed in the best interests of the people living in the home and to meet the National Minimum Standards for a Care Home for Older People. There were 26 people in the home at the time of the inspection. Judgements made during the inspection were based on information from the manager and proprietor, three care workers, the cook, a district nurse, and a GP. Four care files were examined and routines and practices were observed. Contact with residents was kept to a minimum as people were being treated for a contagious outbreak of scabies. What the service does well: The manager has a very practical, ‘hands on’ approach and knows every resident in the home. Residents are valued for their individuality and are able to move freely about the home with the minimum of restrictions. The proprietors have an open attitude to complaints and take action to try to deal with any concerns brought to their attention. Money has been invested to improve the environment and the control of odour is well managed. Staff provide care in a calm, relaxed, non confrontational manner and know when to give residents their own personal space. This reduces episodes of challenging behaviour. The proprietors show a commitment to staff training and take advantage of any training funding opportunities which can advance their training programme. The monthly reports on the conduct of the home give a good picture of what is good and what can be improved Lister Specialist Care Home J52 S60012 Lister Specialist Care V229521 250505 Stage 4.doc Version 1.30 Page 6 What has improved since the last inspection? What they could do better: The home needs a Statement of Purpose, which is easy to read, and gives clear information about what the home sets out to do and how it sets out to achieve its aims. There must be evidence to show that everyone has signed an agreement to show they understand the terms and conditions of occupancy. The home should be able to demonstrate how they will provide the resources to meet the full range of needs of any person assessed as needing care. This must be followed by a plan of care which is regularly reviewed in consultation with the resident or their representatives and updated to provide guidance for all staff. Care staff must take more responsibility for giving detailed attention to personal care in order to maintain the dignity and self esteem of all residents. The records regarding medication must be improved to avoid the risk of errors. in administration. Staff should utilize their knowledge of residents’ past lives and achievements to develop more creative and imaginative activity programmes. Some foods should be provided which recognise the dietary preferences of people from different racial origins. All staff should be familiar with procedures for adult protection. The gardens should maintained so as not to pose a risk for residents. The rota must provide a true record of full names of all the people working on any shift, including any changes. The CSCI must be notified about any situations that may affect the well being of residents. The recruitment and selection procedures must be tightened up as agreed. Residents should have easier access to their personal allowances in order to use the money to improve their quality of life on a day to day basis. Lister Specialist Care Home J52 S60012 Lister Specialist Care V229521 250505 Stage 4.doc Version 1.30 Page 7 The manager must be suitable qualified. Monthly reports on the home should include an agreed and realistic action plan. Records of routine Health and Safety checks must be kept up to date. 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. Lister Specialist Care Home J52 S60012 Lister Specialist Care V229521 250505 Stage 4.doc Version 1.30 Page 8 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 Lister Specialist Care Home J52 S60012 Lister Specialist Care V229521 250505 Stage 4.doc Version 1.30 Page 9 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. Without a Statement of Purpose to describe what the home provides and an up to date assessment residents and their representatives cannot know if the home will meet their needs. It was apparent that several people had not received a contract from the home which made clear the terms and conditions of occupancy. EVIDENCE: At the time of inspection the home did not have a new Statement of Purpose. Assurances were given that the final draft copy of this document will be sent to the CSCI by the end of June after staff have had the opportunity to read the contents and give their comments. The contracts have been re written since the present owners took over the home. Several contracts giving the terms and conditions of occupancy were still in the filing cabinet unsigned. The proprietor is to seek advice from the Office of Fair Trading to ensure the contracts are satisfactory. Lister Specialist Care Home J52 S60012 Lister Specialist Care V229521 250505 Stage 4.doc Version 1.30 Page 10 A very good pre admission assessment of needs was found in the file of a person admitted from one of the other homes in the group. This had not however been updated at the time of her transfer to the present home therefore it was difficult to see how the home had been able to establish that they could meet her needs Lister Specialist Care Home J52 S60012 Lister Specialist Care V229521 250505 Stage 4.doc Version 1.30 Page 11 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 The proprietors and manager are committed to improving the basics of care in the home and this was evident in the improved standard of clothing, appearance of residents and general health care. Care plans were not of a satisfactory standard and medication records must be improved. EVIDENCE: Four care files were examined, including one for the most recent person admitted to the home. The care of this person relied on what had been a very good pre admission assessment from the home she had moved from. This had not been updated before her move to Lister Care Home when her care needs changed. District nurses, medical staff and professional advisers visit the home but there was no written evidence of this in the care plans to ensure all staff were consistent in the way they provided care and treatment. Some written progress notes had been completed by the manager but in one case the treatment recommended had been overlooked. The manager acknowledged that care plans had lapsed as she had to spend so much of her time monitoring care practices to ensure residents were receiving a satisfactory standard of care. The proprietor agreed to provide additional support to allow time for the care plans to be reviewed and updated. Lister Specialist Care Home J52 S60012 Lister Specialist Care V229521 250505 Stage 4.doc Version 1.30 Page 12 Daily records gave a picture of people’s behaviour but there was no evidence that staff looked at events leading up to an episode of challenging behaviour and no clear action plan of how staff were to provide care. This seemed to be based on an individual approach which the staff spoken with were able to describe. The visiting district nurse felt that care had improved and staff followed her advice and directions for treatment. Medication records were confusing as the pharmacy continued to send printed medication sheets which included medication that had been discontinued. Some medication had not been signed as having been given. There was an overall improvement in the care of clothing and appearance of residents but it was acknowledged that there are still lapses in attention to the details of hair care and dress appropriate to some individuals. Lister Specialist Care Home J52 S60012 Lister Specialist Care V229521 250505 Stage 4.doc Version 1.30 Page 13 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) 12,15 There were no care plans to give guidance on how the social and recreational needs of people living in the home were to be met. Residents were able to move freely about the home and interact with staff but there was a general atmosphere of boredom. Meals were of a satisfactory standard but the home must do more to understand the dietary needs of residents from different cultural backgrounds and make some provision EVIDENCE: More recent files gave insufficient information about peoples’ past lives to be able to establish what their expectations and preferences might be. Staff had some knowledge of past history but this was not utilized to provide activities which might be of interest. One record showed a visit to the circus last September and one person has a room large enough to accommodate an organ. Another person helps with domestic tasks around the home and another had a daily newspaper. A cupboard in one of the lounges contained a selection of board games Organised activities were described as ball games and exercises but the TV and the fish tank provided the only stimulation observed during the two visits. Lister Specialist Care Home J52 S60012 Lister Specialist Care V229521 250505 Stage 4.doc Version 1.30 Page 14 Staff commented that they felt they lacked the skills to provide imaginative activities and felt the activities available were ‘rather childish’. The recently employed cook has many years experience of catering in the care sector and can provide for ‘special diets’. The day’s menu offered a choice and the mealtimes appeared unhurried. Residents said the food was good. No special provision has been made for a resident of African Caribbean origin. Lister Specialist Care Home J52 S60012 Lister Specialist Care V229521 250505 Stage 4.doc Version 1.30 Page 15 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 The home is willing to listen to complaints and ensure any legitimate cause for complaint is resolved. There should be more evidence in the complaints log to show that residents have a voice and complaints from relatives, residents and staff have been dealt with. It was acknowledged that staff need training to understand the adult protection procedures and arrangements have been made for training to take place to ensure that this vulnerable group of people are protected. EVIDENCE: The proprietor stated he is keen to know if there are any complaints in order to allow him to rectify any problems and provide a good service. Details in the main entrance area tell the reader what to do if they wish to complain. The manager has a log book for complaints but this had not been completed fully. There have been three complaints since Christmas. Where parts of complaints have been upheld, action has been taken to resolve the matter to the complainants satisfaction. Matters raised by an anonymous complainant were investigated at the time of the inspection. Action had already been taken to deal with some of the points and others were not upheld. The proprietor stated that there was still some confusion in the home regarding the adult protection procedures. The Adult protection team are to provide training for senior staff on 21st June. Lister Specialist Care Home J52 S60012 Lister Specialist Care V229521 250505 Stage 4.doc Version 1.30 Page 16 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) 19,20,26 The proprietor has made satisfactory arrangements to ensure the house and grounds are to be maintained to a satisfactory standard for the safety and comfort of the residents EVIDENCE: The home’s maintenance person who is responsible for routine repairs, safety checks and maintenance and the upkeep of the gardens has just retired. The ex cook has been employed to do the garden, which is becoming overgrown, and the company’s maintenance person is to do the other routine work. There is a rolling programme for redecoration. The manager stated that new lounge chairs had been ordered. Lister Specialist Care Home J52 S60012 Lister Specialist Care V229521 250505 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) 27,29,30 The staff numbers have on occasions fallen below the required level. This has a impact on the level of care residents receive and the morale of the staff team. The proprietor and manager have taken steps to deal with poor attendance by staff. Staff recruitment and selection procedures have not been sufficiently robust to ensure the protection of service users. Staff have the skills to approach residents in a non confrontational way and know when to retreat and give people time to express their feelings. EVIDENCE: The staff rota showed occasions when staffing had been below the minimum for the home. Full names had not been recorded on the rota. The manager stated she stays behind and works on such occasions but this had not been shown on the rota. The CSCI had not been notified when staffing shortages had occurred. Disciplinary action is taken if staff fail attend for duty and don’t follow procedures as this can leave the home short staffed and residents at risk. Some staff felt pressurised to work shifts for colleagues who failed to arrive for work. Lister Specialist Care Home J52 S60012 Lister Specialist Care V229521 250505 Stage 4.doc Version 1.30 Page 18 The proprietor spoke of the increasing difficulties experienced in recruiting suitable staff. Interviews were arranged on the day of the second visit to fill staff vacancies. The first applicant didn’t arrive. It was acknowledged that the staff recruitment and selection process must be carried out more rigorously as some gaps were noted in employment records. In one file the application showed no evidence of qualifications, there was nothing to show gaps in employment history had been checked, no notes of a verbal reference and the CRB check had not been done prior to employment. The home has a fast track programme for NVQ. Staff felt that they worked well as a team and were able to discuss how they provided care and worked effectively with people with challenging behaviour Lister Specialist Care Home J52 S60012 Lister Specialist Care V229521 250505 Stage 4.doc Version 1.30 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 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) 31,32,35,37,38 The environment, personal appearance and physical care of residents has improved under the present style of management. Record keeping leaves room for improvement and residents should have better access to their personal allowances. EVIDENCE: The manager has not yet completed the Managers Award and spoke of the difficulties presented by the organisation of the course. She has a sense of humour and shows a genuine ‘liking’ for the residents in her care and an understanding of the different personalities. She admitted that much of her time has been spent monitoring basic care practices and some of the record keeping had suffered as a result. At the time of the inspection she was trying to organise herself in a new office space. This area provides more privacy for administrative tasks but allows her to oversee Lister Specialist Care Home J52 S60012 Lister Specialist Care V229521 250505 Stage 4.doc Version 1.30 Page 20 daily routines. The layout of the care files and records made it difficult to track information. Staff stated they enjoy working in the home and feel the management team are supportive. A representative from the organisation makes monthly visits to the home and completes a report which monitors the way the home is being conducted. The effectiveness of this could be improved by agreeing a monthly action plan. The new deputy manager has several years experience in care work, has completed NVQ2 and a short course in the care of people with dementia and takes responsibility for the home in the absence of the manager. She was observed to relate well to residents and other health professionals. Residents personal money is held at head office and it was not possible to access the financial records on the homes computer. It was agreed that the system would be reviewed to allow some money in the home for each resident to spend on ‘treats’ which would enhance their quality of life Routine Health and Safety checks are recorded. There was a short lapse in some of these which will be picked up as part of the new maintenance arrangement. Lister Specialist Care Home J52 S60012 Lister Specialist Care V229521 250505 Stage 4.doc Version 1.30 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 2 2 2 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 x 14 x 15 3 COMPLAINTS AND PROTECTION 3 3 x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 2 3 x x 3 x 2 3 Lister Specialist Care Home J52 S60012 Lister Specialist Care V229521 250505 Stage 4.doc Version 1.30 Page 22 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. Standard OP1 Regulation 4 Requirement The home must have a statement of purpose which is relevant to the service user group There must be evidence to show that every person has received a contract of the terms and conditions of occupancy Every person must have a plan of care which provides sufficient detail for all staff to be consistent in the way they give care Medication records must be of a satisfactory standard The home must provide an activity programme which is meaningful and appropriate The rota must provide a true record of the arrangements for staff cover on every shift The home must follow recruitment and selection procedures which protect the people in their care The manager must complete the managers award and be suitably qualified for the type of home she manages The homes records must be kept up to date at all times Timescale for action 31st July 05 2. OP2 5 By 31st Aug 05 By 31st Aug 3. OP7 12,15 4. 5. 6. 7. OP9 OP12 OP27 OP29 13,17 16 17,18 17,18 By 31st July By 31st August By 31st July By 31st July 8. OP31 9 By 31st Dec 2006 By 31st Sept 05 Page 23 9. OP1,2,7,9, 27. 12,17 Lister Specialist Care Home J52 S60012 Lister Specialist Care V229521 250505 Stage 4.doc Version 1.30 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. 3. 4. Refer to Standard OP4 OP15 OP18 OP32 Good Practice Recommendations Pre admission assessments should show how the home proposes to meet the full range of needs of each person admitted The food should take into account the cultural origins of people living in the home All staff should receive training on the protection of vulnerable adults The monthly report on the conduct of the home should include an action plan Lister Specialist Care Home J52 S60012 Lister Specialist Care V229521 250505 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection Aire House Town Street Rodley Leeds, LS13 1HP 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 Lister Specialist Care Home J52 S60012 Lister Specialist Care V229521 250505 Stage 4.doc Version 1.30 Page 25 - 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!