Inspection on 09/01/07 for Sunningdale Court Nursing And Residential Home Hull

This inspection was carried out on 9th January 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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Sunningdale Court Nursing And... 15/12/05

Sunningdale Court Nursing And... 11/05/05

Sunningdale Court Nursing And... 19/10/04

Sunningdale Court Nursing And... 17/06/04

Sunningdale Court Nursing And... 05/05/04

Sunningdale Court Nursing And... 02/03/04

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

CARE HOMES FOR OLDER PEOPLE Sunningdale Court Nursing And Residential Home Hull Birkdale Way Newbridge Road Kingston Upon Hull East Yorkshire HU9 2BH Lead Inspector Eileen Engelmann Unannounced Inspection 9th January 2007 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Sunningdale Court Nursing And Residential Home Hull DS0000000956.V326588.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 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. Sunningdale Court Nursing And Residential Home Hull DS0000000956.V326588.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Sunningdale Court Nursing And Residential Home Hull Birkdale Way Newbridge Road Kingston Upon Hull East Yorkshire HU9 2BH 01482 587924 01482 222012 Address 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) Ashbourne Homes Limited Position Vacant Care Home 49 Category(ies) of Dementia (49), Old age, not falling within any registration, with number other category (49), Physical disability (49) of places Sunningdale Court Nursing And Residential Home Hull DS0000000956.V326588.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. To admit another service user under the `younger disabled` category, therefore, increasing the number in this category to three (3). 15th December 2005 Date of last inspection Brief Description of the Service: Sunningdale Court is a care home with nursing, which provides accommodation for 49 residents within the categories of Dementia, Old age, Physical Disabilities and Terminal Illness. The home is purpose built for its current use and accommodation is located on two levels, with passenger lift access to the upper floor. The home is owned by Ashborne Homes, a national organisation, which provides support to the homes management team from a regional office. The home is situated to the east of the City of Hull, easily accessible by the citys link road and close to public transport services. Local amenities are within a short walk of the home. Information about the home and its service can be found in the statement of purpose and service user guide, both these documents are available from the manager of the home, and copies are in every resident’s bedroom. The latest inspection report for the home is kept in the manager’s office and copies are available on request. Information given by the manager on 05/12/06 within the Pre-Inspection Questionnaire indicates the home charges fees from £327.50 per week for residential care to £327.50 plus the nursing band payment for nursing care. There is a ‘top-up’ fee of £11.00 per week for all residents. Residents will pay additional costs for optional extras such as hairdressing, private chiropody treatment, toiletries and newspapers/magazines. Information on the specific charges for these can be obtained from the manager. Sunningdale Court Nursing And Residential Home Hull DS0000000956.V326588.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Ann Bond is the acting manager of Sunningdale Court and is not registered with the Commission. Throughout this report she is referred to as the manager. This unannounced visit was carried out with the manager, staff, relatives and residents of Sunningdale Court. The visit took place over 1 day and included a tour of the premises, examination of staff and resident files and records relating to the service. Staffs on duty, two relatives and four of the residents were spoken to; their comments have been included in this report. Information was gathered from a number of different sources before the inspector visited the home. Questionnaires were sent out to a selection of relatives, residents and staff and their written response to these was good. The inspector received 10 back from relatives (67 ), 8 from staff (40 ) and 9 from residents (32 ). The manager completed a pre-inspection questionnaire and returned this to the Commission within the given timescale. The manager and staff at Sunningdale Court have worked hard to maintain high standards at the home and indeed have exceeded the expectations in a number of areas. During this visit concerns were raised over the recruitment practices within the home. This area of the service is usually very rigorous and up to date, but for some reason there was a drop in the homes standards at one point last year. The manager has assured the inspector that this was an oversight and will not happen again. What the service does well: The home’s statement of purpose, and service user guide are given/explained to each resident living at the home. Information within the documents gives residents a good idea of the service provided and four individuals said ‘ we were able to talk to the manager and staff before coming into the home and find out more about what living at the home would involve and how our needs and interests would be met’. The home has an experienced and enthusiastic team of staff who work well together and enjoy taking part in training and development sessions. The staff are motivated and keen to ensure that residents receive high standards of care. Residents have good access to professional medical staff and are able to access external services such as dentists and opticians. Sunningdale Court Nursing And Residential Home Hull DS0000000956.V326588.R01.S.doc Version 5.2 Page 6 Meals are well presented and offer people at the home a choice and variety of different foods. Visitors to the home are made welcome and the home has a relaxed atmosphere that encourages families and friends to join in with activities and other social events. Resident’s comments indicate they hold the staff in high regard, one individual said that ‘the staff are friendly, helpful and always supportive’. Four residents said that they ‘enjoy living at the home and that it has a very comfortable and pleasant atmosphere’. Residents are provided with a warm, safe and comfortable environment that is homely and welcoming. The home is clean and staff work hard to make sure the building is odour free. Residents said they are happy with their bedrooms and can bring in their own possessions, making it feel more like home. What has improved since the last inspection? 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. The summary of this inspection report can Sunningdale Court Nursing And Residential Home Hull DS0000000956.V326588.R01.S.doc Version 5.2 Page 7 be made available in other formats on request. Sunningdale Court Nursing And Residential Home Hull DS0000000956.V326588.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Sunningdale Court Nursing And Residential Home Hull DS0000000956.V326588.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4 and 6. Quality in this outcome area is good. All residents undergo a full needs assessment and are given sufficient information about the home and its facilities prior to admission, to enable them to be confident that their needs can be met by the service. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The statement of purpose and service user guide is found within each resident’s bedroom and copies are available from the manager. Each of the packs is produced in a clear print version, and the manager said work is going on to provide a taped version and large print format as and when needed. There is a monthly newsletter giving individuals more information about events taking place within the home. Copies of the newsletter are available from the activities co-ordinator and are on display throughout the home. Information from the surveys shows that the majority of residents received sufficient information to make an informed choice about the service before accepting the placement offer. These individuals have also received a Sunningdale Court Nursing And Residential Home Hull DS0000000956.V326588.R01.S.doc Version 5.2 Page 10 contract/statement of terms and conditions from the home. One individual said ‘ I was not really well enough at the time of transferring to the home, to make the decision about the move. My son and daughter looked around on my behalf and were given all relevant information’. Each resident has their own individual file and four of those looked had a need assessment completed by the funding authority and the home has also completed its own needs assessment before a placement was offered to the resident. The home develops a care plan from the assessments, identifying the individual’s problems, needs and abilities using the information gathered from the resident and family. Those residents at the home who receive nursing care have undergone an assessment by a NHS registered nurse from the local Primary Care Trust, to determine the level of nursing input required by each individual. Staff members on duty were knowledgeable about the needs of each resident and had a good understanding of their specific problems/abilities and the care given on a daily basis. The home employs four staff from Ghana, South Africa and Russia. These individuals offer staff an insight into different cultures and informal discussion with the staff indicates they work well together as a team. Residents are able to make a limited choice of staff gender when deciding who they would like to deliver their care, as the home has two male care staff as well as the female members. The staff training files and the training matrix show that new staff go through an induction before starting work and that the home has a training programme in place. Information from the files and matrix indicates that the majority of staff are up to date with their basic mandatory safe working practice training, and the manager said she is looking into providing training in more specialised subjects linked to conditions of old age. The employment records show that the manager is using a selective approach to recruitment; ensuring new staff have the right skills and attitude to meet the needs of the residents. Information from the Pre-Inspection Questionnaire and discussion with the residents indicates that all of the residents are of white/British nationality. The home does accept residents with specific cultural or diverse needs and everyone is assessed on an individual basis. Discussion with the deputy manager indicated that the home looks after a number of people from the local community, although placements are open to individuals from all areas. Comments from the relatives and residents surveys indicate they are pleased with the care being given and have a good relationship with the staff. Sunningdale Court Nursing And Residential Home Hull DS0000000956.V326588.R01.S.doc Version 5.2 Page 11 The home does not accept intermediate care placements so standard six is not applicable to the service provided. Sunningdale Court Nursing And Residential Home Hull DS0000000956.V326588.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is good. The health, personal and social care needs of the residents are clearly documented and are being met by the service and staff. Improvements to the staff performance around record keeping within the medication system must be made, to ensure the residents’ welfare is protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Since the last visit in December 2005 the home has changed the format of its care plans, all documents have been up dated and reviewed and information transferred onto the new paperwork. Individual care plans are in place for all residents and the four examined set out the health, personal and social care needs identified for each person. The plans looked at have been evaluated on a monthly basis and any changes to the care being given is documented and implemented by the staff. Risk assessments were seen to cover pressure sores, nutrition, moving/handling and activities of daily living. Information about the resident’s social interests, likes and dislikes, spiritual needs and wishes regarding death and dying are Sunningdale Court Nursing And Residential Home Hull DS0000000956.V326588.R01.S.doc Version 5.2 Page 13 included within the individuals care plan. The funding authorities are carrying out yearly reviews of the care plans and the minutes of these meetings show that residents have input to this process (where possible), and family/representatives are also invited to the reviews with the resident’s permission. Residents or their representative have signed the care plans at the point of their being written to show they agree with the content, however there is little evidence that residents are consulted on a regular basis about their care, especially when staff are completing the monthly evaluations. This was discussed with the manager and she said she would look at how staff could involve the residents more in this process. Four residents said that they have good access to their GP’s, chiropody, dentist and optician services, with records of their visits being written into their care plans. They all have access to outpatient appointments at the hospital and records show that they have an escort from the home if wished. Responses to the surveys indicated that the residents and relatives are satisfied with the level of medical support given to the people living at the home. Entries in the care plan specify where individuals have dietary needs, including PEG feeds, supplement drinks and pureed diets. The staff weighs everyone on a regular basis and evidence in the plans show that dieticians are called out if the home has particular concerns about an individual. One dietician was visiting the home at the time of this inspection, they told the inspector that they were pleased with the care in the home, individual peg sites are clean and healing and dietary instructions are carried out promptly. The nurses within the home carry out specialist tasks such as PEG tubes/feeding regimes and wound dressings. Pressure areas are monitored carefully and proactive measures include risk assessments and special mattresses and seat cushions. Information from the pre-inspection questionnaire and discussion with the manager indicates that currently there are two residents with pressure sores, their wounds are documented in their care plans and wound care is given as appropriate. Checks of the wound care records showed these were detailed around the type of dressings used and the progress of the wound. The staff ask the tissue viability nurse for advice, where required, and documented any changes as necessary. Relatives commented that they are kept informed of their relative’s wellbeing by the staff; they are regularly consulted (were appropriate) on their care and feel involved in their lives. Overall there is a good level of satisfaction with the care being given to the residents. During the last visit in December 2005 it was noted that there were some problems with the way medications were being give and issues around time management. The manager took immediate action to rectify these concerns and altered care practices to ensure residents received their medication on time and in a safe manner. Sunningdale Court Nursing And Residential Home Hull DS0000000956.V326588.R01.S.doc Version 5.2 Page 14 At this visit it was observed that on the whole the medication records are up to date and accurate. One person who has been case-tracked throughout this inspection is fairly new into the home and their medication is not synchronised with the four-week cycle that usually operates in the medication system. Staff have not documented the quantities of mediation received for this individual and this makes auditing the stock levels very difficult. Medication brought forward from the previous medication cycle is also not recorded for this person. This was discussed with the manager who said she would ensure the staff took action immediately to sort out the problems. The medication policy for the home says that individuals can self-medicate if they want to and after a risk assessment has been completed and agreed. All four of the residents spoken to prefer to have staff administer their medication. Checks of the controlled drugs and register showed that these are up to date, accurate and well managed. Resident and relative comments show they are very satisfied with the care and support offered by the staff. Chats with the residents revealed that they are happy with the way in which personal care is given at the home, and they feel that the staff respect their wishes and choices regarding privacy and dignity. Two individuals spoken to said ‘ the staff are lovely, they are always around to offer help and support when we need it and are very considerate of our feelings’. One individual spoken to is new into the home, they said ‘the staff have been extremely good at helping me settle into my room and are friendly, kind and take the time to talk to me every day’. Sunningdale Court Nursing And Residential Home Hull DS0000000956.V326588.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is good. Residents are provided with choice and diversity in the meals and activities provided by the home. Relatives and visitors are made welcome at the home and good links to the community enrich the residents social and leisure opportunities. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Verbal feedback from four residents was extremely positive about the home and the social activities that are provided for the resident’s entertainment. One individual said ‘the food at Christmas was wonderful, we had a lovely time and I thoroughly enjoyed the Party’. At the time of this visit the Activity coordinator was hold in a Quiz in the upstairs lounge, around fifteen residents were participating and others were listening too. Answers to the questions were flying thick and fast through the room and everyone was enjoying themselves. Information from the resident surveys showed that everyone is extremely satisfied with the social activities on offer and individuals felt there was always something they could participate in. Two residents said ‘ activities are always available, but we prefer the peace and quiet of our rooms, and the staff Sunningdale Court Nursing And Residential Home Hull DS0000000956.V326588.R01.S.doc Version 5.2 Page 16 respect this’. The monthly newsletter keeps everyone informed of forthcoming events and activities and there is a rolling programme of internal and external entertainment, with trips out on a regular basis. Residents’ files indicate that there are a number of individuals who follow different spiritual faiths, including Church of England, Methodist and Catholicism. Discussion with the residents showed that they do not want to go to church on a regular basis, but those expressing a wish to do so are assisted by the staff to attend local services. Major Christian festivals (Easter and Christmas) and birthdays are celebrated within the home and families are encouraged to join in with these events. Discussion with the residents indicates that they have good contact with their families and friends. Everyone said they were able to see visitors in the lounge or in their own room and they could go out of the home with family or staff would take them into the town. Visitors were seen coming and going during the day, staff were observed making them welcome and there clearly was a good relationship between all parties. Two relatives spoken to were full of praise for the staff and the home, one said ‘you cannot find a better home in the whole of Hull, I am so glad that mum came here’. Information about advocacy services is on display in the home and includes leaflets made available to the residents and relatives from the manager. Discussion with the manager indicated that no one at the home is currently using an advocacy service, although these have been accessed in the past. Four residents spoken to were well aware of their rights and said that they had family members who acted on their behalf and took care of their finances. Information from the pre-inspection questionnaire indicates one resident has the manager as their appointee. Residents spoken to are satisfied that they can access their personal allowances when needed. All the residents said that the home encouraged them to bring in small items of furniture and personal possessions to decorate their bedrooms. The home continues to receive the ‘Heartbeat Award’ from the local council in recognition of the quality of food provided for the residents. Comments from the surveys received from staff, residents and relatives indicate that overall there is a good level of satisfaction with the meals provided by the home. One individual said ‘the food is lovely, choices are good and there is plenty of it’, another commented that ‘the new cook has made such a difference, she takes time to talk to us about our preferences and makes an effort to provide individual choices and meals’. Observation of the midday meal showed it to be well prepared and presented, and the kitchen staff had made an effort to provide soft/pureed diets in an attractive way. Staff were organised when serving the meal and a number of individuals were seen to offer assistance to residents who need help with eating and drinking. Menus are available on the dining tables and jugs of squash were seen in the Sunningdale Court Nursing And Residential Home Hull DS0000000956.V326588.R01.S.doc Version 5.2 Page 17 dining room and lounges. Residents said ‘we can help ourselves or the staff will get us a glass and those who need assistance have regular drinks offered’. Sunningdale Court Nursing And Residential Home Hull DS0000000956.V326588.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. The home has a satisfactory complaints system with some evidence that residents feel that their views are listened to and acted upon. Staff and residents are confident about reporting any concerns and the manager acts quickly on any issues raised. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Checks of the complaints record shows that the home has not had any formal complaints since the last inspection. Discussion with the manager indicates she would deal with any ‘niggles or grumbles’ on a daily basis. The home has a complaints policy and procedure that is found within the statement of purpose and service user guide. It is also on display within the home. Four residents showed a clear understanding about how to make their views and opinions heard and said ‘the manager comes round every day to see us and will discuss any problems at this time. She will take immediate action, if needed, to resolve any issues brought to her attention’. The staff on duty displayed a good understanding of the vulnerable adults procedure and three residents spoken to said they ‘felt safe at the home’. Staff training files show that Protection of Vulnerable Adults from Abuse training has taken place and is an ongoing process, and information from the staff surveys indicates they are confident about the whistle blowing procedure and discussing any concerns with the management team. Sunningdale Court Nursing And Residential Home Hull DS0000000956.V326588.R01.S.doc Version 5.2 Page 19 The home has policies and procedures to cover adult protection and prevention of abuse, whistle blowing, aggression, physical intervention and restraint, and management of resident’s money and financial affairs. Examination of a number of staff files showed that although the majority of staff have their employment and background history checks (Criminal Records Bureau) in place, some of the new staff were started in employment before the results of their adult protection register checks were obtained. There is evidence that these individuals were supervised during their work and this is not the usual standard of recruitment practices carried out within the home. The manager assured the inspector that from now on new staff would not start work until the checks are completed. This will be followed up at the next visit. Sunningdale Court Nursing And Residential Home Hull DS0000000956.V326588.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 22, 24 and 26. Quality in this outcome area is good. The standard of environment within the home is good, providing residents with an attractive and homely place to live. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager has a record of the ongoing maintenance and renewal programme within the home and this indicates that the provider is committed to improving the facilities and environment within the home. Since the last visit in December 2005, the home has purchased four more hospital beds for high dependency residents, replaced four bedroom carpets, fitted new window restrictors to the upstairs floor, bought six new bedside tables and four commodes, replaced the ‘blown’ glass windows around the home, fitted a new grill in the kitchen and has ordered a new cooker. There is a rolling programme of redecoration within the home and at the time of this visit the maintenance man was busy redecorating one of the bedrooms. Sunningdale Court Nursing And Residential Home Hull DS0000000956.V326588.R01.S.doc Version 5.2 Page 21 All areas seen at this visit were clean, tidy and welcoming. Inspection of the home showed that it has been designed and built to meet the needs of disabled individuals. Doorways to bedrooms, communal space and toilet/bathing facilities are wide enough for wheelchairs, and corridors are spacious and have enough room for people in wheelchairs or with walking frames to pass by comfortably. The home is built on two floors with flat walkways inside and out, providing safe and secure footing for people with limited mobility. Access to the upper floor is by use of a stair lift or the passenger lift. Discussion with the staff indicates that there is a wide range of equipment provided to help with the moving and handling of the residents and to encourage their independence within the home. This includes mobile hoists, stand aids and handrails. Key coded door locks are in place at the top of the stairs to prevent residents from risk of falling. Four residents spoken to were very pleased with their individual rooms and said that they had ‘brought in a number of personal possessions to make them feel more at home’. The rooms are decorated to a high standard and supplied with sufficient furnishings to meet the needs of the residents. Double rooms are supplied with privacy curtains that can be drawn across the room when individuals are receiving personal care. All bedrooms are supplied with door locks and lockable storage space to ensure resident’s valuables are kept safe. Staff have a master key, which can be used to gain access in an emergency. The environment is clean, warm and comfortable and no malodours were present. Comments from the surveys indicates that the residents find the home to be spotlessly clean and are satisfied with the laundry service provided by the home. Sunningdale Court Nursing And Residential Home Hull DS0000000956.V326588.R01.S.doc Version 5.2 Page 22 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is good. Staff morale is high resulting in an enthusiastic workforce that works positively with residents to improve their whole quality of life. Improvements are needed to the recruitment practices to ensure the standard of vetting and obtaining appropriate checks remains high, protecting residents from risk. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Comments received from the residents, relatives and staff were positive about the staffing levels, and everyone was satisfied that there were sufficient people on duty to meet the needs of the residents. One relative said that ‘ the staff are friendly and communication is good. I am confident that my mother is warm, safe and feels loved and cared for’. Staff morale on the whole is good, and individuals said that there is a good working atmosphere at the home. Staff said ‘ it would be nice if there were some rotation of staff onto all the units so we can get to know the residents on each unit and floor within the home’. Inspection of the duty rota and discussion with the manager indicates that the staffing levels at the home remain the same as at the last inspection. In general there are two nurses and seven care staff on duty during the day and one nurse and three care staff at night. Observation of the staff showed that the home is busy, but well organised. Sunningdale Court Nursing And Residential Home Hull DS0000000956.V326588.R01.S.doc Version 5.2 Page 23 The residential staffing guidance does not give specific hours for nursing input and it is up to the management of the home to decide how many hours of nursing care are required to meet the needs of the residents, based on the dependency levels of the individuals. Discussion with the manager revealed that there are 32 residents receiving nursing care and 14 receiving personal care. Information from the pre-inspection questionnaire about the number of staffing hours provided, and information gathered during the inspection about the dependency levels of the residents, was used with the Residential Staffing Forum Guidance and showed that the home is meeting the recommended guidelines. There is an induction and foundation course for new members of staff, and 57 of the care staff have achieved an NVQ 2 or 3. The home provides a mandatory staff-training programme and the manager plans to add more specialised training that reflects the different care needs of the client group. There is no evidence that staff have received training around equality, diversity and disability rights and this should be included in the rolling programme of staff training and development. The home has an equal opportunities policy and procedure. Information from the staff personnel and training records and discussion with the manager, shows that that this is promoted when employing new staff and throughout the working practices of the home. The manager said that she has tried to recruit more male carers in the past as she is aware that the majority of staff are female, but this has proved difficult as there have been few suitable applicants. She is aware that this may affect resident’s wishes regarding gender choice for giving of personal care, and this is discussed before an individual is offered a placement at the home. Comments from the manager indicate that the majority of the residents are from a white British background, but the home is able to offer a range of services when they are approached from someone of another culture or ethnic group. The home has a recruitment policy and procedure that the manager understands and has used rigorously in the past. However, there appears to have an upset in using this process before Christmas as the four files for new staff seen by the inspector on this visit showed the employees had started work before their Adult Protection Register check had been obtained by the home. Anyone working at the home who has had an Adult Protection Register Check completed and before their Criminal Records Bureau report is received by the Provider, must be supervised at all times. There is evidence in the staff files to indicate that these individuals had received supervision during their work hours. The manager assured the inspector that all future employees would not start work until the checks were completed and received. This area of practice will be checked at the next visit. Sunningdale Court Nursing And Residential Home Hull DS0000000956.V326588.R01.S.doc Version 5.2 Page 24 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. Quality in this outcome area is good. The management of the home is satisfactory overall and the home regularly reviews aspects of its performance through a good programme of audits and consultations, which includes seeking the views of residents, staff and relatives. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The requirement in the last report (December 2005) for a registered manager has not been met and will remain in this report. There is no registered manager and this has been the case since 2003 when the last manager left. There have been four acting managers since this time, but none made application for registration to the CSCI. Ann Bond (the manager) is supported by trained nurses twenty-four hours a day at the home, Sunningdale Court Nursing And Residential Home Hull DS0000000956.V326588.R01.S.doc Version 5.2 Page 25 and has additional support from Ashbourne Homes Limited on a regular basis. She is in the process of applying to be registered as the manager of the home and is over half way to completing the Registered Managers Award training certificate. Ann said she hopes to complete the award by the end of 2007. Staff spoke highly of the manager saying that ‘ Ann gives clear guidance on what is expected of us and is very supportive, she tells us if we are not doing something right and is strict but fair’. The home has achieved the Hull City Council’s Quality Assurance Award (QDS 1 and 2), and there is evidence of regular audits being carried out by the manager. Meetings for the staff and residents are taking place; minutes are kept and are available for any interested parties to read. Policies and procedures are up dated and reviewed as an ongoing practice and action is being taken to ensure the requirements of the inspection reports are met. Feedback is sought from the residents and relatives through regular meetings and satisfaction questionnaires, and the manager is working on producing an annual development report as part of this process to highlight where the service is going and/or indicate how the management team is addressing any shortfalls in the service. Checks of the finance systems within the home found that since the last visit in December 2005 the handwritten records have been replaced by a computerised system. This is faster and easier for the administrator to keep up to date. A number of residents have arranged for their pensions to be paid into the home’s account where their fees are deducted and their personal allowance transferred to their own separate Personal Allowance account. Other residents have their families looking after their financial affairs and their relatives top up the resident’s individual personal allowance account on a regular basis. Resident’s who have asked the home to look after their personal allowances are able to access their money on request. All monies are kept safe and secure within the home and only the administrator or manager has access to the funds. The homes accounts are audited twice a year by external senior management staff employed by the company. Maintenance certificates are in place and up to date for all the utilities and equipment within the building. Accident books are filled in appropriately and regulation 37 reports completed and sent on to the Commission where appropriate. Staff have received training in safe working practices and the manager has completed generic risk assessments for a safe environment within the home. Risk assessments were seen regarding fire, moving and handling, cot sides and daily activities of living. Sunningdale Court Nursing And Residential Home Hull DS0000000956.V326588.R01.S.doc Version 5.2 Page 26 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 X X 3 X 3 X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X X 3 Sunningdale Court Nursing And Residential Home Hull DS0000000956.V326588.R01.S.doc Version 5.2 Page 27 Are there any outstanding requirements from the last inspection? Yes. STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP9 Regulation 13 Requirement Timescale for action 01/06/07 2. OP18 OP29 3. OP31 Medications in the custody of the home must be handled according to the requirements of the Medicines Act 1968, guidelines from the Royal Pharmaceutical Society, the requirements of the Misuse of Drugs Act 1971 and Nursing staff abide by the UKCC/NMC Standards for the administration of medicines. 12, 13, 19 The registered person must 01/06/07 ensure they operate a thorough recruitment procedure based on equal opportunities and ensuring the protection of the residents. 8 A manager must be appointed 01/06/07 and seek registration with the Commission (given timescales of 1/11/04, 01/09/05 and 01/06/06 were not met). Sunningdale Court Nursing And Residential Home Hull DS0000000956.V326588.R01.S.doc Version 5.2 Page 28 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 OP4 Good Practice Recommendations The manager should introduce more specialised training linked to Old age and their associated conditions, so staff have up to date knowledge and skills to meet the changing needs of the residents. The manager should ensure care staff have access to equality and diversity training as part of the rolling programme of training within the home. The manager should ensure the annual development plan is completed and published by the end of April 2007. 2. 3. OP30 OP33 Sunningdale Court Nursing And Residential Home Hull DS0000000956.V326588.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Hessle Area Office First Floor 3 Hesslewood Country Office Park Ferriby Road Hessle HU13 0QF National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Sunningdale Court Nursing And Residential Home Hull DS0000000956.V326588.R01.S.doc Version 5.2 Page 30 - 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. 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