Inspection on 15/06/05 for Sunningdale House

This inspection was carried out on 15th June 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 no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Sunningdale House 19/02/09

Sunningdale House 22/11/06

Sunningdale House 01/03/06

Similar services:

Whiteley House

Tyndale Avenue

2-10 Norfolk Road

Bennfield House Nursing Home

Eastfield Residential Home

Sign Health

Springwood

Fairburn Mews

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

CARE HOME ADULTS 18-65 Sunningdale House 103/105 Franklin Road Harrogate North Yorskhire HG1 5EN Lead Inspector John Trainor Unannounced 15 June 2005 10:30 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Sunningdale House J04 J53 Sunningdale House S63606 V232877 140605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Sunningdale House Address 103/105 Franklin Road Harrogate North Yorkshire HG1 5EN 01423 569188 01423 569188 john@franklinhomes.co.uk Franklin Homes Limited 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) Mrs Alyson Margaret Finer Care Home 13 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (13) of places Mental Disorder, excluding learning disability or dementia - over 65 years old. (2) Sunningdale House J04 J53 Sunningdale House S63606 V232877 140605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. Category of Mental Disorder, excluding learning disability or dementia - over 65 years old is to be restricted to two named service users Date of last inspection 17/11/04 Brief Description of the Service: Sunningdale is a care home providing personal care and accommodation for up to 13 adults who have mental health problems. The accommodation provided is in 10 single bedrooms and 1double bedroom located on the top 3 floors of the house all of which are accessed by flights of stairs. There is a wide range of communal space and a number of small kitchens for use by the service users as part of rehabilitation programmes. There is a garden to the front of the home, parking on the road at the front and private parking at the rear of the home. Sunningdale House J04 J53 Sunningdale House S63606 V232877 140605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over five and a half hours. Five service users were spoken to and four members of staff including Mrs Finer the manager. Records were inspected including care records, policies and procedures and health and safety documentation. What the service does well: What has improved since the last inspection? What they could do better: Although training had begun there were areas still needing development. Particularly training on adult abuse issues to safeguard people living at the home from potential abuse. The environment was in need of some refurbishment and the home looked a bit grubby around the edges. A programme for refurbishment scheduling timescales to complete works is necessary to improve the home for the people who live there. Peoples care needs could be written down in a clearer way which details their needs in relation to risk and relapse management. Sunningdale House J04 J53 Sunningdale House S63606 V232877 140605 Stage 4.doc Version 1.30 Page 6 The home should stop wedging open doors unless with approved fire safety devices and should complete a fire risk assessment to improve the management of the safety of people in the home. 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. Sunningdale House J04 J53 Sunningdale House S63606 V232877 140605 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Sunningdale House J04 J53 Sunningdale House S63606 V232877 140605 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2, 4, 5 Individual choice is encouraged and supported. EVIDENCE: People spoken to felt they had enough information to make a decision to move into the home and visiting prior to making a decision is supported. People reported having contracts and contracts were signed which confirms the nature of the contractual relationship with the individual. Not all files had a pre admission assessment recorded so there was not enough evidence to support due consideration of peoples needs prior to admission. However following admission there was attention given to securing appropriate support to meet people’s needs. The failure in this area seems to be in the recording and not in the practice as individually peoples aspirations and needs seemed well supported when all evidence was considered. Sunningdale House J04 J53 Sunningdale House S63606 V232877 140605 Stage 4.doc Version 1.30 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7 and 9 People are considered individually and efforts made to help them develop their aspirations, meet their needs and encourage choice. EVIDENCE: Two people mentioned being supported towards independent living showing the home strives to develop individuals towards more independence. All people spoken to felt they could make choices. Following admission there was attention given to securing appropriate support to meet peoples needs with input from multi disciplinary specialist teams, primary care and involvement in education and voluntary sector service provision. Risk assessments had not always been developed into risk management plans so whilst their was some evidence risks were considered when planning peoples care there was not enough evidence that action was taken to minimise risks by the care planning process. Sunningdale House J04 J53 Sunningdale House S63606 V232877 140605 Stage 4.doc Version 1.30 Page 10 Care plans were in place but would benefit from more attention to detail in particular the risk/relapse management process. This would aid staff to facilitate people’s well being and clearly signpost trigger factors helping to avoid breakdown. Sunningdale House J04 J53 Sunningdale House S63606 V232877 140605 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14, 15, 16, and 17. The home was good at supporting and encouraging people into a lifestyle, which met their individual aspirations and needs. EVIDENCE: One person attended college and had occupational activities arranged, another was supported to attend a healthier lifestyle self help group and a third was on home visit to family at the time of inspection. People made use of local amenities and pursued individual hobbies showing independence and individuality were supported. The home had facilities for home entertainment so people could choose to stay in and watch T.V. if they wished. Sunningdale House J04 J53 Sunningdale House S63606 V232877 140605 Stage 4.doc Version 1.30 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19, and 20 People received the healthcare support they needed. EVIDENCE: Involvement was recorded from multi disciplinary specialist teams, primary care and other health services. People were happy that their needs were being met. Staff had completed the two week medications course at Harrogate College to enable them to dispense medication safely. Improvement to the recording of drugs into the building when not in monitored dosage packages was necessary to enable an audit trail monitoring the safety of the medication dispensing. Sunningdale House J04 J53 Sunningdale House S63606 V232877 140605 Stage 4.doc Version 1.30 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 and 23 Though there were mechanisms for recording and dealing with concerns and complaints more attention was needed to adult abuse training and procedural issues to ensure the safety of the people in the home. EVIDENCE: People living at the home were aware of the complaints procedure and felt they could complain if they needed to There has been no training for staff in adult abuse issues to enable people to identify what abuse is and know how it should be dealt with if suspected. Sunningdale House J04 J53 Sunningdale House S63606 V232877 140605 Stage 4.doc Version 1.30 Page 14 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, and 30 Though clean the environment did not reflect the standard of care in the home and attention was needed to improve this. EVIDENCE: Laundry room was full of old furniture which needed discarding. Poor décor left the home looking grubby round the edges and so did not reflect the efforts of the cleaning staff. The service user kitchen needed refurbishment to enable it to be used for it’s stated purpose in encouraging people towards independence. The laundry room had no soap dispenser or paper towels to promote safe infection control practices. Sunningdale House J04 J53 Sunningdale House S63606 V232877 140605 Stage 4.doc Version 1.30 Page 15 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32 and 35 There was a staff team who had sufficient opportunity to develop in competence in order to meet all of the needs of the people in the home. EVIDENCE: Staff were deployed in numbers sufficient to support people in the home, were courteous and kind to people and had been provided with training opportunities to develop practice. A training programme had been developed since the last inspection and staff training needs were outlined on a matrix available for inspection. Some training has commenced and more is planned in order to support staff to meet peoples needs. Not all staff have received training as yet. A staff supervision programme has been introduced which will include a six monthly appraisal. Sunningdale House J04 J53 Sunningdale House S63606 V232877 140605 Stage 4.doc Version 1.30 Page 16 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37 and 42 The home is being managed with competence though some improvements to health and safety issues would ensure a safer environment for people resident. EVIDENCE: The manager has been in place for seven years and is now in the process of completing the registered managers award. There is a strategic business plan in place outlining a vision and strategy for the company. Gas and electrical safety certificates were in place and fire safety checks had been completed ensuring safety in the environment. Safety procedures would be improved by completion of a fire risk assessment and by ensuring doors are not wedged open unless with those devices designed to safely do so as agreed with the local fire officer. Sunningdale House J04 J53 Sunningdale House S63606 V232877 140605 Stage 4.doc Version 1.30 Page 17 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 1 x 3 3 Standard No 22 23 ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 x 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 1 x x x x x 2 Standard No 11 12 13 14 15 16 17 x 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score x 2 x x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Sunningdale House Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 2 x x x x 1 x J04 J53 Sunningdale House S63606 V232877 140605 Stage 4.doc Version 1.30 Page 18 NO 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 YA2 Regulation Requirement Timescale for action From the day of inspection and to be maintained thereafter. 30th September 2005. 2. YA 24 3. YA 42 14 People must not be admitted to Schedue 3 the home without a full (1(a)) assessment of need and an assurance that the home is able to meet the needs of gthe person assessed. This must be recorded in the care file. 23 (2(d)) A programme of refurbishment of the home must be developed prioritising areas in need and establishing timescales for completion. This must be forwarded to the Commission by 30th September 2005. 23(4) Doors must not be wedged open unless by those devices designed to safely do so as agreed with the fire officer. A Fire risk assessment must be completed in conjunction with the fire officer and a copy forwarded to the Commission by 30th September 2005. From the day of inspection and to be maintained thereafter. 30th September 2005. Sunningdale House J04 J53 Sunningdale House S63606 V232877 140605 Stage 4.doc Version 1.30 Page 19 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 YA 6 & YA 9 YA 23 Good Practice Recommendations Care Plans should be developed to include more detail of risk and relapse management plans. Care plans would benefit from more attention to task/intervention specific detail. Staff should receive training in Adult Abuse issues so they know how to identify and deal with potential abuse. The home should obtain a copy of the Multi Agency Strategy for Adult Abuse. Soap Dispenser and Paper towels should be available in the Laundry to aid infection control. Efforts should be made to ensure the staff training programme is rolled out to all staff and their individual training needs are identified and adressed It is recommended that the registered person achieves the Registered Managers Award by 2005. 2. 3. 4. 5. YA 30 YA 32 YA37 Sunningdale House J04 J53 Sunningdale House S63606 V232877 140605 Stage 4.doc Version 1.30 Page 20 Commission for Social Care Inspection York Area Office Unit 4, Triune Court Monks Cross York, YO32 9GZ 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 Sunningdale House J04 J53 Sunningdale House S63606 V232877 140605 Stage 4.doc Version 1.30 Page 21 - 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!