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Inspection on 19/11/09 for Sunningdale House

Also see our care home review for Sunningdale House for more information

This inspection was carried out on 19th November 2009.

CQC found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

We thought that the manager had an excellent system of introducing staff to new residents both before and after admission. Staff showed that they tried hard to make people feel settled in the home. The attention to personal care was good. Staff ensured that residents were seen regularly by Doctors, Dentists and Opticians. Care plans contained sufficient information to enable staff to care for people. Medication was properly ordered, stored and administered. Staff have received training in this area. Residents had access to a good range of social activities and more are planned. The home was clean and smelled fresh. A good amount of redecoration and refurbishment had taken place. The laundry in particular was well organised and very clean. Residents said the laundry service was excellent. Residents told us that they knew how to complain if they needed to. Staff were trained in adult protection and demonstrated a good understanding of the issues that could arise. There were leaflets informing residents of their right to a representative or advocate. Staff recruitment, selection, training and supervision was good. There is an established staff team that seems to work well together. All of the residents spoken to praised the attitude of the staff. They said they were hard working and caring. There was a good relaxed atmosphere in the home. The manager seems to lead the staff team well. She was clear about the standards to be reached and communicated well with staff. Residents monies were well managed and accounted for. Record keeping was generally good. With the exception of the gas safety certificate, health and safety checks, tests and drills were up to date.

What has improved since the last inspection?

The premises have been redecorated. New carpets have been provided for communal areas and some bedrooms. Bedroom furniture has been changed in some rooms and new dining furniture has been provided. This has resulted in a better environment for residents to live in.

What the care home could do better:

The menu was different to the planned one that day. The main course was well cooked and very tasty but the dessert was not. There did not seem to be a good reason for changing both planned meals. The manager is addressing this. Waste bins need to be changed to be foot operated. This helps to contain and prevent the spread of infection. The gas safety certificate had expired. The manager, though competent and experienced, has not applied to CQC for registration.

Key inspection report Care homes for older people Name: Address: Sunningdale House Dene Road Hexham Northumberland NE46 1HW     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Janet Thompson     Date: 1 9 1 1 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 26 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Sunningdale House Dene Road Hexham Northumberland NE46 1HW 01434606767 01434607010 sunningdalehouse@schealthcare.co.uk www.southerncrosshealthcare.co.uk Southern Cross Care Homes No 2 Ltd Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Type of registration: Number of places registered: care home 48 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 48 The registered person may provide the following category of service only: Care Home only, Code PC. To service users of the following gender: Either. Whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category, Code OP, maximum number of places 48 Date of last inspection Brief description of the care home Sunningdale House is a purpose built three-storey building situated on the outskirts of Hexham. The home is built on a hill. There is access to landscaped gardens and patio areas on each level. There are two double rooms available for those who wish to share and all rooms have en-suite facilities. Many of the bedrooms in the home have doors, which give access to the garden area. There are lounges and dining rooms on each Care Homes for Older People Page 4 of 26 Over 65 48 0 Brief description of the care home floor and other quiet sitting areas are located around the home. Local shops, cafes, transport and other amenities are within walking distance. Sunningdale House can accommodate frail elderly service users. The home does not provide nursing care. The cost of the service varies per week dependant on financial assessment. Information is available for new and prospective service users, which outlines services provided in the home. Care Homes for Older People Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This is an overview of what the inspector found during the inspection. The quality rating for this service is two stars. This means the people who use this service experience good quality outcomes. We have reviewed our practice when making requirements. Some requirements from previous inspection reports may have been deleted or carried forward to this report as recommendations. This will only happen when it is considered that people who use the service are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. Before the visit we looked at information we received since the last visit to the home. This includes how the service dealt with any complaints, changes to how the home is run, the views of people who use the service and the managers views of how well they Care Homes for Older People Page 6 of 26 care for people. An unannounced visit was made on 19 November 2009. During the visit we talked with people who use the service, some staff and the manager. We looked at information about people who use the service and other records which must be kept. We checked that staff had the knowledge, skills and training to meet the needs of the people they care for and we looked around the building to make sure it was clean, safe and comfortable. Following the inspection feedback was given to the manager. Care Homes for Older People Page 7 of 26 What the care home does well: What has improved since the last inspection? What they could do better: The menu was different to the planned one that day. The main course was well cooked and very tasty but the dessert was not. There did not seem to be a good reason for changing both planned meals. The manager is addressing this. Waste bins need to be changed to be foot operated. This helps to contain and prevent Care Homes for Older People Page 8 of 26 the spread of infection. The gas safety certificate had expired. The manager, though competent and experienced, has not applied to CQC for registration. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 26 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are properly assessed, taking account of their needs and wishes, so that they can be assured this is a suitable home and receive an individual care service. Evidence: Three pre-admission assessments were seen. They contained enough information to enable staff to assess if they could meet the individual needs of people before admission. Information from other health professionals and carers was included in the assessment. The manager or deputy go out to visit residents to assess their needs before admission. A senior carer also goes along to this visit, this is to introduce the prospective resident to someone else on the staff team and provide another familiar face on admission. On the day of inspection a carer was introducing herself to a new resident. She took Care Homes for Older People Page 11 of 26 Evidence: time to let the resident ask her questions and demonstrated a compassionate caring attitude. A resident told us that she visited the home several times before her admission and had met many of the staff before she eventually was admitted to the home. Care Homes for Older People Page 12 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive personal care that is well planned and takes account of their diverse needs. Evidence: Three care plans were examined and two were case tracked. This means that we spoke to the individual residents or observed their care then matched our observations to what was written in the care plan. Both case tracked care plans did reflect the actual care needed by the residents. Care plans took account of peoples diverse and differing needs. People were supported to achieve independence and meet individual goals. Other health professionals contributed to the planning of care. These contributions were clearly recorded. The actual plan of care had been evaluated monthly but not actually rewritten to reflect the small changes that had taken place for people. The manager agreed to address this with staff and, as the changes were very few and minor, we have not made a requirement about this. The actual care people received appeared to be good. We spoke to residents who told us that they were well cared for. They said staff responded quickly if they rang the call Care Homes for Older People Page 13 of 26 Evidence: bell and were attentive to their needs. We noted that everyone was well dressed and looked clean and cared for. Staff were knowledgeable about individual needs and there was a good atmosphere of chat and banter between staff and residents. Medication ordering, administration, storage and disposal were examined. All medicines were accounted for and all those administered were signed for. Two amounts of controlled drug were checked and were correct. Staff were seen to treat residents politely and respectfully. Staff knocked on doors before they entered rooms and respected the privacy of the people living in the home. Care Homes for Older People Page 14 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported to lead a healthy and fulfilling personal lifestyle. This takes account of their wishes and diverse abilities. Evidence: There was a staff member in charge of activities. She has transferred to a carer role on night duty and the manager is currently recruiting someone else to take charge of activities. Residents are supported to use a range of services within the local community and are encouraged to be in control of their own lives as far as possible. One resident was coming in from an independent shopping trip in the local town in his motorised chair on the day of inspection and two others were out with relatives. Another resident told us that she regularly goes to the Abbey for services and confirmed that she is free to go out at any time. There is a broad plan of activities which showed that residents are offered things such as bingo, music, crafts and card games. Records showed that residents had been offered a good range of social events in the past year and more were planned. Day to day events seem to have lapsed in the absence of the activities co-ordinator. On the day of inspection there were no activities taking place. Residents told us they could choose how to spend their day. One resident had brought Care Homes for Older People Page 15 of 26 Evidence: a large number of personal items and furniture with her and it was good to see that her room was so well personalised. Many residents control their own financial affairs, medication and health care. This is encouraged as much as possible. Residents wishes are recorded regarding their preference for care and routine. Residents said they liked the food. We ate the food at the home. The menu had been changed from the intended one for that week. We had stew and dumplings which tasted very good. This was served with carrots, peas and sweetcorn which were all frozen. The provider aims to use one fresh vegetable and one frozen vegetable at this meal, but this was not achieved. The pudding had also been changed from fruit salad to tinned mandarin oranges. There was no apparent reason for this as there was a lot of fresh fruit available in the kitchen. The menu is devised to provide a range of nutrients that are balanced using an independent tool therefore variations should be of equal value. We did not think the manadarin orange pudding was sufficient or appropriate to serve as the main pudding of the day. Care Homes for Older People Page 16 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are protected from harm through thorough policies, procedures and staff training. Evidence: Staff follow the homes policies and procedures relating to the management of complaints and allegations of abuse. Staff have had training on the protection of vulnerable adults. There has been one incident requiring the intervention of the vulnerable adults team, this was due to a medication error. It was dealt with very well by staff and the correct procedures were followed. Residents are told how to complain through the complaints procedure. This was clearly visible within the home. Residents spoken to said they would complain if they needed to but none of them had any current complaints. We spoke to three residents who assured us that all small issues were dealt with immediately. They said they could not find anything to complain about because of this. One resident had been given a leaflet about independent advocates to help her deal with her personal financial situation. The leaflets were available in the entrance of the home for all residents and relatives. Care Homes for Older People Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in a safe comfortable home that is generally pleasant and clean. Evidence: The home was generally clean and free from odours. The furniture and general decor provides residents with a comfortable homely environment. A great deal of upgrading has taken place. In the past year communal areas have been redecorated and carpets replaced. One floor is still waiting for a new carpet but this has been ordered. Dining furniture has been replaced as well as some bedroom and sitting room furniture. Residents told us that the home was warm and comfortable. We noted that bedrooms were very individual and well personalised. Bathrooms in the home were in a good state of repair. The shower room on the top floor was particularly good in that it was spacious, very accessible and well decorated. The bath on this floor is about to be renewed. One of the baths on the middle floor is no longer used as it is not assisted and none of the residents are able to climb in. Consideration should be given to making this into a shower room to increase choice for residents and utilise the space better. The dining room on the middle floor was a little dark due, in part to the blocking of the kitchen hatch. This was done for fire safety reasons. The manager is to investigate Care Homes for Older People Page 18 of 26 Evidence: better lighting for this room. The laundry was very clean and well organised. The laundry is fitted with machines that cope with soiled and infected linen to control the risk of infection. The laundry assistant confirmed that she had received training in infection control and she appeared to be knowledgeable about this subject. The waste bin in the laundry was open topped, in other parts of the home there were bins with hand opened lids. All waste bins should be fitted with a top that is foot operated. Care Homes for Older People Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service are supported and protected through staff numbers, skill and ability. Evidence: The home was adequately staffed on the day of inspection and enough staff were scheduled to be on duty in the near future. The manager said and records confirmed that well over 50 of staff had achieved NVQ level 2. All staff were up to date with essential training such as moving and handling, adult protection and infection control. Staff had also received training in equality and diversity and deprivation of liberty. Staff spoken to said they received the correct amount of training to carry out their jobs and that they were supported to develop their skills. Senior staff have received training in handling of medicines and are about to take an in-house assessment on the subject. There are three staff identified as dignity champions, these staff attend dignity meetings and cascade information to other staff. Three staff recruitment files were examined. These were for one new carer and two long term employed senior care staff. All contained good information. Thorough background checks had been carried out before employment. Residents were protected through checking of criminal records information for all employees. Care Homes for Older People Page 20 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using this service are protected through reflective management taking account of the diverse needs of the service. Evidence: The home has an experienced registered manager. She has not been assessed by CQC as being fit to run the home. This is because the manager has had periods of absence which have interrupted the application process. She is, however, experienced and knowledgeable enough to run the home. Residents told us that the home seems to run well. Staff appeared to be able to communicate with the manager and ask her advice. The relationship between the manager, staff, residents and relatives appears to be good. The home does operate a quality assurance system. Residents, their relatives and professionals have access to questionnaires which are then sent to the provider. The questionnaires are left in the entrance to the home, we advised that they should be Care Homes for Older People Page 21 of 26 Evidence: actually given out to people to increase uptake. The manager stated that residents and relatives meetings were planned but they were not well attended. She feels that the home is small enough that she is able to see people on an individual basis regularly. Servicing and maintenance agreements are in place for facilities and equipment. However the gas safety certificate expired in March 2009. Risks in the environment and tasks, including safe working practices are assessed and reviewed. All fire safety checks, tests and instructions to staff are conducted at the required frequency and recorded. There were no obvious trip hazards in the home. Fire exits were clear of obstruction and all hazardous fluids locked away. Residents monies were managed by the home for some people. The money is held in a central account with individual accounts held. We were therefore unable to count individual amounts. Monies are regularly audited and checked by administrative staff within the organisation. Care Homes for Older People Page 22 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 23 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 26 13 All waste bins must be foot operated. This will help to contain and control the spread of infection. 01/01/2010 2 31 8 The manager must apply for registration. This ensures the home is run by a fit and competent person. 01/01/2010 3 38 13 The gas system must be checked annually and the safety certificate made available. This verifies that the gas systems within the home are safe. 01/01/2010 Care Homes for Older People Page 24 of 26 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 2 15 21 When the menu is changed there is a good reason for doing so and replacement meals should be of equal value. Provide a shower room on the middle floor Care Homes for Older People Page 25 of 26 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 26 of 26 - 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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