Inspection on 29/04/05 for Sunningdale House, Perranporth

This inspection was carried out on 29th April 2005.

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 House, Perranporth 16/03/09

Sunningdale House, Perranporth 11/11/08

Sunningdale House, Perranporth 28/11/07

Sunningdale House, Perranporth 27/06/06

Sunningdale House, Perranporth 08/02/06

Sunningdale House, Perranporth 03/11/04

Sunningdale House, Perranporth 13/08/04

Sunningdale House, Perranporth 27/05/04

Sunningdale House, Perranporth 24/03/04

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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 House Boscawen Road Perranporth Cornwall TR6 0EP Lead Inspector Ian Wright Unannounced 29 April 2005 10.00 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Sunningdale House D52-D04 S8907 Sunningdale House V215883 290405 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Sunningdale House Address Boscawen Road Perranporth Cornwall TR6 0EP 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) 01872 571151 01872 572633 Mr Alan Anthony Beale Care Home 36 Category(ies) of Dementia - over 65 years of age (6), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (6), Old age, not falling within any other category (36) Sunningdale House D52-D04 S8907 Sunningdale House V215883 290405 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 3 November 2004 Brief Description of the Service: Sunningdale House provides care for up to 36 elderly people. This includes registration for 6 people with Dementia / mental disorder. The registered provider (owner) is Welling Limited. The Commission for Social Care Inspection is currently determining an application for the registered manager’s post. The home is situated near the centre of Perranporth with easy access to shops and other local community facilities. The home has a pleasant front garden overlooking the boating lake. The majority of bedrooms in the home are en suite. The home has several lounges, and the registered provider is currently building a sun lounge for service users. The home provides some day and respite care. Sunningdale House D52-D04 S8907 Sunningdale House V215883 290405 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over seven and a quarter hours. The inspection was carried out on an unannounced basis. The primary focus was on the requirements from the previous inspection, which was completed on 3 November 2004. The inspector was able to speak to approximately half of the service users, and several of the staff on duty. A relative of a service user was also spoken to. The inspector examined the medication system, staff and care records, and toured the building. Training records were also inspected in further detail following the inspection. What the service does well: What has improved since the last inspection? Management and the staff team have worked hard and have made a lot of effort to improve standards over the last six months. Subsequently there has been a noticeable improvement in levels of satisfaction among service users. A new manager has been employed and feedback from service users regarding her is positive. The management of the medication system has improved significantly, and all staff who administer medication have received appropriate training. The registered provider is in the process of providing a new sun lounge for service users use, and the stair lift has been extended to improve access to the first floor. Sunningdale House D52-D04 S8907 Sunningdale House V215883 290405 Stage 4.doc Version 1.30 Page 6 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. Sunningdale House D52-D04 S8907 Sunningdale House V215883 290405 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Sunningdale House D52-D04 S8907 Sunningdale House V215883 290405 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,3,4,5 Service users are provided with suitable information regarding their rights and responsibilities on admission. Service users are appropriately assessed before admission, so staff can ascertain whether they can meet their needs. Service users can visit before admission to assist them in making a choice whether they wish to live in the home. As training records are currently not adequate it is not clear whether staff have the necessary knowledge and skills to meet service users needs. A suitable training plan is however in place. The staff team do have suitable links with external professionals to enable service users to receive appropriate support for example with their health care needs. EVIDENCE: The registered provider has developed a suitable service user guide, and this has been issued to service users. The registered provider has also developed an informative brochure. Copies of pre admission assessments are kept on service user files inspected. These are completed before the service user comes to live in the home. A suitable care plan is subsequently developed from this. Sunningdale House D52-D04 S8907 Sunningdale House V215883 290405 Stage 4.doc Version 1.30 Page 9 Staff training records are still patchy and subsequently it is unclear if staff are receiving the minimum training requirements as required by regulation. The registered provider has developed a comprehensive training plan for the forthcoming year. From discussion and records it appears there are suitable links with external professionals such as district nurses and general practitioners. The inspector spoke to service users who said they were able to visit the home before formal admission was arranged. Sunningdale House D52-D04 S8907 Sunningdale House V215883 290405 Stage 4.doc Version 1.30 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 9, 10 Care plans provide suitable information so staff can provide appropriate care. A review system of care plans has recently been developed but it is too early to ascertain whether this is effective. Arrangements regarding service users medication are appropriate. Service users spoke positively regarding support received from staff. EVIDENCE: Individual plans of care are available, and these are informative and comprehensive. A system of review of care plans has just been implemented from last month. The registered provider has developed a suitable policy regarding the handling and storage of medication. The medication system was inspected, and recording and storage of medication was satisfactory. The inspector also observed staff administering medication and this was satisfactory. There is a suitable system for the disposal of medication. Team Leaders administer medication and have received suitable training from the pharmacist. Sunningdale House D52-D04 S8907 Sunningdale House V215883 290405 Stage 4.doc Version 1.30 Page 11 The inspector spoke to several service users who said they felt their rights were respected, and they were treated with dignity by staff. Staff were observed working with service users in an appropriate manner for example knocking on bedroom doors before entering. Sunningdale House D52-D04 S8907 Sunningdale House V215883 290405 Stage 4.doc Version 1.30 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 13, 14, 15 Visiting arrangements are suitable and there are appropriate facilities for service users to receive visitors in private. Service users are able to exercise choice and control over their lives. Meals are to a good standard and support provided is generally appropriate. EVIDENCE: Several service users spoken to said they could receive visitors at any time. A relative of one service user said she was happy with care received. Information how to contact advocacy services is available in the service user guide. Service users said they were able to bring their personal possessions into the home. Service users manage their financial affairs where they have the capability. The manager said some service users moneys were kept for small purchases and records for this are kept. However the inspector did not check these were accurate on this occasion. The inspector shared a meal with service users, which was enjoyable and to a good standard. Menus are placed on each table. Two choices are available for each course-although it is a pity the alternative is only a salad on some days. Service users said they were generally happy with meals provided. Support provided by staff was observed as appropriate. The evening tea was observed. Sunningdale House D52-D04 S8907 Sunningdale House V215883 290405 Stage 4.doc Version 1.30 Page 13 Hot and cold options are available and seemed appetising. Some service users said they occasionally were upset by other service users behaviour, and they did not like having to wait too long at times for food and drinks. The provider is building a sun lounge which may be used as an alternative venue for meals. The introduction of a cup of tea at the table after meals was seen as very positive development. One service user described this at ‘the best cup of tea of the day’. Sunningdale House D52-D04 S8907 Sunningdale House V215883 290405 Stage 4.doc Version 1.30 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16, 17, 18 Arrangements regarding complaints and adult protection procedures are satisfactory. Service users have the opportunity to vote in elections. The home has developed a suitable plan regarding staff receiving training in adult protection. EVIDENCE: Copies of the home’s complaints procedure are displayed around the home, and a summary of this is contained in the service users guide. Service users have postal votes arranged if they wish to vote. A suitable adult protection policy has been developed, and the home’s training plan states staff will receive training regarding the prevention of abuse. From training records provided it appears that currently only a minority of staff have received formal training in this area. A requirement has been made for staff to receive this training if it has not already been received. Sunningdale House D52-D04 S8907 Sunningdale House V215883 290405 Stage 4.doc Version 1.30 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19-26 Sunningdale House has suitable facilities for the service users. The home is generally clean, pleasant and hygienic, although the smell of urine was noted in some bedrooms. The majority of bedrooms are en-suite; although screening must be improved in one double bedroom. Although redecoration is not presently a priority, when this is completed the registered provider should take in to consideration the needs of people with dementia (e.g. colour schemes) as presently decorations may create some confusion for people with these needs. EVIDENCE: The property is well maintained, appears to be safe and is homely. The home is currently being improved by the addition of a sun lounge. The home has three lounges where service users can choose to relax. Other facilities such as bathrooms and toilets are suitable. The home was clean and generally hygienic on the day of inspection; although several bedrooms had a smell of urine. Subsequently a requirement from the previous inspection is renotified. Bedrooms are generally suitable for purpose, although the screening in one double bedroom is still inadequate and does not offer satisfactory privacy. Subsequently a requirement from the previous inspection is renotified. The Sunningdale House D52-D04 S8907 Sunningdale House V215883 290405 Stage 4.doc Version 1.30 Page 16 majority of bedrooms have a lock, although this work has not been completed as some doors may need replacement. Subsequently the previous requirement regarding this issue is renotified. Suitable moving and handling equipment was observed such as hoists, a chair lift and assisted baths. There are appropriate records regarding the servicing of this equipment. Sunningdale House D52-D04 S8907 Sunningdale House V215883 290405 Stage 4.doc Version 1.30 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27-30 Staffing levels are suitable to meet the needs of service users. The home has an appropriate training plan. However at the time of inspection there was insufficient evidence regarding the delivery of training which is required by regulation, and other training required for people to carry out their jobs. Copies of training certificates were provided after the inspection. The registered provider completes appropriate checks on staff as part of the recruitment process. EVIDENCE: Sunningdale House D52-D04 S8907 Sunningdale House V215883 290405 Stage 4.doc Version 1.30 Page 18 The inspector observed there was an appropriate number of staff on duty on the day of the inspection. Rota’s also provided evidence of satisfactory staffing i.e. 5 staff from 7:30 to 10:30, 4 staff from 10:30 until 19:30, 3 staff from 19:30 until 21:00, and two waking night staff from 21:00 until 07:30. A team leader is included in this staffing from 07:30 until 21:00. Staff files contain satisfactory information regarding individual staff recruitment, for example all staff have a Criminal Records Bureau check, and a copy of two references. Five of the sixteen care staff currently have NVQ 2 or equivalent (31 ). The home has a suitable training plan and this includes a plan to increase the percentage of staff with an NVQ in care. Staff training records require improvement, as at the time of inspection it was not possible to evidence whether all staff had received appropriate induction and training. For example the induction checklist of one member of staff was not fully completed, and was absent from two other files examined. At the time of inspection there was insufficient evidence regarding whether staff have received appropriate training to carry out their jobs (i.e. first aid, moving and handling, infection control, food handling / hygiene, fire safety). The registered provider must for example liaise with the environmental health and fire departments regarding whether video based training (e.g. fire, moving and handling, first aid, food handling / hygiene) is satisfactory and meets regulatory requirements. There was also insufficient evidence regarding whether staff have received other training appropriate to their roles (e.g. NVQ 2 in care, protecting service users from abuse and dementia awareness). However the registered provider subsequently provided further evidence of training which staff have received. Although there are some gaps, it must be noted the Commission does recognise the home has made considerable efforts to improve training delivery in recent weeks. It is also appreciated there have been a number of difficulties in implementing appropriate training, and improving documentation for example the absence of a registered manager. The registered provider has however been renotified regarding the requirement regarding food handling / hygiene, infection control, first aid and fire safety training on five occasions. A requirement regarding moving and handling training has been renotified now on three occasions. Although video based training in these areas have been delivered, the registered provider must ascertain whether this is satisfactory and provides adequate protection for service users. Failure of the registered provider to provide an appropriate training for staff and appropriate documentation regarding this could result in legal action being taken by the Commission for Social Care Inspection. Sunningdale House D52-D04 S8907 Sunningdale House V215883 290405 Stage 4.doc Version 1.30 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 37, 38 An application for registered manager has recently being determined, although currently there is insufficient information to complete this process. Interactions between staff, and with service users are appropriate. Record keeping in the home is satisfactory. There are generally suitable health and safety precautions, however a requirement has been made regarding health and safety training. EVIDENCE: The manager Ms Rudge has recently become the manager of Sunningdale House. She appears to have suitable knowledge, experience and skills to carry out the role. Service users and staff spoke positively of her. The Commission for Social Care Inspection is currently determining an application for Ms Rudge to become the new registered manager. The commission has had difficulty in obtaining two references for the applicant-including from the applicant’s previous employer. Subsequently the inspector has asked the applicant to Sunningdale House D52-D04 S8907 Sunningdale House V215883 290405 Stage 4.doc Version 1.30 Page 20 chase these references up. The applicant is required to apply for a Criminal Records Bureau /Protection of Vulnerable Adults check via the Commission for Social Care Inspection at her earliest opportunity. Failure to provide appropriate information could result in the Commission of Social Care Inspection being unable to determine the application. The inspector observed staff working well together, and sat in at the staff handover. Staff appeared professional, positive and knowledgeable regarding service users needs. There appeared to be a good atmosphere between team members. Staff meetings occur and these are recorded appropriately. Suitable records are kept regarding the running of the home, and individual service users. These are kept confidentially. Appropriate records are kept regarding health and safety issues. Health and safety precautions, and working practices are generally satisfactory. For example there is appropriate testing of fire equipment, gas appliances and portable electrical appliances. However requirements regarding health and safety training are renotified elsewhere in the report. Sunningdale House D52-D04 S8907 Sunningdale House V215883 290405 Stage 4.doc Version 1.30 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 2 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 3 2 3 2 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 2 3 x x x x 3 3 Sunningdale House D52-D04 S8907 Sunningdale House V215883 290405 Stage 4.doc Version 1.30 Page 22 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP19 Regulation Requirement Timescale for action 1 August 2005 2. OP30 3. OP24 4. OP2 5. 6. OP30 OP31 12, 16, 23 Screening must be improved in one of the shared bedrooms.(Timescale of 31 March 2005 not met)2nd Notification 18(1)(c) The registered provider must provide training required by regulation i.e. fire training, infection control, food handling, first aid.(Timescale of 31 March 2005 not met)5th Notification 12, 16, 23 Service users must be provided with a lock on their bedroom doors. A risk assessment must be completed to assess whether service users can be provided with a key.(Timescale of 31 March 2005 not met)3rd Notification 16(2)(k) The registered provider must improve odour control e.g. in some service user bedrooms.(Timescale of 31 March 2005 not met)2nd Notification 13(6), Care staff must receive training 18(1)(c) regarding adult protection and dementia awareness 9 The applicant for the registered managers post must ensure appropriate information is D52-D04 S8907 Sunningdale House V215883 290405 Stage 4.doc 1 August 2005 1 August 2005 1 July 2005 1 August 2005 1 July 2005 Sunningdale House Version 1.30 Page 23 7. OP30 13(3-6) 8. OP38 13(3-6) provided to the Commission for Social Care Inspection in order for the commission to determine her application The registered manager must provide training for staff to assist service users with appropriate moving and handling.(Timescale of 31 March 2005 not met)3rd Notification The registered provider must liaise with the district council environmental health department, and fire department regarding whether video based health and safety training (first aid, moving and handling, infection control, fire etc.) is satisfactory and report back to the Commission. 1 August 2005 1 August 2005 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 15 Good Practice Recommendations The improvement of seating arrangements at meal times is recommended to minimise disturbance from some service users. Arrangements to improve waiting times for food and drinks should be considered and should at least be monitored to ensure they do not deteriorate. There should be two choices of hot meals at lunchtime When the home is redecorated, the registered provider should consult with specialist organisations regarding the needs of people with dementia 2. 3. 15 22 Sunningdale House D52-D04 S8907 Sunningdale House V215883 290405 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection John Keay House Tregonissey Road St Austell Cornwall PL25 4AD 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. 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