Inspection on 21/02/07 for Sunningdale Lodge

This inspection was carried out on 21st February 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Sunningdale Lodge 10/01/06

Sunningdale Lodge 23/08/05

Sunningdale Lodge 03/02/05

Sunningdale Lodge 27/07/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Sunningdale Lodge Sunningdale Road Yeovil Somerset BA21 5LD Lead Inspector John Hurley Unannounced Inspection 21st February 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 Lodge DS0000016089.V331494.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 Lodge DS0000016089.V331494.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Sunningdale Lodge Address Sunningdale Road Yeovil Somerset BA21 5LD 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) 01935 422980 01935 706334 Somerset Care Limited Mrs Patricia Anne Ellesmere Care Home 38 Category(ies) of Dementia - over 65 years of age (0), Old age, registration, with number not falling within any other category (0) of places Sunningdale Lodge DS0000016089.V331494.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. Up to a maximum of 38 persons in category OP. Up to a maximum of 19 persons in category DE(E), all of whom will reside on the middle floor of the home. The category of DE(E) will be reviewed when alternative accommodation in Yeovil provided by Somerset Care Ltd is registered for this category. The named servise user under 65 years may be admitted for regular periods of respite care as agreed between the home and the Care Manager One named service user, as per request 16/5/06, in the category of MD, under 65 years may be admitted. Date of last inspection Brief Description of the Service: Sunningdale Lodge provides personal care services to 38 service users within the older person category of registration. 19 beds on the middle floor are registered to provide specialist residential care (SRC) for people with dementia care needs. The home is part of Somerset Care Ltd. The home is located in a residential area of Yeovil, close to local shops, Post Office, GP practice and Church. The town centre is within walking distance but only for those who are physically fit and can manage traffic safely. All bedrooms in the home are single and have washing facilities. Service users accommodation is on three floors, made accessible by a passenger lift. Each of the floors has a number of small sitting areas. Those accommodated on the top and ground floors have use of the ground floor dining room and lounges, the top floor has quiet seating areas. Service users on the first floor have enduring mental health problems associated with old age. They have a kitchenette and lounge/diner. Access to all floors is through a keypad system. Downstairs there is a conservatory giving access to a large patio with seating areas and summerhouse. Sunningdale Lodge DS0000016089.V331494.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first key inspection of Sunningdale of 2007. The inspection process followed the Commission for Social Care Inspection Inspecting for Better Lives methodology, which included paper surveys of clients and client relatives a completed pre-inspection questionnaire by the registered provider and a site visit to the service in Yeovil. Comments from clients and relatives were positive, indicating they were very satisfied with the quality of the service they receive. A tour of the premises was made, interaction between staff and service users observed as well as care practices that included the administration of medicines and the serving of food. The inspector also joined the service user for lunch. The inspector toured the building, spoke with staff on duty and spoke with five-service users, one visiting professional and two relatives during the course of the inspection. They all provided a very positive account of the home. The inspector sampled of the service user documentation along with records relating to staff and other records required by regulation. What the service does well: The home continues to offer a warm welcome and a pleasant relaxed atmosphere throughout. Service users in the dementia care part of the home were relaxed and engaged in planned and spontaneous activities, in a safe environment with full staff supervision. The admission procedure was thorough and provided prospective service users with good information prior to deciding to move in. Relatives and service users confirmed these observations. There was evidence of service user involvement in all aspects of the admission process as well as people important to them. The admission system includes follow-on reviews and visits by key professionals, particularly for service users with dementia care needs. The manager confirmed that robust vetting procedures on staff recruitment had continued. Staff seen confirmed that induction process is undertaken. The staff are appropriately supervised and training continues to be valued by the staff. Service users access to health and social care services is well documented. Sunningdale Lodge DS0000016089.V331494.R01.S.doc Version 5.2 Page 6 The care planning arrangements were very good with a person-centred care approach and good clear guidance for staff. The receipt, storage, administration and recording of medications is good with a robust audit trial in place. On the day there were choices of main dishes and an appetising sweet trolley for the lunch meal. Choices were also advertised for the tea meal. All service users seen praised the food and choices offered daily. There is a dedicated activities organiser providing activities for those on the second floor and the day care organiser provides activities on the ground floor. 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 be made available in other formats on request. Sunningdale Lodge DS0000016089.V331494.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Sunningdale Lodge DS0000016089.V331494.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,5,6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has thorough pre-admission procedures that provide information and opportunities to assist the service user when making a decision about moving in. Care assessments are clear, concise and generally reflect the needs of the individual. Service user’s are protected by a contract that specifies terms and conditions of occupancy and includes the complaints procedure. EVIDENCE: There have been no changes made to the Statement of Purpose or Service user guide since the last inspection. Sunningdale Lodge DS0000016089.V331494.R01.S.doc Version 5.2 Page 9 The service user the inspector spoke with confirmed that they had been given plenty of opportunities to visit the home and had documented information with which to make an informed choice. They further confirmed that they had been consulted about their individual needs and how they would like them to be met. Service users confirmed that they had a months trial period “a test drive’ to see whether the home suits their needs. The relatives further confirmed that at the time they were happy with the admissions process. All service users have a contract that includes a statement of terms and conditions of occupancy. Signed copies of these where seen during the inspection. The home provides suitable surroundings and trained staff to meet the care needs of older people. The specialist development team from the Somerset Partnership assesses users who have dementia type conditions prior to referral to the home. They continue to have input into the care of this group of service users once they have taken up residency. At the time of the inspection the specialist nurse was visiting the service. They confirmed that they are pleased with the positive relationship that has developed between the service and Somerset Partnership which has lead to good out comes for those service users in residency. The assessment documentation that was sampled evidenced that care plans had been developed from the initial assessment of need. The inspector noted that the initial assessment need made by the home needs to reference all behaviours noted on the pre admission assessment documentation, the registered manager acknowledged this point. Sunningdale Lodge DS0000016089.V331494.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The care planning and review of existing plans demonstrate how needs are being met. Good links with health professionals have been maintained to enable service users’ health needs to be met. The home has a good medication management system ensuring the safety of service users. EVIDENCE: The inspector sampled the service user documentation and found that care plans are maintained for each service user. These include details of individuals’ needs, daily routines and preferences. Care plans were thorough and included detailed directions to staff of the level and type of assistance to be provided to each person. A moving and handling assessment had been Sunningdale Lodge DS0000016089.V331494.R01.S.doc Version 5.2 Page 11 completed for each service user. Pressure area and falls risk assessments had been completed. Pressure-relieving equipment is provided as required care plans had been regularly reviewed and updated as required. Feedback from visiting professionals given via questionnaires informed the inspector of the good professional relationships that have been maintained. They further confirm that the service user attend appointments and have their health care needs met through partnership working. Care plans are regularly reviewed with the involvement of the service user or their representative. A holistic “person-centred” model had been adopted that provided detailed account of care needs. Service users are able to meet privately with visitors in their bedroom or one of the lounges. Interaction between staff and service users was friendly and respectful. Through discussion with the service user the inspector established that the care staff fully respected their privacy and dignity and that they were not made to do anything they did not wish to, such as attending activities or having meals in the dining room. They further confirmed that all personal care was provided in the privacy of their bedrooms or bathrooms. The care plans and associated documents supported these representations. Medicines are well stored. There was a fridge for medicines needing refrigeration and the temperature was being monitored and recorded. The administration of medicines was observed and correctly carried out. The MARsheets were appropriately completed and signed, checked by supervisors in each shift daily and the control drugs and records were also appropriately maintained. There are clear rationales for the administration of medication via the per required needs route. The inspector noted that the temperature in the medication cupboard on the first floor felt rather warm. It would be helpful if the temperature of this room was monitor to the same standards as else where. Sunningdale Lodge DS0000016089.V331494.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The pace of life appears to suit the service users expectations and aspirations. Visitors are welcomed and service users are assisted with maintaining contact with relatives and friends. The food is home cooked and appears to offer a balanced diet. EVIDENCE: Service users were observed in a number of different locations following selfdirection. They choose when to get up and when to retire. Service users are enabled to hold a key to their bedroom and to keep it locked if they wish. They have free access to their bedroom and communal facilities. Service users spoken with indicated that they were happy with their life in the home and confirmed having freedom of movement and that staff support them in following their preferred lifestyle. Sunningdale Lodge DS0000016089.V331494.R01.S.doc Version 5.2 Page 13 Freedom of movement is restricted for those on the first floor in that they had no free access to safe outdoors unless staff enabled it. Service users on this floor are due to move to a new home where freedom of movement will be far more easily achieved. One service user spoken to confirmed that they are looking forward to moving to the new home. They were able to inform the inspector of the arrangements being made for this transfer. The service users on the first floor are well supervised. At the inspection the planned activities were observed demonstrating good social interaction. There was a relaxed atmosphere with good levels of staff at hand to assist and prompt. Appropriate navigational cues had been added to the communal room and the corridors in order to assist the service user move around this floor of the building. Other areas also have orientation clues to assist service user such as their photographs on their own bedroom doors, the Bathrooms and WCs were identified with pictures. Service users in the ground floor explained that there were activities during the day downstairs. The day care organiser provided these. It was a shame that activities were not displayed for all to see and better choose. This was recommended to the manager. Visitors were observed entering or leaving the home. All visitors were warmly welcomed. The inspector spoke with one relative who spoke highly of the home. The menu of the day was displayed on boards on ground and middle floors. There was a good choice of main and sweet dishes, both for the lunch and the tea meals. Choices included special diets. Meals were served in nicely laid tables. Both dining rooms were appropriately staffed to attend service users and their needs. The inspector joined three-service user for dinnertime meal. This was served in a relaxed manner. Meals came in good portions the meat being plated and a choice of vegetables being available from a central serving dish.. Service users spoken with, praised the food served in the home Sunningdale Lodge DS0000016089.V331494.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service users felt confident that any complaints or concerns would be listened to and taken seriously EVIDENCE: A complaints procedure is in place. The service users who the inspector spoke with informed them that they felt able to complain and said they would have no concerns complaining to any staff member should they have need to. They felt that the manager and staff are very approachable and will deal with any issues, no matter how minor, there and then if they could. The home keeps a record of any complaints made. There have been no issues recorded at the home, similarly there have been no complaints made directly to the regulator. The complaints procedure was displayed and issued to new service users. The POVA training manual was available, staff confirmed having training regarding the protection of vulnerable adults, and the manager confirmed that a POVA check is performed at the time of requesting CRB check prior to starting work. Sunningdale Lodge DS0000016089.V331494.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19,22,24,26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from comfortable, safe and well maintained surroundings. Service users can personalise their private space and contribute to the décor of communal areas. Service users benefit from a home that is generally maintained in a clean and tidy condition. EVIDENCE: Service users have access to private and communal spaces in the home. Outside there is a large and safe patio accessed via the conservatory. This is not accessible to service users on the middle floor, unless staff enable it. A Sunningdale Lodge DS0000016089.V331494.R01.S.doc Version 5.2 Page 16 new home is being built where service users in this unit will move next year and it is expected that access to outdoor facilities will be improved then. Bedrooms are personalised and comfortable. Orientation cues on bedroom doors and in the corridors on the first floor have been completed. The majority of service users have en-suite facilities that they use and benefit from well equipped and maintained WCs and bathroom facilities. There is a range of hoists fixed and mobile to meet service users’ needs. There is a passenger lift to all floors. All mobile equipment is regularly maintained as evidenced by records seen. All bathrooms and WCs were spotlessly clean and had equipment and materials to prevent the risk of infection, such as paper towels, liquid soap and hand bacterial rub. Public areas were well maintained and furnished. The home has a variety of communal areas in all floors. Sunningdale Lodge DS0000016089.V331494.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The recruitment practices establish the suitability of the prospective employee. The staff have received regular training with regards to the tasks they daily perform. There is evidence that new staff receive a structured recorded induction into the care home. EVIDENCE: The home continues to be well staffed. On the day of the inspection the staff were observed meeting the needs of the service users in a professional and respectful manner. The inspector talked with the staff on duty who were knowledgeable with regards to how to meet the assessed needs of the service user group. The service users themselves confirmed that the staff meet their individual needs in a way that suites them. They further commented that if they use the call system a member of staff will attend to them without to much delay. One service user indicated that it can be busy in the mornings. Sunningdale Lodge DS0000016089.V331494.R01.S.doc Version 5.2 Page 18 The staff turnover continues to be low and staff provide good continuity of care. The manager has promoted an ethos that values training and staff were able to confirm receiving training to practice safely and for personal development. All staff spoken with had NVQ qualifications. The staff files that were sampled contained sufficient detail with which to establish the prospective employees suitability for the job, all requirements as set out in the National Minimum Standards are complied with. The inspector spoke with a new member of staff who further confirmed that they had completed an application form, undertook a formal interview and had received an induction into the care home. Statutory training is well documented. This is to link to the company’s training database that prompts homes when staff training updates are due. The registered manager confirmed that all staff have or a due to receive statutory training as and when required. Sunningdale Lodge DS0000016089.V331494.R01.S.doc Version 5.2 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 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The management team at the service provide good and positive leadership. The staff group are formally supervised or their work appraised. The health and safety of the all who work and reside at the home is dealt with well. EVIDENCE: The comment cards that have been received from relatives and comments made by the service users and staff, indicate that the home is being managed in a way that benefits the users of the service or those that provide the Sunningdale Lodge DS0000016089.V331494.R01.S.doc Version 5.2 Page 20 service. Service users continue to enjoy a comfortable and pleasant home which is receiving improvement and investment, as it is required. New staff continue to express appreciation for the assistance given during the induction process and supervision. Notes of frequent supervision were evident in the staff files seen. As in the previous inspection, all records inspected were well organised, well maintained and up to date. Records inspected included care records, the complaints log, accidents, medication, staff files, rotas, the fire logbook, training records, safety checks and maintenance. The home keeps small amounts of cash for some service users. Records are kept and cash receipts have two signatures. Receipts are issued as copies of the receipt book evidenced. The home does not manage service users’ finances. A tour of the premises found a safe and comfortable home free from obvious hazards. Fire safety equipment has been serviced and tested as required. Staff have been provided with regular fire safety training. Equipment servicing records have been appropriately maintained. All supervisory staff have received First Aid appointed persons training and there is always a supervisor on duty. Accidents are recorded and evaluated. Copies are enclosed in the care file. The home operates a comprehensive system of quality audits to ensure that service users are provided with a safe and comfortable environment Sunningdale Lodge DS0000016089.V331494.R01.S.doc Version 5.2 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x 3 x 3 x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 x x 3 Sunningdale Lodge DS0000016089.V331494.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? no 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP9 OP7 Good Practice Recommendations That the registered manager considers monitoring the temperature in the first floor medication cupboard. That the registered manager ensures that initial care plans accurately reflect the assessed needs of the service user. Sunningdale Lodge DS0000016089.V331494.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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 Lodge DS0000016089.V331494.R01.S.doc Version 5.2 Page 24 - 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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