Inspection on 23/01/06 for Sunningdale Lodge

This inspection was carried out on 23rd January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Sunningdale Lodge 29/10/09

Sunningdale Lodge 11/11/08

Sunningdale Lodge 07/11/07

Sunningdale Lodge 11/10/06

Sunningdale Lodge 26/07/05

Sunningdale Lodge 08/03/05

Sunningdale Lodge 30/07/04

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

CARE HOMES FOR OLDER PEOPLE Sunningdale Lodge Dene Road Hexham Northumberland NE46 1HW Lead Inspector Aileen Beatty Unannounced Inspection 11.00 23 January 2006 rd 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 DS0000040471.V258459.R01.S.doc Version 5.0 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 DS0000040471.V258459.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Sunningdale Lodge Address Dene Road Hexham Northumberland NE46 1HW 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) 01434 603357 01434 608865 sunningdalelodge@highfield-care.com Southern Cross Home Properties Limited Ms Michelle Kinmont Care Home 50 Category(ies) of Dementia - over 65 years of age (50) registration, with number of places Sunningdale Lodge DS0000040471.V258459.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. One named resident is known to be under pensionable age. No further under pensionable age admissions are to take place without the prior agreement of the NCSC. 26th July 2005 Date of last inspection Brief Description of the Service: Sunningdale Lodge is a 50-bedded care home, which provides care including nursing for elderly people with dementia.The home is located on the outskirts of Hexham, adjacent to another residential care home, both of which are owned by the Highfield Group.The home is purposebuilt with accommodation on three floors accessed by a lift shaft. The lower ground level provides catering and laundry facilities.There is a large attractively landscaped rear garden, with seating. Sunningdale Lodge DS0000040471.V258459.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place on 23/01/06 and comprised of a tour of the premises, discussions with staff and residents and visitors and a review of records. The inspection found that the overall standard of care is good. What the service does well: 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. Sunningdale Lodge DS0000040471.V258459.R01.S.doc Version 5.0 Page 6 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 DS0000040471.V258459.R01.S.doc Version 5.0 Page 7 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 the following standard(s): 3. Service user needs are assessed prior to admission to the home. Intermediate care is not provided. EVIDENCE: Care files were examined for 5 residents. All contained pre admission information and comprehensive assessment. It was noted that detailed personal history information is available for most residents. This is a useful aid to care and activity planning. Sunningdale Lodge DS0000040471.V258459.R01.S.doc Version 5.0 Page 8 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 the following standard(s): 7,8,9,and 10. Service user’s health needs are fully met and set out in an individual plan of care. Medication procedures are not satisfactory. Service users are usually treated with respect and their right to privacy upheld. EVIDENCE: Care plans for 5 residents were examined. In the majority of cases these are detailed and up to date. Health needs are met. Physical care plans are of a good standard. Notifications sent to CSCI by nurses (Regulation 37 reports) are completed to a very high standard and contain the required information. Where these notifications relate to serious illness or death of a resident, they are written sensitively and professionally. They describe attention the person has received from GP’s or hospital staff, demonstrating that they have been monitored closely. Physical assessments including risk of pressure sores and malnutrition are carried out on a regular basis. Where a person is found to be a high risk, preventative care plans are in place. Sunningdale Lodge DS0000040471.V258459.R01.S.doc Version 5.0 Page 9 One care plan was difficult to understand and it was agreed that this would be re written to ensure it could be followed correctly. Physical care appears good. Discussions with staff revealed that knowledge of dementia is limited and some staff expressed an interest in learning more, including about current best practice or advances in the field. Further training and development of therapeutic practices for people with dementia is planned. Medication trolley and cupboards on the ground floor were checked. It was found that there were numerous out of date items in both. Medication belonging to people who no longer live in the home was also found. Medication procedures must be improved, and regular audits carried out. People are treated with dignity and respect. Staff no longer display personal information, which is good. Care information held in bedrooms is now attached discreetly on the inside of wardrobe doors, which is good. Staff were also observed knocking on bedroom doors. Some discretion is required at mealtime, see standard 15. Sunningdale Lodge DS0000040471.V258459.R01.S.doc Version 5.0 Page 10 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 the following standard(s): 12 and 15. Social and recreational needs are usually met. A wholesome appealing diet is provided in pleasant surroundings. EVIDENCE: The member of staff currently responsible for arranging social activities was spoken to during the inspection. A number of activity resources have been purchased and there are plans to buy more. The activity co-ordinator is keen to organise small group activities and one to one sessions. A regular newsletter is now written and contributed to by relatives and friends of residents. On the afternoon of the inspection, the lounge curtains were closed, and soft music played. Staff said that this was to encourage some quiet relaxation time and happens regularly. A very warm, calm and pleasant atmosphere was created. A varied diet is provided. It was confirmed that there are alternative choices available. Kitchen staff receive regular training and have completed healthy eating training and food hygiene since the last inspection. New charts are being brought into use in the kitchen which detail likes dislikes and weights and special dietary requirements. Kitchen staff demonstrate a good understanding of food supplements, including home made ones. Sunningdale Lodge DS0000040471.V258459.R01.S.doc Version 5.0 Page 11 The mealtime was observed and most residents appeared to enjoy the meal. It was noted that some staff tend to stand over some residents requiring assistance with feeding. This is poor practice and some training for some staff would be beneficial, including sitting at the same level and not rushing people. A little more discretion to prevent embarrassing resident being fed should be encouraged. Sunningdale Lodge DS0000040471.V258459.R01.S.doc Version 5.0 Page 12 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 the following standard(s): 16 and 18. Satisfactory complaints procedures are in place. Service users are protected from abuse. EVIDENCE: A satisfactory complaints procedure is in place. A complaint was received by CSCI in November 2005. There were 5 main elements to the complaint. 1. Patio doors leading from bedrooms are not always alarmed. 2. There appears to be insufficient staff on duty at times. 3. Sometimes personal care is not performed to a satisfactory standard. 4. Carpets are malodorous. 5. Drinks do not appear to be given regularly enough. Concern number 1 was upheld. Number 4 was partially upheld. The remainder were unsubstantiated. At this inspection it was found that not all doors were alarmed due to airing bedrooms. In this case the main door must then be locked to prevent someone leaving the building without the knowledge and care of staff. Most staff have received training in Protection of Vulnerable Adults (POVA), carried out by Future Strategies. Satisfactory adult protection procedures are in place. There have been no POVA referrals since the last inspection. Sunningdale Lodge DS0000040471.V258459.R01.S.doc Version 5.0 Page 13 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 the following standard(s): 19, 24 and 26. The home is generally safe and well maintained. Service User’s live in safe comfortable surroundings with their belongings around them. The home is generally clean pleasant and hygienic. EVIDENCE: Maintenance records were examined and found to be up to date. There is an ongoing process of redecoration and re painting of some rooms. Upon entry to the home, some malodour is noticeable and although it is not very strong, this must be closely monitored. Bedrooms are nicely decorated and residents are encouraged to personalise their rooms with their own belongings. Bubbled lino in an identified bedroom must be replaced or repaired. The torn plastic mattress cover identified during the inspection must be discarded and replaced. Sunningdale Lodge DS0000040471.V258459.R01.S.doc Version 5.0 Page 14 Bathroom and shower areas are nicely decorated and tiled. Some are rather bare, however, and would benefit from some pictures for example. The small kitchen for use by visitors (upstairs) was found to be a little untidy, and there was no washing up liquid available. This has been noticed before, and perhaps a regular check to ensure it is kept clean and tidy could be introduced as part of quality monitoring systems. Communal lounges are clean and tidy and homely. The removal of notices and desk from lounges has improved the “homely” feel of the home, and less institutional. On the day of the inspection, some parts of the building were experiencing a problem with the heating. One lady was found to be very cold in her bedroom, and staff responded quickly to this information by providing a warm drink, warmer clothes and moving a heater into the room. The maintenance man was made aware of the problem and had identified cold spots around the building, probably due to the failure of on of the boilers. Staff were advised to monitor temperatures in the building until the problem was resolved. The ground floor treatment room was quite untidy, partly due to numerous out of date records being stored there. It is recommended that all non-essential items are removed from this room, and old records archived. Sunningdale Lodge DS0000040471.V258459.R01.S.doc Version 5.0 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 29 and 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are not always fully protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. EVIDENCE: The staff rota’s examined found that there are sufficient staff on duty. The book at the front door, which records when staff arrive and leave duty, is not always completed. Sometimes there is no record of when staff have left the building. As it was confirmed that this record is also used for the purposes of fire drills, it is recommended that this be kept up to date. The recruitment procedures in the home are generally satisfactory, although there were some shortfalls identified during the inspection. It was found that only one reference had been received for an ancillary staff member prior to them being appointed. It was also noted that on the application form, one member of staff had neglected to give a reason for leaving their previous employment. Any gaps should be identified as part of the recruitment process. Other staff files were found to contain all of the required information. It is recommended that staff health questionnaire information be held in a sealed envelope in staff files. Staff are appropriately trained and over 50 have NVQ level 2 or above. Sunningdale Lodge DS0000040471.V258459.R01.S.doc Version 5.0 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31 and 38. Service users’ live in a home that is managed by a person fit to be in charge. Service users’ financial interests are safeguarded. The health, safety and welfare of service users and staff are generally promoted and protected. EVIDENCE: The registered manager has been on maternity leave and an acting manager has been in post. There has been positive feedback from relatives who say the home is well managed. Most requirements from the previous inspection have been met and the acting manager has demonstrated a proactive approach to meeting these. There are effective health and safety procedures in place. All health and safety requirements set at the last inspection have been met. Sunningdale Lodge DS0000040471.V258459.R01.S.doc Version 5.0 Page 17 At the last inspection some hazardous items were found to be stored around the home. There were no hazardous items found at this inspection, indicating that procedures have been tightened up and monitored. One of the large yellow waste bins outside the premises was open and overflowing. The bins should be locked, and must not be over filled. The patio doors must be locked or alarmed where they lead from bedrooms to garden areas. The garden was not fully inspected for safety during this inspection visit. Staff are trained in manual handling and electric hoists are serviced on a regular basis (the last time was January 2006). Wheelchairs were found to be clean and well maintained, with both footrests in place. All electrical items were being tested during the inspection. Sunningdale Lodge DS0000040471.V258459.R01.S.doc Version 5.0 Page 18 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 X X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 1 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 X 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X X X X 2 Sunningdale Lodge DS0000040471.V258459.R01.S.doc Version 5.0 Page 19 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 2 Standard OP15 OP9 Regulation 19 13 (2) Requirement Training in how to assist residents with feeding should be provided. Procedures for the administration and storage and return of medication must be improved and closely monitored. 2 references must be provided for all staff. Gaps must be investigated in application forms. Internal bedroom patio doors must be locked or alarmed. Clinical waste bins outside must be locked and not over filled. Timescale for action 23/03/06 23/02/06 3 4 5 OP29 OP38 OP38 19 13 (4) 13 (4) 23/01/06 23/01/06 23/01/06 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 OP19 OP29 Good Practice Recommendations It is recommended that some bathroom areas are made more homely. It is recommended that staff health questionnaires be held in a sealed envelope in individual files. DS0000040471.V258459.R01.S.doc Version 5.0 Page 20 Sunningdale Lodge 3 4 OP27 OP19 It is recommended that staff receive regular updated training in dementia care, including qualified staff. It is recommended that the malodour upon entering the building is closely monitored and source found. Sunningdale Lodge DS0000040471.V258459.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Cramlington Area Office Northumbria House Manor Walks Cramlington Northumberland NE23 6UR 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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