Inspection on 07/11/07 for Sunningdale Lodge

This inspection was carried out on 7th November 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 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 11/10/06

Sunningdale Lodge 23/01/06

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 Key Unannounced Inspection 09:30 20th November 2007 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.V352111.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 DS0000040471.V352111.R01.S.doc Version 5.2 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@schealthcare.co.uk Southern Cross Home Properties Limited Mrs Elin Winter Care Home 50 Category(ies) of Dementia - over 65 years of age (50) registration, with number of places Sunningdale Lodge DS0000040471.V352111.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 26th September 2007 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, next to another residential care home, also owned by the Southern Cross Group. The home is purpose-built with accommodation on three floors. Rooms are single, some with en –suite. The lower ground level provides catering and laundry facilities. There is a large attractively landscaped rear garden, with seating. Fees range from £383 to £400.78 (council) and £478 private. Information about the home is available including inspection reports. Sunningdale Lodge DS0000040471.V352111.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. How the inspection was carried out Before the visit: We looked at: • Information we have received since the last visit in October and November 2006 • How the service dealt with any complaints & concerns since the last visit. • Any changes to how the home is run. • The provider’s view of how well they care for people. • The views of people who use the service & their relatives, staff & other professionals. The Visit: An unannounced visit was made on 20th November 2007 During the visit we: • • • • • • Talked with people who use the service, relatives, staff, the manager & visitors. Looked at information about the people who use the service & how well their needs are met, Looked at other records which must be kept, Checked that staff had the knowledge, skills & training to meet the needs of the people they care for, Looked around the building/parts of the building to make sure it was clean, safe & comfortable, Checked what improvements had been made since the last visit We told the manager and provider what we found. What the service does well: The range of activities available is good and helps residents to maintain hobbies and interests. Most staff demonstrate a good understanding of person centred care meaning that residents are treated as individuals. The home is clean and well maintained making it a pleasant place to live. Sunningdale Lodge DS0000040471.V352111.R01.S.doc Version 5.2 Page 6 Relatives spoken to say they are very happy with the care provided in the home and praise the dedication of staff. The standard of meals provided is good and enjoyed by residents. 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 DS0000040471.V352111.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 DS0000040471.V352111.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): 3. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Comprehensive assessments are carried out before and after admission to ensure that people’s needs can be planned and properly met. EVIDENCE: A pre admission assessment is carried out by the home manager or deputy prior to new residents moving into the home. There is also involvement with the care manager from social services who supplies the home with detailed information about the person’s needs. Care records read show that this information was gathered before people were admitted. On the day of the inspection, the manager was planning a new admission. It was demonstrated that care is taken to have all information available before taking the decision that the home is able to meet their needs. Sunningdale Lodge DS0000040471.V352111.R01.S.doc Version 5.2 Page 9 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 and 11 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The standard of care planning has improved and now gives a good level of information to staff to support meeting residents needs. There is insufficient attention to planning care in advance for around the time of death. EVIDENCE: The information from the pre admission assessment is formulated into a plan of care for each resident. These are reviewed regularly, and needs are assessed on an ongoing basis. This means that the care plans reflect the most up to date situation. Care plans read included a variety of physical and social assessments that are carried out. These include assessments of nutrition and dietary needs, moving and handling requirements (which tells staff how well the person is able to Sunningdale Lodge DS0000040471.V352111.R01.S.doc Version 5.2 Page 10 walk and move and how much help they need). There are also assessments of skin health and whether the person is at risk of developing pressure sores (sometimes known as bed sores). These are evaluated regularly. One care plan notes that a resident has a history of “absconding”. It was suggested that the nurses think about an alternative to this phrase as it implies some degree of control and does not fit with the philosophy of the home that people are able to make choices. For example, it may be more appropriate to write that someone has a tendency to leave the home without informing staff, reinforcing the message to more junior staff that people do have rights and that care must be taken when restricting liberty for any reason. Social assessments are carried out and the standard of social care plans has improved since the last inspection. For example, the social programme for one lady details her likes including where she likes to go to church, and the TV shows and type of music she enjoys listening to. These specific details help staff to support the residents to continue to enjoy the things they used to. Care plans are audited (checked) regularly in line with Southern Cross healthcare policies and procedures. Residents all have access to a GP. They may continue to see their own doctor if they wish and it is practical for them to do so. District nurses, chiropodist, dentists, opticians and dietician all visit the home on a regular basis. The home provides new staff with an induction programme and part of this includes advice for new staff about respecting the rights of residents to make choices. There were numerous examples of residents being given choices throughout the inspection. For example, choices of meals and drinks are offered. One resident has her own room key demonstrating that the potential for people to be as independent as possible, is assessed by the home. There were occasions when choices were made for people. This was also picked up at the thematic inspection carried out in September looking specifically at dignity in care. It is acknowledged that the majority of staff are skilled and demonstrate they are aware of the importance of choice privacy and dignity. The findings of this inspection with regard to dignity are the same as in September. There is a privacy & dignity policy within the home and findings of this inspection are that on the whole residents are supported by staff who respect their dignity and privacy. Staff in the home have received training in person centred care developed by the Alzheimer’s Society. It is called “Yesterday, today and tomorrow” and all staff including domestic staff receive this. There were some good examples of staff being very caring towards residents and spending time chatting to people. A very small minority of staff still tend to interact with people mainly during a Sunningdale Lodge DS0000040471.V352111.R01.S.doc Version 5.2 Page 11 task. It was noted for example that during quieter periods some staff sit in the lounge on their own, and don’t appear to use the time to chat to people. They appear to be waiting for the next task to do. This does not demonstrate good person centred care, and instead a task orientated approach to care. This happened a few times during the inspection but as stated was limited to a very small number of staff with the majority clearly having benefited from the training. A policy for the safe handling of medicines is in place in the home. This includes guidelines about the safe storage, receipt and handling of medicines and there are regular medication audits carried out by Southern Cross. The inspection of medication procedures found that staff are adhering to this policy and medicines are safely stored and administered. Medication on the ground floor only was checked. Information provided by the home before the inspection details how the home will care for people who are dying. The home provides nursing care and there are times when it is the wish of family members that residents remain in the home for as long as possible, including at the time of their death. There are detailed notifications sent to The Commission for Social Care Inspection when someone dies, including details of the cause of death, who was present at death and whether it was expected or unexpected. Details of whether the coroner is involved are also supplied. There is little done, however, to record what the person wants to happen in the event of their death. The section in assessments relating to wishes in the event of the death of a resident is often left blank. This may be due to people feeling uncomfortable about approaching relatives about this and it is acknowledged that it may not be most appropriate to discuss this upon admission. It should be possible to complete this information once a relationship has been formed with the family. Many older people have already considered what they would like to happen in the event of their death, or have religious considerations. Some residents may have spoken about their wishes before becoming ill and it is important that the home is aware of these wishes if possible. Sunningdale Lodge DS0000040471.V352111.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 and 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents have good opportunities to take part in a variety of leisure pursuits and interests, which help them to maintain links with the local community and keep and develop social skills. Most staff are able to support residents well during mealtimes. EVIDENCE: There is a good range of activities available to residents in the home. There is an activities coordinator who has been employed since the last inspection and has introduced some new activities including a breakfast and luncheon cub. Most recent events enjoyed by residents include a Halloween party, fireworks night and broth night. Details of future events are available. Care records show that individual interests are recorded for most people. Where is states that a person likes to visit a particular church, checks found that they do actually receive support to go on a regular basis. Sunningdale Lodge DS0000040471.V352111.R01.S.doc Version 5.2 Page 13 On the day of the inspection there was a Karaoke session in the afternoon with a staff member supplying the equipment and much of the talent. The residents appeared to thoroughly enjoy the singing with some spontaneously clapping or dancing in their chairs. Visitors present during the session were also involved and really enjoyed the afternoon. A new greenhouse is available and it was reported that 3-4 people use it regularly, growing tomatoes, parsley and flowers. Two dining rooms were visited at lunch- time. In the first lounge, residents were brought to sit at bare tables with staff explaining that they do not set the tables as residents move things around. Tables were set later but setting tables might have given some residents a clue about why they were sitting down as some residents tend to get up and wander away from the table. (Visual clues are important to people with dementia in particular who are often trying to figure out what they are meant to be doing). At the thematic inspection in September it was noted that people often have to sit at the table for up to half an hour before a meal arrives which is difficult for a number of people. There has been some improvement in practices at mealtimes but there continue to be some areas that could be improved. In one dining room, a staff member was crouching down to help a resident with their meal resulting in them having to stand up when their legs got tired to help with the remainder of the meal. The remaining staff sat beside the person they were helping which is good practice. Residents were offered choices at mealtimes by showing them the two choices available, which is also good practice. Choices are taken the day before by staff but it is recognised that people often change their mind or cannot remember what they have ordered. When a resident is impatient or noisy, staff served them first which was effective in helping them to settle. One resident refused lunch but was gently persuaded and encouraged to try a little and then some pudding. Choices of drinks and snacks are offered on a regular basis including home made cakes. The kitchen was inspected and found to be clean, tidy and well organised. Catering staff know the needs and preferences of residents and use the new “Nutmeg” tool to develop menus that are nutritionally balanced. There is some constant readjustment to menus to ensure local favourites are not missed off the new menu and that new choices are being enjoyed. Sunningdale Lodge DS0000040471.V352111.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 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are comprehensive policies and procedures and these are followed by the home. EVIDENCE: There have been no complaints since the last inspection. The manager reported that any minor “niggles” are dealt with quickly and resolved which has resulted in no formal complaints being made. It was suggested that minor concerns could be recorded in case there are any that tend to reoccur. This will be helpful in the ongoing monitoring of the quality of the service. There has been one safeguarding issue since the last inspection involving an allegation made by a resident about staff. This was dealt with formally and recorded in line with company and local safeguarding procedures. The allegation was unsubstantiated and care plan is in place to instruct staff about how to manage this situation. Staff receive training in safeguarding adults and a new course has been booked with “future strategies” as a refresher for some staff and for any new staff. Sunningdale Lodge DS0000040471.V352111.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 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The building is generally clean and well maintained. EVIDENCE: Most communal areas including lounges, toilets and bathrooms were inspected as well as a number of bedrooms. Most rooms are clean and well maintained, and some areas in the home have been redecorated since the last inspection. Bedrooms are nicely personalised and residents are encouraged to bring their own belongings into the home. A small minority of rooms have an odour problem and the manager is aware of these. Most clocks in bedrooms are wrong or have stopped. Sunningdale Lodge DS0000040471.V352111.R01.S.doc Version 5.2 Page 16 Not all bedroom doors have names on and signage to help people with dementia find there way around the home is inadequate. Signs showing purpose of rooms such as dining rooms and toilets should be provided to maximise the resident’s potential to be as independent as possible. This can also prevent incontinence. Most doors have a picture frame beside them with the name of the resident and a photograph usually of themselves as they are now. One resident has a picture of a dog next to her door and clearly uses this as an aid to finding her own room. New corridor and lounge carpets have been provided since the last inspection. Some tables and chairs in lounges have been replaced. In future the managers are considering “themed” areas in the home, which will help to identify different spaces as they all currently look the same. The wall in one identified bathroom needs to be repaired and repainted. There is a large, pleasant garden area with seating and areas of interest. It is securely enclosed. The path extends across the length and breadth of the garden but they are gravel paths and too uneven to enable residents to explore the garden freely and safely. It also makes wheelchair access difficult. The home was found to be clean and tidy during the inspection. One relative said that they felt the standard of cleanliness in the home can fluctuate at times. The manager was advised and agreed to monitor this. Sunningdale Lodge DS0000040471.V352111.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 adequate. This judgement has been made using available evidence including a visit to this service. There may not be sufficient numbers of staff are in post to meet the needs of residents. Robust recruitment procedures are in place, which help to prevent risk of harm to residents. EVIDENCE: There are sufficient staff on duty during the day in the home but there are some concerns about the staffing levels at night. On a daily basis the staffing is as follows: Downstairs there are 24 residents with 4 or 5 carers (including at least one senior). 8a.m to 8.p.m. Upstairs (nursing) there are 26 residents cared for by 1 nurse and 4 carers. 8a.m. to 8.p.m. The manager is supernumerary. Sunningdale Lodge DS0000040471.V352111.R01.S.doc Version 5.2 Page 18 At night there is one nurse and 4 carers upstairs and two carers downstairs. It was felt by the inspector that two staff downstairs can not provide sufficient supervision of other residents if they are working together to help people. The manager advised that staff from upstairs can come down to help if required but this still means that unless a third person is asked for at the start of the shift, residents could remain unsupervised for some time. The manager confirmed that staffing vacancies have been filled and three new carers have just been appointed. Agency staff are not used as the home has use of a regular bank of staff who know the home and are familiar with the residents. The files of two new staff were read. They contain all of the required recruitment information such as references and criminal records and health checks. There was a concern that the induction of one new staff member had been carried out in one day. This induction was very detailed and included instruction in the role of the care worker, safety at work, a fire instruction video, instructions about communication techniques with the elderly, abuse and neglect and key legislation and further information relevant to the role. All of these areas were signed on the same day and the manager agreed that it would not be possible or advisable to do so. Staff receive regular training including a rolling programme of statutory training, and a mixture of in house and external courses. Training sessions planned includes customer care, equality and diversity, adult protection, safe handling of medication, mental capacity act and infection control. Staff have individual training files. Over 70 of staff have NVQ level 2 or above. Sunningdale Lodge DS0000040471.V352111.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 and 38. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There is an experienced manager in the home, which is generally run in the best interests of residents. EVIDENCE: Elin Winter is an experienced manager who is currently completing her Registered Managers Award qualification. She has been through the fit person interview process with the Commission for Social Care Inspection and was found to be fit to manage the home. The manager is aware of her own development needs and interests and is currently finding out more about the specialist needs of people with dementia. The company runs a dementia forum where managers can meet to discuss current best practice. Sunningdale Lodge DS0000040471.V352111.R01.S.doc Version 5.2 Page 20 The manager is supported by a deputy and there are clear lines of accountability. The home is generally run in the best interests of residents. Despite some staff still struggling with meeting some person centred principles, the vast majority of staff have developed well in this area, demonstrating good skills and knowledge. It is anticipated that this improvement will continue. Southern Cross healthcare has its own systems of quality monitoring in place in the form of regular audits. Areas audited include finance, pressure area care, care files, accident records and kitchen audits. These are carried out by a senior manager form Southern Cross, and a regulation 26 inspection is carried out each month. This is a check that the Commission requires to be carried out by a manager from outside the home on a monthly basis. Records of these visits are available. Health and safety checks are carried out on a regular basis. Maintenance records show that checks of equipment for fire fighting and water temperature checks are among those carried out regularly. The procedure for holding money for residents in the home has changed. Each home previously had a pooled account for residents’ personal allowances. There is now one large pooled account for all Southern Cross homes operated by Barclays bank. Each resident has an individual account held on the computer in the home, which can show deposits and withdrawals. A cash float is held in the home in case people want access to funds. One resident spoken to was very upset and concerned they had not been given sufficient money the day before. Upon investigation, the resident should have received £40, but was given less. The administrator explained this was due to insufficient funds in the home. It was agreed that there should be enough money available to give residents their allowance as agreed on the day the should receive it. Sunningdale Lodge DS0000040471.V352111.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 X X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 3 10 3 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 2 STAFFING Standard No Score 27 2 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 2 X X 3 Sunningdale Lodge DS0000040471.V352111.R01.S.doc Version 5.2 Page 22 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. Standard OP8 Regulation 18 (1) (ci) Requirement Staff must demonstrate person centred values in their practices and by doing so avoid appearing task orientated. Staff must record wishes of residents in the event of their death to enable them to care for residents effectively at this time. Training in how to assist residents with meals should be provided. OUTSTANDING at last two key inspections. Tables must be fully set at meal times. 4. OP19 23 (1) (a) Signage must be provided to help residents to find their way around the home. Clocks must be routinely checked to ensure they are telling the correct time. Malodour to be addressed in bedrooms identified to ensure the environment is pleasant. A review of night staffing must be carried out to ensure there DS0000040471.V352111.R01.S.doc Timescale for action 20/01/08 2. OP11 14 (1) (a) 20/01/08 3. OP15 16 (2) (g) 20/12/07 20/01/08 5. OP27 18 (1) (a) 20/12/07 Sunningdale Lodge Version 5.2 Page 23 6. OP29 18 (1) (c) 7. OP35 16 (1) (l) are sufficient staff on duty at night to supervise residents safely. The induction for new staff must 20/12/07 take place over recommended period to ensure staff are properly trained. There must be sufficient money 20/11/07 held in the cash float to ensure residents can gain access to their own money when required. 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 OP16 OP8 Good Practice Recommendations Minor concerns should be recorded as part of the homes quality assurance system. Consider use of language in care plans which could undermine care practice principles e.g. use of the word “absconding”. Sunningdale Lodge DS0000040471.V352111.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Cramlington Area Office Northumbria House Manor Walks Cramlington Northumberland NE23 6UR 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 DS0000040471.V352111.R01.S.doc Version 5.2 Page 25 - 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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