CARE HOMES FOR OLDER PEOPLE
Sunningdale 7-9 Albany Road Southport Merseyside PR9 0JE Lead Inspector
Claire Lee Unannounced 4th May 2005 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 F53 F03 S17257 Sunningdale V224775 040505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Sunningdale Address 7-9 Albany Road Southport Merseyside PR9 0JE 01704 538568 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) Mrs Patricia Jane Bennett Mrs Amanda Jane Williams Care Home 32 Category(ies) of Old Age registration, with number of places Sunningdale F53 F03 S17257 Sunningdale V224775 040505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: 1.Service users to include up to 32 OP 2.This service should at all times employ a suitably qualified and experienced Manager who is registered with the Commission for Social Care Inspection. 3.May from time to time admit persons between the ages of 60 and 65 years of age. 4.Service to include 1 named service user within the PD category Date of last inspection 2nd November 2005 Brief Description of the Service: Sunningdale is a large detached building that provides nursing care for 32 older people. The home is siutated within a short walk to Southport town centre and local amenities are close by. The home has 30 single rooms and 1 double room and some have ensuite facilities. The accommodation is situated over 4 floors and a passenger lift is used to access all areas. There is a large conservatory to front of the building which is used as a lounge and the home also has a separate dining room. There is a ramp to the side and and the gardens are accessible for residents who requiure the use of a wheelchair. The home has baths suitably adapted and a walk in shower to assist those who are less able. A call system is available throughout the home. Sunningdale is privatel owned by Mrs Patricia Jane Bennett and it is managed by Mrs Amanda Williams. Sunningdale F53 F03 S17257 Sunningdale V224775 040505 Stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection took place over 8 hours. It was an unannounced visit and conducted as part of the regulatory requirement for care homes to be inspected at least twice a year. There has been no cause for any visits to the home since the last routine inspection in November 2004. A tour of the building was conducted. A selection of care, staff and nursing home records were also viewed. The manager, administration, 3 staff members, 6 of the 25 residents and 1 relative were spoken with and their views obtained of the home. Satisfaction comment cards were also given to residents and relatives to complete at their leisure. Comments received have been favourable regarding the home and the very caring nature of the staff. What the service does well:
Residents spoke highly of the care they receive within attractive and comfortable accommodation. They were pleased with the staff who they found very hard working, polite and motivated at all times. The manager is able to bring in extra staff when required to meet the care needs of the residents. A relative praised the manager’s professional handling of a concern that had recently been identified and felt that the home was providing a very good service. The relative referred to the home making “everything just right.” The health care needs of residents were being met and comments from residents included, “staff doing everything they can to make sure I am well cared for” and “I am told of any changes to my care or treatment.” Care staff receive a verbal report at the beginning of each shift and are quick to report any changes that affect the well being of the residents. The manager assesses all prospective residents and a detailed plan of care is then written after admission. Medical referrals are made when needed to other health professionals. The home had a pleasant relaxed atmosphere and at the time of the inspection all areas were very clean and hygienic. Staff ensure residents are offered various activities and accompany them on outings out from the home. Some residents prefer to stay in their rooms and this wish is respected. Residents enjoy the food and the menu was varied and appetising. Residents who required some assistance with meals were given time to enjoy their lunch and help was provided by staff in a discreet and unhurried manner. Relatives are able to have meals with their family member.
Sunningdale F53 F03 S17257 Sunningdale V224775 040505 Stage 4.doc Version 1.30 Page 6 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 F53 F03 S17257 Sunningdale V224775 040505 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 F53 F03 S17257 Sunningdale V224775 040505 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) 3 There was a good standard of assessments enabling the home to be sure of meeting residents’ care needs. EVIDENCE: Individual records are kept for each resident and the manager completes the assessment documentation prior to admission. Assessments completed by social workers, hospital and community staff were also on file. The information is then used to form the basis for the resident’s plan of care. A relative whose family member had been admitted for respite care described the admission procedure and the staffs’ subsequent involvement with the care. Although the manager had not completed the home’s own assessment document a detailed social service assessment was on file. This contained sufficient detail to ensure the home could meet the resident’s care needs. A staff member was able to discuss various details of the assessment and this included support for the family. Sunningdale F53 F03 S17257 Sunningdale V224775 040505 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9,10 It was clear that that the health, personal and social care needs of residents were understood and set out in an individual plan of care. EVIDENCE: Each resident had an individual plan of care that identified relevant aspects of health, social and personal care. The care plans were detailed, easy to read and had been reviewed regularly. There was therefore a good understanding of the medical, nursing and personal care needs of the residents. Formal reviews with the residents and relatives are conducted and care plans updated by staff to reflect any changes. The resident’s or relative’s signature to these changes would be beneficial to ensure information is kept up to date and accurate. Residents who had medical conditions, for example, diabetes were receiving input from the community diabetic service and their care needs were identified in their plan of care and were monitored by staff. Care files included information regarding helping residents who require help with walking and transferring from chair to bed (including the provision of special mattresses and manual handling equipment). Dietary provision and
Sunningdale F53 F03 S17257 Sunningdale V224775 040505 Stage 4.doc Version 1.30 Page 10 social needs were also recorded. Residents were weighed monthly and meal replacement drinks prescribed for those whose intake was poor. Residents can see their own GP unless moving away from his/her area and theses visits along with hospital, optical and chiropody appointments were recorded in the care files. A resident described the treatment she received at a local hospital and the excellent standard of “after care” she was receiving by the staff. Another resident commented on the good standard of transport arrangements made by the home for attending various clinics. Medicine sheets were signed and dated by staff and risk assessments and selfmedication forms were completed for those who wished to use this form of administration. Staff receive medicine awareness training and literature is available for the home on medicines prescribed. Staff interviewed discussed how the privacy and dignity of the residents is respected and a resident said, “the staff are always polite and so helpful, you could not wish for better.” Another reported, “ staff knock on my door before entering and assist me with washing and dressing, I am given plenty of time to get ready.” Sunningdale F53 F03 S17257 Sunningdale V224775 040505 Stage 4.doc Version 1.30 Page 11 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) 12,15 The daily life and routine in the home is flexible to suit individual needs. Meal times and social activities were well managed and provided in comfort. EVIDENCE: The menu was on display in the dining room and the staff ask residents what they would like for each meal. All residents stated that they were very pleased with the meals and particularly enjoyed the main meal of the day at lunchtime. The menu offered a good choice of hot and cold meals 3 times a day with light refreshments at other times. Residents discussed the good standard of “home baking” and the daily contact they have with the cook. A resident said, “the food is always piping hot and I enjoy every meal. I am happy with the menu as I am able to ask for anything I like.” Meals are served at set times however arrangements are flexible to suit individual needs. Some residents prefer to receive their meals in their rooms and this wish is respected. A small kithen is available on the top floor to enable a resident to prepare her own meals which she has requested. Activities are arranged daily and are displayed on the notice board in the main hall. Residents interviewed said the tuck shop continues to be popular and they are able to purchase a variety of items including, sweets, biscuits, cards and general toiletries.
Sunningdale F53 F03 S17257 Sunningdale V224775 040505 Stage 4.doc Version 1.30 Page 12 Bingo, singing, raffles and quizzes are arranged weekly and outside entertainers brought in. The home’s activities organiser arranges outings and staff accompany residents to town or for a walk along the sea front. Some residents are content just to watch television and digital viewing is available on request. The hairdresser was at the home and many of the residents commented on the very good service she provides. The home publishes a newsletter for the residents and staff. This includes forthcoming events in the home, training details for staff and their achievements. Sunningdale F53 F03 S17257 Sunningdale V224775 040505 Stage 4.doc Version 1.30 Page 13 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 Complaints are handled fairly and promptly. Residents and relatives were confident that if they needed to make a complaint this would be listened to and acted upon. EVIDENCE: The home has a complaint procedure and residents interviewed were aware of the document. A relative was pleased wit the action taken by the home in a response to a recent complaint. She stated that the incident had been dealt with professionally and had been resolved to a satisfactory standard. This complaint was logged in the complaint file. Residents interviewed had no cause for concern or wished to make a complaint. All stated that the manager was approachable and “would do everything she could to get things sorted.” Staff discussed the complaint procedure and how they would deal with a concern. Sunningdale F53 F03 S17257 Sunningdale V224775 040505 Stage 4.doc Version 1.30 Page 14 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) 19,20, 21, 22, 23,24,25 and26 The layout and location of the home is suitable for older people. Surroundings are comfortable and homely. Since the last inspection there has been progress with the home’s plans for replacing carpets and carrying out general painting of the building. A bedroom now requires decoration this has a potential for compromising the comfort of the resident. EVIDENCE: Since the last inspection the home have continued with their redecoration and refurbishment programme. Painting of scuffed skirting boards and door frames, replacement of the top floor landing carpet and decoration of Room31 should be included in this year’s maintenance plan as these are now affected by general wear and tear. New carpets have been laid in the conservatory, dining room, staff office and some resident rooms. A resident stated that the new colour was “just lovely.” Another resident said, “the home is like a hotel, you could not live anywhere better. It is looked after so well.” A tour of the
Sunningdale F53 F03 S17257 Sunningdale V224775 040505 Stage 4.doc Version 1.30 Page 15 building found the home very bright and clean. Residents interviewed were full of praise for the domestic staff and also stated that their personal items of clothing were washed daily and returned promptly. Bedrooms had personal belongings and the bed linen and drapes were colour co-ordinated. A resident commented on the very attractive wallpaper in her room and the fact that the home was kept so clean and was very comfortable. When viewing the home 1 area required attention. • The pillar in Room 41 has badly torn wallpaper and this must be replaced. Hot water temperatures prior to bathing residents were recorded. The home is soon to commence building work on the top floor of the home. Room 45 and Room 46 are being knocked through to make 1 large bedroom with a small lounge. This room will not have an ensuite facility. 1 bedroom will therefore be deregistered and the home will provide 31 places. The manager must advise the Commission in writing of this proposed work and a new Certificate of Registration will be issued on completion of the work. The exterior of the home was well maintained and the gardens provide wheelchair access. Sunningdale F53 F03 S17257 Sunningdale V224775 040505 Stage 4.doc Version 1.30 Page 16 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, 29 Sufficient numbers of well-trained staff were deployed to meet the needs of the residents. Recruitment procedures are robust to safeguard and protect the people living in the home. EVIDENCE: A qualified member of staff is on duty 24 hours a day and inspection of the staffing rota and direct observation confirmed that sufficient staff were on duty during the day. When needed additional staff are employed to meet the varying needs of the residents. There are currently no care staff vacancies however a position exists for a full time qualified staff member. The manager is currently covering any outstanding shifts and this position is being advertised. Staff interviewed felt that the home was sufficiently staffed. Staff meetings are held and minutes take. The meetings are well attended. Residents interviewed were complimentary regarding the standard of care they receive by staff and the very caring and kind approach offered to them. A relative said, “the staff are attentive” and direct observation of the staff supported this view. Staff were seen working as an effective happy team. The personnel files of 3 staff employed indicated that the home had undertaken all the necessary recruitment checks to ensure protection of residents. Protection of Vulnerable Adults [POVA] checks and Criminal Records Bureau checks at enhanced level were available. The home obtains these via the Registered Nursing Homes’ Association. Written references had been sought and this included information from the most recent employer.
Sunningdale F53 F03 S17257 Sunningdale V224775 040505 Stage 4.doc Version 1.30 Page 17 Student nurse placement at the home will commence this summer following a successful audit earlier this year. Sunningdale F53 F03 S17257 Sunningdale V224775 040505 Stage 4.doc Version 1.30 Page 18 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) 31,32,38 The manager provides guidance, leadership and direction to staff to ensure residents receive consistent quality care. EVIDENCE: Staff interviewed were full of praise for the manager (Mrs Williams) and her positive approach to managing the home. Staff stated that Mrs Williams had an “open” door policy and was willing to listen and take on board new ideas and suggestions. Mrs Williams also works closely with staff and assists the residents with their personal care. Her “hands on” approach is very much valued by them. The owner, Mrs Bennett, an administrator and qualified staff, support Mrs Williams in her role. Residents spoke favourably regarding the overall management of the home. Inspection of records indicated that fire prevention equipment was tested regularly and staff receive fire prevention training. Fire drills were conducted. This was confirmed when talking with staff.
Sunningdale F53 F03 S17257 Sunningdale V224775 040505 Stage 4.doc Version 1.30 Page 19 Accidents that had affected the well being of the residents, staff or a visitor to the home had been recorded and any subsequent treatment noted. Other equipment certificates were available within the home. Sunningdale F53 F03 S17257 Sunningdale V224775 040505 Stage 4.doc Version 1.30 Page 20 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 x x 3 x x x 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 x 14 x 15 3
COMPLAINTS AND PROTECTION 2 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 x 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x 3 3 x x x x x 3 Sunningdale F53 F03 S17257 Sunningdale V224775 040505 Stage 4.doc Version 1.30 Page 21 No 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 19 Regulation 23 Requirement The pillar in Room 41 has badly torn wallpaper and this must be replaced Timescale for action 1/9/05 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 7 Good Practice Recommendations When conducting reviews with the resident and or relative regarding the plan of care, any changes made should be signed by them to ensure the records are kept accurate and up to date. Painting of scuffed skirting boards and door frames, replacement of the top floor landing carpet and decoration of Room 31 should be included in this years maintenance plan 2. 19 Sunningdale F53 F03 S17257 Sunningdale V224775 040505 Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection Burlington South Wing, 2nd Floor Crosby Road North Waterloo, Liverpool L22 0LG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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