Inspection on 22/01/07 for Sunningdales

This inspection was carried out on 22nd January 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

Sunningdales 06/02/06

Sunningdales 23/08/05

Sunningdales 08/03/05

Sunningdales 20/08/04

Sunningdales 09/03/04

Similar services:

Trevaylor Manor

Stallcombe House

Stroud Lodge

The Woodmill

Woodland Vale

Bolealler House

Claremont Nursing Home

Althea Park House

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

CARE HOMES FOR OLDER PEOPLE Sunningdales 75 Southbourne Overcliff Drive Southbourne Bournemouth Dorset BH6 3NN Lead Inspector Martin Bayne Key Unannounced Inspection 22nd January 2007 09:00 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 Sunningdales DS0000003990.V328366.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. Sunningdales DS0000003990.V328366.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Sunningdales Address 75 Southbourne Overcliff Drive Southbourne Bournemouth Dorset BH6 3NN 01202 426745 01202 420944 sunningdales75@aol.com 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) Mrs Betty Mary Turner Care Home 10 Category(ies) of Dementia - over 65 years of age (10), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (10) Sunningdales DS0000003990.V328366.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. One named service user (as known to CSCI) in the category LD (Learning Disability) may be accommodated to receive care. One named service user under the age of 65 years (as known to CSCI) in the category DE (Dementia) may be accommodated to receive care. 6th February 2006 Date of last inspection Brief Description of the Service: Sunningdales is a care home providing personal care and accommodation for 10 older people who have dementia or a mental disorder. Mrs Betty Turner who is also in day-to-day charge of the service, owns the home and is the Registered Provider. The home is located in the Southbourne area of Bournemouth and is close to the sea, shops and other local amenities. Accommodation is arranged on the ground and first floor levels. There is no passenger or chair lift access to the first floor. All rooms are centrally heated, carpeted and furnished. The home has one double room that has an ensuite facility the other eight rooms are for single occupancy and have a wash hand basin. There is a communal lounge/diner and conservatory on the ground floor. There is also a very attractive secure garden at the rear of the property. The fees for the home as provided to CSCI at the time of inspection range from £461 to £520. Additional charges include hairdressing, chiropody, toiletries and newspapers. See the following website for further guidance on fees and contracts. http:/www.csci.org.uk/about_csci/press_releases/better_advice_for_people_ choos.aspx Sunningdales DS0000003990.V328366.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was an unannounced key inspection, the aim of which was to evaluate the home against the key standards for older people and to follow up on the one requirement that was made at the last inspection in Feb 2006. Mrs Turner, the Registered Provider, assisted throughout the inspection. A tour of the promises was made, samples of the records that the home is required to keep up to date were seen and some residents spoken with. Due to the mental frailty of the residents, it was not possible for them to give much of an account of what it was like to live in the home. The one requirement made at the last inspection had been complied with and in general it was found that the home was providing good care to the residents. What the service does well: What has improved since the last inspection? What they could do better: Provision of a stair lift would enhance the facilities of the home. Staff must not start work at the home until checks against the register of staff deemed unsuitable to work with vulnerable residents have been returned. The staff application form could be improved to seek information required under the Regulations. More detailed records could be kept on the food provided to residents. Sunningdales DS0000003990.V328366.R01.S.doc Version 5.2 Page 6 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. Sunningdales DS0000003990.V328366.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 Sunningdales DS0000003990.V328366.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. Residents of the home benefit from an assessment of need being completed before a place at the home is offered. EVIDENCE: The home is a small family run business with Mr & Mrs Turner living on site. Mrs Turner informed that about half the residents were funded through Social Services and the other half being privately funded. The home does not advertise and many of the referrals to the home are through word of mouth. At the time of the inspection the home was full with 10 residents accommodated. When a vacancy becomes available at the home, prospective residents and family members are invited and welcome to visit the home. The service specializes in catering to the needs of people with dementia or mental health Sunningdales DS0000003990.V328366.R01.S.doc Version 5.2 Page 9 needs and so it is usually family members who arrange the placement on behalf of the referred person. If the family wish to continue with the referral, Mrs turner will go and visit the prospective resident and carry out an assessment of need to ensure that the placement is appropriate and the needs of the person can be met. Throughout the inspection a sample of two residents who had been admitted to the home since the last inspection were used to track how the home met their needs and the records that were kept as evidence of this. An assessment of need had been carried out and recorded within their personal file. The assessment form used by the home was found to record all the topics that are detailed within the Older Person Standards. A six-week trial placement is offered to all people who are admitted. Where a person is referred through Social Services, the home obtains copies of the care management assessment and contracting arrangements. It was found that the residents at the home had been admitted within the categories of registration and that their needs were being met. The home does not provide an intermediate care service and therefore Standard 6 does not apply. Sunningdales DS0000003990.V328366.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. Residents benefit from their care and health needs being met through the care planning system of the home. Medication is safely administered by trained members of staff. Residents at the home are treated with respect and dignity. EVIDENCE: Once a person has been admitted to the home the assessment process is continued so that a care plan can be drawn up on how to meet their care needs. Mrs Turner has a questionnaire that she asks families to complete that provides a history and details of the resident’s lifestyle that helps the home to understand the needs of the person who has been admitted. It was found that for both residents tracked through the inspection a care plan had been developed and directions for staff were recorded under care headings with a Sunningdales DS0000003990.V328366.R01.S.doc Version 5.2 Page 11 second page that gave a good pen picture of the resident and how they should be supported. The plans were kept up to date, with a review each month or when needs of the resident change. Relatives are invited to sign the care plans so that they are informed and involved in how needs are to be met. Risk assessments had also been carried out and recorded in a separate file. These demonstrated that the home had fulfilled its responsibility to minimise risk of harm to residents and any necessary action had been incorporated into the care plans. After each shift there is an expectation of the staff to complete daily recording for each resident. The above documents provided ample evidence that health needs of residents were being met at the home. The home works closely with the community mental health team who advise and assist should any problems arise. An example was given of one resident who has eating difficulties and the home had arranged for the psycho geriatrician to visit for an assessment. All residents are registered with a GP and Mrs Turner informed that the home had good relations with the doctors and the district nurse. A chiropodist visits the home every six weeks, the optician once a year and should a resident have hearing difficulties referred to their GP. One resident who was bed bound had a specialist mattress to maintain their skin and the home has two hoists should a resident require one for moving and handling. Throughout the inspection staff were observed interacting with residents who appeared to be at ease with the staff. From discussions with Mrs Turner it was clear that she knew all the residents personally, their behaviour and needs. The home has a medication trolley that is affixed to the wall in the lounge area. This is kept locked with the key held in the staff office. Only Mrs Turner or her deputy administer medication to residents and both have been trained in safe medication administration. The medication administration records for all of the residents were seen and it was found that these had been completed with no gaps within the record. It was agreed that where a hand entry is entered onto the record, this in future would be checked by a second member of staff and signed as a measure to counter possible errors in entering the record. The medication cabinet was seen and medicines were being stored correctly. Mrs Turner informed that the procedure in medication administration was for the medicines to be given to the resident individually and then a record made. Due to the mental frailty of all the residents, there were none who could self medicate and a risk assessment to this effect was seen in the files for the two residents tracked through the inspection. Sunningdales DS0000003990.V328366.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 home tries to meet the lifestyle choices of residents within the parameters of their choice balanced against the home’s duty of care to protect them from harm. Visitors are made welcome at the home and families involved in the care provided at the home. Residents benefit from a balanced and wholesome diet. EVIDENCE: By gaining information about a resident’s life, their past interests and work experience, the home is better able to understand each resident and provide a person centred approach to their care. Mrs Turner informed that she had found that most group activities were not of value to the residents and that the majority of activities were arranged individually. Occasionally a singer is invited to the home, as this is one activity enjoyed by the majority of the residents. The staff were seen to interact positively and supportively with Sunningdales DS0000003990.V328366.R01.S.doc Version 5.2 Page 13 residents and there was a lot of interaction between staff and residents. Mrs Turner informed that family members were positively encouraged to be involved in the home and visitors are made welcome. Residents are supported as far as their dementia allows making decisions and having choice in the way they lead their lives. Mrs Turner informed that she does the cooking during the weekdays and at the weekends the senior care. Both hold Basic Food Hygiene certificates. There is a four-week menu, however this only acts as a rough guide as food is prepared to the likings of the residents that are accommodated. There was evidence that individual tastes are taken account of and Mrs Turner was able to show that she provided to individual tastes. A record of food was seen on the meals provided to residents and it was recommended that more detail be provided to record of what each resident had eaten. The weight of residents is monitored and specialist help sought should a resident have difficulties with eating. Liquidised diets are provided to one resident who requires a pureed diet. Sunningdales DS0000003990.V328366.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. Residents benefit from the complaints procedure being provided to their families who can complain on their behalf and from the staff being trained in adult protection. EVIDENCE: The complaints procedure is detailed within the Service User Guide and this is given out to members of residents’ families. Due to the mental frailty of the residents they are unable to comprehend the procedure and so rely on their families to complain should there be any cause. The home maintains a record of complaints and none have been made since the time of the last inspection and none have been brought to the attention of CSCI. The home has copies of all the relevant procedures and policies for adult protection and all of the staff have received training in this field. Sunningdales DS0000003990.V328366.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 & 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents benefit from a homely environment that has been risk assessed. The home would benefit from the provision of a stair lift if this is possible to install. The home is clean, free from odour with infection control measures in place for protection of residents. EVIDENCE: A tour of the premises was made. The home was found to be clean with no odours and in good decorative order. There was evidence that residents are able to bring their own possessions to personalise their rooms. Radiators have been individually assessed as to the potential to cause burns and those deemed high risk covered. The hot water outlets of baths have had Sunningdales DS0000003990.V328366.R01.S.doc Version 5.2 Page 16 thermostatic mixer valves fitted to protect residents from scalding water. The home does not have a passenger or stair lift and so residents need to be able to manage these safely. Residents’ mobility is assessed at the time of referral to ensure that they can manage the stairs. Mrs Turner informed that she was investigating the possibility of installing a stair lift. This would enhance the facilities of the home and will be followed up at the next inspection. The home has three single rooms on the ground floor and resident with mobility problems are accommodated in these rooms. The home has a locked door policy as many of the residents are at risk of wandering from the home and there is a busy road that runs outside the home. The door locking mechanism is linked to the fire safety system so that in the event of a fire the residents can be evacuated safely. The home does not have a sluice facility, however procedures for cleaning commodes have been put in place in the interests of infection control. The laundry area is situated on the first floor and is away from food preparation area and has a washing machine with a sluice cycle. Infection control policies and procedures are in place and there are alcohol hand gels in bathrooms and strategic places in the home. The staff are provided with protective clothing such a gloves and aprons in order to minimise the risk of cross infection. Sunningdales DS0000003990.V328366.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 is a potential risk to residents with staff starting work before the return of the POVAFirst check. Staff are suitably trained and staffing levels meet the needs of the residents. EVIDENCE: Two new staff members have been recruited to the staff team since the time of the last inspection. The records for these staff were used to track the home’s compliance with the legislation on recruitment checks for new staff. It was found that staff complete an application form and are then interviewed as to their suitability to work in the home. A criminal record bureau check (CRB) had been carried out as required, however if was found that the staff had started work prior to the POVAFirst check having been returned, (this is the check against the register of people deemed unsuitable to work with vulnerable adults). A requirement was made that staff do not start work until the POVAFirst check has been returned. It was also recommended that the staff application form be revised to seek information from candidates in line with changes to the regulations regarding references, employment histories and reasons for leaving jobs working with vulnerable adults. References had been taken up and the other requirements of recruitment legislation complied with. Sunningdales DS0000003990.V328366.R01.S.doc Version 5.2 Page 18 Mrs Turner informed that there are always two care staff on duty at the home during the daytime and during the nighttime there is one awake member of staff with another available if required who carries out a sleep-in duty. All new staff undertake a period of induction that complies with the standards set out by Skills For Care. Copies of the induction records were seen. Staff are trained in core areas such as first aid, health and safety, moving and handling, infection control and caring form people with dementia. It was noted that on the staff notice board there were courses available to the staff in dementia care and basic food hygiene. Mrs Turner informed that tow of the staff had achieved NVQ level 2 with another two due to begin this training. Once they are qualified this will bring the percentage of staff trained to 50 Records of staff supervision were available demonstrating that staff were being managed in line with best practice. Sunningdales DS0000003990.V328366.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 home is well managed and run in the interest of the residents. Residents’ financial interests are protected. Health and safety is promoted in the home. EVIDENCE: Mrs Turner has 18 years of nursing experience and also experience of care management and residential care. The aim of the service is to provide good quality care in a homely environment. Overall it was found that the home is well-managed with interests of residents paramount. Sunningdales DS0000003990.V328366.R01.S.doc Version 5.2 Page 20 A requirement was made at the last inspection with regards to one resident’s finances. Mrs Turner is appointee concerning the person’s benefits, although a relative also takes some responsibilities. A record of the resident’s finances is kept, however advice was given so that the record maintains a balance of money held. This will afford better protection for both the resident and also Mrs Turner and will be followed up at the next inspection. Sunningdales DS0000003990.V328366.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 3 9 3 10 3 11 X 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 3 STAFFING Standard No Score 27 3 28 3 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 2 X X 3 Sunningdales DS0000003990.V328366.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. 1. Standard OP29 Regulation Schedule 2 Requirement Staff must not start working with residents until a satisfactory POVAFirst check has been returned. Timescale for action 29/01/07 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. 3. Refer to Standard OP30 OP15 OP29 Good Practice Recommendations Hand written entries on Medication Administration Records should be signed and a second person should check this and sign to confirm this. It is recommended that the records of food provided to residents provides more detail so that it is possible to determine individually that diet is satisfactory. It is recommended that the staff application form be revised so as to seek information required under recruitment legislation. Sunningdales DS0000003990.V328366.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF 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 Sunningdales DS0000003990.V328366.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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!