CARE HOME ADULTS 18-65
Sunny Fields 241 Queenborough Road Halfway Sheerness Kent ME12 3EW Lead Inspector
Graham Cummings Unannounced 02/08/05 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. Sunny Fields H56-H05 S42841 Sunny Fields V225627 020805 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Sunny Fields Address 241 Queenborough Road, Halfway, Sheerness, Kent, ME12 3EW 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) 01795 661064 01795 661064 Forward Care (Residential) Ltd Gary Greening CRH 4 Category(ies) of Care Home for Younger Adults (18 - 65) - LD x 4 registration, with number of places Sunny Fields H56-H05 S42841 Sunny Fields V225627 020805 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 16 December 2004 Brief Description of the Service: Sunnyfields is a small Home for 4 people with a learning disability who need a lot of staff attention. Service users are cared for on an individual basis and each has varied choice of daily activities that they can enjoy. The home had a friendly and welcoming feel and is well maintained, as are the gardens to the rear of the Home. A hen house has been built at the far end of the garden and service uses enjoy feeding the chickens. The Home is situated on the Isle of Sheppy, near Queensborough and Sheerness. There is off road parking available at the front of the Home and there is a main bus route running past the Home. Sunny Fields H56-H05 S42841 Sunny Fields V225627 020805 Stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. Graham Cummings carried out the unannounced inspection on Tuesday August 2nd 2005. The Inspector arrived at 09:20 and left at 13:45. The home is set up to meet the needs of 4 younger adults with severe Learning Disabilities. The Inspector spoke with the Senior worker on duty and a member of staff, the Inspector also spent time with the Registered Manager Gary Greening after the Inspection had been completed. The inspector viewed the home and looked at 2 staff and 1 Service User file. Service users were not spoken to but the Inspector did note positive interaction between staff and Service users. The home had a relaxed atmosphere and was clean and tidy. There are 3 staff on duty throughout the day and 1 sleep in staff with an on call manager or senior member of staff. The homes paperwork seen was of a good standard and reflected the needs and the care offered to the Service Users. The home had applied for a variation to increase the size of the home to 5 but this is now being withdrawn and will be confirmed to the Commission in writing. The home is run to meet the needs of the Service Users and the Inspector left the home with no concerns for Service Users Health, safety or welfare. What the service does well:
The home is run to put the needs of the Service Users first and this is done through maintaining their well being and good health, Service users are given choice and options wherever possible and the home strives for Service user self-improvement. The activities carried out with Service Users include horse riding, aromatherapy sessions, visits to cafes, fast food restaurants, parks, beach, picnics, feeding ducks and local events that take place such as a circus visiting the area. The home works hard to have and maintain good relationships with Service User families, care managers and the local community. The company encourages and expects staff to attend training courses at every opportunity, recent course attended by staff include, First Aid, Adult Protection, Food hygiene, Challenging Behaviour, Infection Control, Non Aversive Psychological and Physical Intervention (NAPPI) and most recently on Sensory Deprivation. One staff member has got the NVQ level 2 in care and 3 more staff are completing it as well. The homes manager is completing his NVQ level 4. The home has 3 staff on duty for 4 Service Users and work is carried out in small groups or individually. The company are good listeners and encourage staff to take new and fresh ideas to them about any improvements that may benefit the lives of Service Users. Sunny Fields H56-H05 S42841 Sunny Fields V225627 020805 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. Sunny Fields H56-H05 S42841 Sunny Fields V225627 020805 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Sunny Fields H56-H05 S42841 Sunny Fields V225627 020805 Stage 4.doc Version 1.30 Page 8 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2 Service Users have information available to make an informed choice about where to live. Pre Placement Assessment forms are available. EVIDENCE: The Service Users, families and care managers have information available for them to help make an informed choice about coming to live at Sunny Fields. The Inspector looked at a Service User file and saw that an assessment had been done prior to placement and that their individual need could be met at the home. Sunny Fields H56-H05 S42841 Sunny Fields V225627 020805 Stage 4.doc Version 1.30 Page 9 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7,9 Families and Care managers know that Service Users changing needs are reflected in their Individual plans. Service Users make choices about their lives wherever possible. Service Users are supported to take risks as part of their independent lifestyle. EVIDENCE: Service Users living at Sunny Fields have a severe Learning Disability and are not able to fully participate in the planning of their care but they are involved wherever possible, the families and care managers are all fully involved. The Inspector noted that the staff were talking to the Service Users when they were with them either encouraging, asking or explaining to the Service Users what was happening or what did they want to happen next. Service Users are encouraged to participate in making teas and coffees, working the controls for their TV’s, videos or C.D’s. The Inspector saw risk assessments on file relating to behaviours and outings these were clear and informative. Sunny Fields H56-H05 S42841 Sunny Fields V225627 020805 Stage 4.doc Version 1.30 Page 10 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11,12,13,14,15,16,17 Service Users have opportunities for personal development. Service Users take part in age appropriate activities. Service Users are part of the local community. Service Users participate in appropriate leisure activities. Service Users have appropriate family support and contact. Service users rights are respected in their daily lives. Service Users are offered and healthy and nutritious diet. EVIDENCE: The Service Users have opportunities for self development through the encouragement of the staff and the activities they participate, this includes learning how to use the different remote controls for the TV or CD player, making drinks within the home and day to day domestic chores. Service Users walk daily to the small shop to purchase different items and they have drinks and meals out at different cafes and fast food restaurants, they also go to parks and feed the ducks have picnics. One of the Service Users likes animals and plans have been made to take them to the visiting Circus in a few weeks time. All of the Service Users have contact with their families through visits to the home and/or going to the family home. The Inspector noted that when being shown around, the staff member was knocking on the bedroom doors
Sunny Fields H56-H05 S42841 Sunny Fields V225627 020805 Stage 4.doc Version 1.30 Page 11 and calling the Service Users name to ensure privacy. The menu seen covered a three week period and appeared to provide a healthy and nutritious diet. Staff on duty prepare and cook the meals and the Service Users are encouraged to participate and help in the process. Sunny Fields H56-H05 S42841 Sunny Fields V225627 020805 Stage 4.doc Version 1.30 Page 12 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18,19,20 Service Users receive personal support in the way they prefer. Service Users physical and emotional health needs are met. Service Users do not selfadminister medication. EVIDENCE: Service Users personal support is set out in the care plan which has been agreed at reviews with family and care managers, all of the Service Users are registered with local Doctors and Dentist, due to the severe Learning Disabilities the Doctor usually visits Service Users at the house. Service Users do not self-administer medication, only the Senior staff on duty give medication which is delivered by Boots Chemists in Blister packs. Sunny Fields H56-H05 S42841 Sunny Fields V225627 020805 Stage 4.doc Version 1.30 Page 13 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 23 Service Users are protected from abuse, neglect and self harm. EVIDENCE: Staff have attended Adult Protection training in the last 6 months and another member of staff is attending on the 22nd August 2005. Policies and Procedures are in place for Adult Protection but they will need to be checked against the new Local Authority protocols that have recently been published. There have been no complaints made against the home. Sunny Fields H56-H05 S42841 Sunny Fields V225627 020805 Stage 4.doc Version 1.30 Page 14 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,25,26,27,28,29,30 Service Users live in a homely, comfortable and safe environment, their bedrooms suit their lifestyle and promote their independence. Service Users have enough bathrooms and toilets to ensure their privacy. The home has ample communal areas that complements Service Users individual space. Service Users have access to specialist equipment if it is required. The home is clean and hygienic. EVIDENCE: The home is clean and tidy and free from any offensive odour. On arrival the Inspector noted that the downstairs area was being hovered. The home is well furnished and the Service Users bedrooms are of a good size and furnished with personal belongings where appropriate, two of the bedrooms have ensuite facilities and there is a communal bathroom and toilet. The home does have access to a wheelchair but this is not used at present. Sunny Fields H56-H05 S42841 Sunny Fields V225627 020805 Stage 4.doc Version 1.30 Page 15 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,34,35,36 Service Users benefit from the clarity of staff roles. Staff are appropriately trained and Service Users benefit from an effective and well supported staff team. Service Users are protected by the homes recruitment practices. EVIDENCE: The Inspector looked at 2 staff files and both contained all of the information set out in Schedule 2 of the Care Home Regulations. Staff have the opportunity to attend lots of training and in the last year staff have attended courses on First Aid, Adult Protection, Food Hygiene, Challenging Behaviour, Infection Control and Non Aversive Psychological and Physical Intervention and Sensory Deprivation. Individual supervision of staff is carried out as are Team meetings. The staff have a communications book, shift handover meetings and a diary of events and jobs that need to be completed. The Inspector spoke to a member of staff who told the Inspector that the ‘there is good communication between staff’ ‘ the management praise us for the good work we do’ ‘there is a good sense of humour and the team work well together’. The staffing structure consists of a Registered Manager, Home manager, 3 Senior support workers and 2 support workers, the Registered Manager visits the home once or twice a week but is in daily contact by telephone. Sunny Fields H56-H05 S42841 Sunny Fields V225627 020805 Stage 4.doc Version 1.30 Page 16 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,38,39,40,42,43 Service Users benefit from a well run home. Service Users benefit from good leadership and management. The families of Service Users are fully involved in their development on their behalf. Service Users are safeguarded by the homes policies and procedures. The health safety and welfare of Service Users are promoted and protected. Service Users benefit from good management of the service. EVIDENCE: The Inspector was informed during conversations with the Senior on duty and a member of staff that the home was well managed and that the home manager ‘was very astute and able to pick up on changes in behaviour of both staff and Service Users’, ‘the home manager discusses problems immediately’ ‘staff get lots of support’, ‘the manager is fair and treats people with respect’. Due to the disabilities of the Service Users they are only able to have minimal input into reviews and the running of the home, they are involved wherever possible and their families are fully involved. The policies and procedures following the last inspection in December 2004 were reviewed in February
Sunny Fields H56-H05 S42841 Sunny Fields V225627 020805 Stage 4.doc Version 1.30 Page 17 2005. The home is run to benefit Service Users, one staff said that the home ‘puts Service Users first’ ‘we strive for self improvement of Service Users’. The Inspector had no concerns regarding the Service Users health, safety and welfare and that the home was run by a competent Manager who was supportive and listened to staff comments and suggestions for improvement. The Inspector had a discussion with the Registered Manager/Provider around whether Sunny Fields would benefit from having a Registered Manager based on site, this could be a possibility when the home Manager completes their NVQ level 4 and Registered Managers ward. Sunny Fields H56-H05 S42841 Sunny Fields V225627 020805 Stage 4.doc Version 1.30 Page 18 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 x x 3 Standard No 22 23
ENVIRONMENT Score x 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10
LIFESTYLES Score 3 3 3 x x
Score Standard No 24 25 26 27 28 29 30
STAFFING Score 3 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score 3 3 x 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Sunny Fields Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 x 3 3 H56-H05 S42841 Sunny Fields V225627 020805 Stage 4.doc Version 1.30 Page 19 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 Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 5 Good Practice Recommendations Statement of Terms and Conditions were on Service Users files but did not have the cost of the service provided on it. The home could keep a copy with the cost of the service provided included so as to fully meet Standard 5.2 (iv) The new protocols from the Local Authority have are now being published and the home needs to ensure that their policies and procedures are reviewed to ensure that they correspond with them. That the company consider having a Registered Manager based at Suny Fields. 2. 23 3. 43 Sunny Fields H56-H05 S42841 Sunny Fields V225627 020805 Stage 4.doc Version 1.30 Page 20 Commission for Social Care Inspection 11th Floor International House Dover Place Ashford Kent TN23 1HU National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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