Inspection on 30/01/07 for Sunny Fields

This inspection was carried out on 30th 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

Sunny Fields 21/02/06

Sunny Fields 02/08/05

Sunny Fields 16/12/04

Sunny Fields 22/07/04

Sunny Fields 24/01/04

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 Sunny Fields 241 Queenborough Road Halfway Sheerness Kent ME12 3EW Lead Inspector Graham Cummings Key Unannounced Inspection 30th January 2007 10:00 Sunny Fields DS0000042841.V327667.R01.S.doc Version 5.2 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 Sunny Fields DS0000042841.V327667.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 Adults 18-65. 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. Sunny Fields DS0000042841.V327667.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Sunny Fields Address 241 Queenborough Road Halfway Sheerness Kent ME12 3EW 01795 661064 01795 661064 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) Forward Care (Residential) Ltd Mr Brian John Lawrence Welsh Gary Greening Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Sunny Fields DS0000042841.V327667.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st February 2006 Brief Description of the Service: Sunnyfields is a small Home for four 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 Sheppey, 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. The fees range from £1,500 to 2,500 per week. Sunny Fields DS0000042841.V327667.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The site visit of the 30/01/2007 completed the homes first Key Inspection. The Key Inspection consisted of looking through past inspections and completing the Inspection Record, speaking to the senior staff member on duty, another staff member, viewing the property and looking at documentation. The Inspector looked at two Service Users’ and two staff files. No Service User, Health Professionals or Relative comment cards were returned prior to the inspection. No new admissions had taken place since the last inspection. The Inspector spoke to the Senior on duty who went through the procedures the home would follow if a new Service User was referred. These met with the standards and good practice guidelines. Individual Care Plans have been reviewed and evaluated. One of the files seen had just had a review. The care plan was being updated to include the outcomes of the review. A second file seen was in the process of being updated by the Home Manager. Risk Assessments and behaviour Management plans were in place. Service Users are involved in choosing their daily activities, they include going out Horse Riding, pub lunches and drinks, cafes, daily walks and drives out in the company car. One Service User often chooses to stay in their room and if they choose to go out it is on a 1-1 basis. Family contact is varied depending on the Service User with one going home every other weekend from Friday to Sunday. Another Service User only has contact with family with a Social Services escort present due to some conflict between the family and the home. This was looked into by the Service User’s Social Worker who found that the home had acted appropriately. All Service Users are registered with a local Doctor, Optician and Dentist, a Chiropodist visits on a regular basis. Service Users wishes regarding illness and death are recorded. The issue relating to the family disagreement was dealt with appropriately and investigated by the Individuals Social Worker who found that the allegations against the home were unfounded. The home has appropriate training in de-escalation techniques and dealing with challenging behaviour. The home has a main lounge/dining room, a small smoking lounge and conservatory. The bedrooms are well furnished and decorated, the individual rooms had some personal belongings on view. Sunny Fields DS0000042841.V327667.R01.S.doc Version 5.2 Page 6 There are three staff on duty between 8am and 8pm. The home is able to access internal and external training. The Inspector noted staff knocking on Service Users’ doors before entering and when speaking to Service Users did so with respect. Service Users meet monthly with their key-worker and staff supervisions are carried out. Staff team meetings do take place, but the home needs to ensure there is a minimum of six meetings with minutes recorded and signed. The staff member spoken to said ‘the staff team are strong and supportive of each other’. The home runs well and wherever possible the views of the Service Users are acted upon. The home has a comprehensive set of Policies and Procedures and the record keeping was good. What the service does well: What has improved since the last inspection? What they could do better: At weekends staffing is reduced to two when a Service User goes home. Staff feel there would be a good opportunity to do more 1-1 work with Service Users if the staffing level remained at three. The home could benefit at looking at the weekend shift pattern to reduce the present system of 12 hours – sleep in – 12 hours. Sunny Fields DS0000042841.V327667.R01.S.doc Version 5.2 Page 7 The staff would benefit if copies of the Care Home Regulations and National Minimum Standards were available for staff and management to access. 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. Sunny Fields DS0000042841.V327667.R01.S.doc Version 5.2 Page 8 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 Outcomes Statutory Requirements Identified During the Inspection Sunny Fields DS0000042841.V327667.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,5 Service Users have the information required to make an informed choice. Service Users’ individual needs are assessed and they have a written Statement of Terms and Conditions. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a detailed Statement of Purpose that has the information required in Schedule 1 of the Care Home Regulations 2001. The Inspector was informed that no placements had taken place since the last inspection. However, if a vacancy arose the home would follow their procedures that included an assessment of needs being carried out prior to any placement being agreed. The Inspector looked at a Service User’s file and saw a Statement of Terms and Conditions. Sunny Fields DS0000042841.V327667.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9 Service Users can be confident that their needs will be assessed and appropriate care plans drawn up based on the outcomes of their assessments. Wherever possible Service Users are supported to take risks and are consulted and make decisions about their lives. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Inspector looked at two care plans and found that they contained good information setting out the care required, behavioural plans and risk assessments. The Inspector noted that the information had been evaluated and updated as required at the last inspection. Service Users, wherever possible, were involved in the day to day running of the home and in their choice of clothes, food and activities. One Service User is offered activities and outings daily but tends to refuse and stay in his room. Sunny Fields DS0000042841.V327667.R01.S.doc Version 5.2 Page 11 The home has a close working relationships with families and care managers who are fully involved in the individuals lifestyle. There has been some difficulty between a Service User’s relatives and the home, the Care Manager dealt with this and all visits are now supervised. The staff go out with the Service Users and look to find venues that are new and widen their experiences in the community setting. All of the individuals activities are risk assessed. Sunny Fields DS0000042841.V327667.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,13,14,15,16,17 Service Users benefit from having opportunities for personal development. Service Users benefit from taking part in age appropriate activities and being encouraged to be part of the local community. Service Users benefit from participating in appropriate leisure activities and having appropriate family support and contact. Service Users benefit from being offered a healthy and nutritious diet. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service Users are given the opportunity to go out on a daily basis. Three go out regularly but one Service User tends to remain in their bedroom, staff do Sunny Fields DS0000042841.V327667.R01.S.doc Version 5.2 Page 13 try to encourage the Service User to go out and sometimes will manage to achieve this. Opportunities for self development are carried out through the encouragement of the staff and the activities they participate in, this includes learning how to use the different remote controls for their personal TV or CD player, day to day domestic chores and choosing trips out to new venues. 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, feed the ducks, have picnics and go horse riding. All of the Service Users have contact with their families through visits to the home and/or going to their family home. There has been some difficulties with a family and the Care Manager was asked to become involved, the outcome is that when the relatives now visit the home they are supervised. The Inspector noted that staff were using the name of the Service Users when speaking to them and knocking on doors before entry. 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 DS0000042841.V327667.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20,21 Service Users can be confident that they will receive personal support in the way they prefer. Service Users can be confident that their physical and emotional health needs will met. Service Users can be confident that their wishes regarding illness and death will recorded and respected. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Each Service User has their own routine that is set out in the individual’s care plan and have been agreed at reviews with family and care managers. Whilst Service Users are registered with local Doctors and Dentist, due to the severe Learning Disabilities, the Doctor usually visits Service Users at the house. Sunny Fields DS0000042841.V327667.R01.S.doc Version 5.2 Page 15 Service Users do not self-administer medication. Only the Senior staff on duty give medication which is delivered by Boots Chemists in Blister packs. The Inspector was informed that the individual wishes regarding illness and death are recorded on the files. Sunny Fields DS0000042841.V327667.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Service Users can be confident that their views will be listened to and acted on. Service users are protected from abuse by the home’s procedures and policies in this area. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service Users are encouraged to participate in the daily running of the home wherever they can. This includes options and choices on trips out, food and clothing. Service Users have a choice of activities to attend and the home encourages all Service Users to go out on a daily basis. The activities offered revolve around the Individuals likes and are all risk assessed. Staff training has taken place in the Protection of Vulnerable Adults, Challenging Behaviour and NAPPI. De-escalation techniques are usually adequate to calm any situation and NAPPI is not used. The Inspector did not see any paperwork relating to an incident that happened on Xmas Eve between a staff member and a family member of a Service User. The Service Users care manager investigated and has said that any further family visits will be supervised and found that staff had acted appropriately. The Inspector was told that the paperwork was with the manager. Sunny Fields DS0000042841.V327667.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24,27,28,30 Service Users live in a homely, comfortable and safe environment that is clean and tidy. Service Users toilets and bathrooms provide sufficient privacy to meet needs. Shared spaces complement Service Users individual space. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home was clean and tidy and free from any offensive odours. The furniture was in good order and there was ample of seating. There are two lounges, the smaller one is used as a smoking room for Service Users. If staff smoke they go into the back garden. There is also a conservatory area for general use and a good sized garden. Sunny Fields DS0000042841.V327667.R01.S.doc Version 5.2 Page 18 Staff are responsible for the cooking, washing and ironing. Service Users are encouraged to participate in the communal areas and their own bedrooms. There are two en-suite bedrooms and a communal bathroom and toilet. Sunny Fields DS0000042841.V327667.R01.S.doc Version 5.2 Page 19 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 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,35,36 The care of Service Users is enhanced because of 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 home’s recruitment practices. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staff have had the opportunity to attend lots of training and since the last inspection have attended courses on De-escalation techniques, Protection of Vulnerable Adults and NAPPI. Other course include First Aid and Medication. Team meetings are carried out on a regular basis, this was confirmed by the staff member spoken to who also said that they do get Supervision but not always every two months. Key Worker meetings take place monthly. Sunny Fields DS0000042841.V327667.R01.S.doc Version 5.2 Page 20 The staff have a communication book, shift handover meetings and a diary of events and jobs that need to be completed. The Inspector looked at two staff files and found that they contained the documentation set out in Schedule 2, all CRB’s are kept at Head Office. The Inspector spoke to a member of staff who told the Inspector that the shift pattern is sometimes quite long and by the end of their time on duty they are tired. When asked they said that some shifts are 8am to 8pm sleep in and then 8am to 8pm. When staff are employed they are made aware of this shift pattern. The home should consider changing the length of time staff are working at the home in one continuous shift as their effectiveness, standards and judgements could be affected. Sunny Fields DS0000042841.V327667.R01.S.doc Version 5.2 Page 21 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 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,41,42 Service users benefit from living in a well run, well managed home. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is well run and staff spoken to indicated that the Manager is approachable and accessible. Service Users meetings are not held due as the formal setting would not benefit the Service Users, however monthly key-worker meetings address this issue and their individual views are then put forward. The home has a comprehensive set of Policies and procedures and the overall record keeping is good. Sunny Fields DS0000042841.V327667.R01.S.doc Version 5.2 Page 22 Service Users health, safety and welfare are promoted and regular checks carried out around the home, these are recorded. Sunny Fields DS0000042841.V327667.R01.S.doc Version 5.2 Page 23 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 Standard No Score 1 3 2 3 3 X 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 3 28 3 29 X 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 3 X 3 X 3 3 X Sunny Fields DS0000042841.V327667.R01.S.doc Version 5.2 Page 24 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. 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. 2. Refer to Standard YA6 YA33 Good Practice Recommendations The Registered Manager makes sure that all Service Users care plans are evaluated at least every 6 months. That the home considers the length of continuous shift pattern that staff work to ensure they are effective at all times. That the home ensures it has a copy of the National Minimum Standards and Care Home Regulations available. 3. 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