Inspection on 02/01/07 for Sunnycroft

This inspection was carried out on 2nd 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

Sunnycroft 23/09/09

Sunnycroft 14/10/08

Sunnycroft 18/03/08

Sunnycroft 28/11/05

Sunnycroft 19/01/05

Sunnycroft 03/08/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Sunnycroft 143 Moorgreen Road West End Southampton Hampshire SO30 2HG Lead Inspector Tim Inkson Unannounced Inspection 2nd January 2007 09:30 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 Sunnycroft DS0000059328.V319925.R02.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. Sunnycroft DS0000059328.V319925.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Sunnycroft Address 143 Moorgreen Road West End Southampton Hampshire SO30 2HG 023 80 472503 02380 472 503 sunnycroft@sunnycroftresthome.co.uk 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) Sunnycroft Residential Care Home Ltd Miss Anna Louise Rogers Care Home 19 Category(ies) of Dementia - over 65 years of age (19), Old age, registration, with number not falling within any other category (19) of places Sunnycroft DS0000059328.V319925.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home can accommodate one named service user D.O.B 23.02.1941 in the category, DE. 28th November 2005 Date of last inspection Brief Description of the Service: Sunnycroft is a large detached chalet bungalow, situated on the outskirts of West End, overlooking fields and is double-glazed throughout. The home has a separate dining room. Residents are accommodated in five double bedrooms and nine single bedrooms. With the exception of one, all bedrooms are provided with an en-suite WC. This bedroom has a toilet near by, which is used exclusively by the occupant of that room. A passenger lift provides access to accommodation on the first floor. The home is registered to accommodate nineteen older people, including those with an age related mental health problem. It is owned by “Sunnycroft Residential Care Home Ltd”, and it is one of three homes operated by Camellia Care, that also operates two other care homes in Hampshire. Potential residents are invited to visit the home and provided with a detailed brochure that contains essential information about the service that the home provides. The brochure refers to the availability in the home of a copy a report of the most recent inspection of the establishment. At the time of the site visit on 2nd January 2007, the homes fees ranged from £385 to £550 per week. The fees did not include the cost of chiropody, hairdressing, dry cleaning, toiletries, and newspapers and journals. Sunnycroft DS0000059328.V319925.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This fieldwork visit was part of a key inspection of the service provided by Sunnycroft and took place on 2nd January 2007, starting at 09:15 and finishing at 16:15 hours. The process included viewing the accommodation including bedrooms, communal/shared areas and the home’s kitchen and laundry. Documents and records were examined and staff working practice was observed where this was possible without being intrusive. Residents, visitors and staff were spoken to in order to obtain their perceptions of the service that the home provided. At the time of the site visit the home was accommodating 18 residents, although 3 of them were in hospital, and of these 4 were male and 14 were female and their ages ranged from 65 to 93 years. No resident was from a minority ethnic group. It was difficult to have meaningful conversations with many residents because a significant number suffered from memory loss and cognitive impairment as the result of age related mental health problems such as dementia. The home’s registered manager and the responsible individual representing Sunnycroft Residential Care Home Ltd were present throughout the visit and were available to provide assistance and information when required. Other matters that influenced this report consisted of information that the Commission for Social Care inspection had received since the last fieldwork visit made to the home in 2005, such as statutory notices received about incidents/accidents that had occurred. What the service does well: Detailed care plans based on the assessments of residents needs provided clear and up to date information for staff and enabled them to provide the help and support that each individual required. People living and working in the home and visitor described the atmosphere as friendly. The home’s routines were flexible and residents were encouraged to make choices for themselves and exercise personal autonomy as far as was reasonably possible. Most residents were positive about the food that the home provided and were pleased with the range of activities in which they could participate and the condition of the accommodation that they occupied. Staff, residents and relatives had confidence in the effectiveness of the home’s manager. Management systems and procedures in the home worked well including, the administration of medication and quality monitoring. There was a strong commitment to staff training and development to ensure that staff were able to fulfil their roles and responsibilities and meet residents needs. Sunnycroft DS0000059328.V319925.R02.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Sunnycroft DS0000059328.V319925.R02.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 Sunnycroft DS0000059328.V319925.R02.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 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There were procedures in place to ensure that the home identified the assistance and support that potential residents needed before they moved into the home. EVIDENCE: The home’ procedure concerning the admission of new residents to the home was clearly set out in the brochure that it provided to potential residents as well as written policies and procedures that informed the working practices in the home. The brochure stated: “All potential residents are invited to visit Sunnycroft for the day before making their final choice of home. We will always carry out an assessment before admission to ensure that we are able to meet a resident’s needs”. Sunnycroft DS0000059328.V319925.R02.S.doc Version 5.2 Page 9 Written procedures concerning the admission of new residents included the following: “We will always invite the potential service users and their family to visit the home to view the available rooms and other facilities… if they wish to proceed, a pre-admission assessment must take place to gauge the home’s suitability to accommodate the service user. This will normally take place in the home, but can be arranged elsewhere if circumstances dictate”. The home adhered to its stated intentions as illustrated from what emerged from evidence obtained during the site visit. A sample of the records of 3 residents was examined and they included documentation specifically concerned with identifying the help and care that potential residents needed. There was evidence from these documents and discussion with the registered manager and a visiting relative that the admissions to the home of the individuals concerned had all been planned with staff with the appropriate knowledge and skills. Also that the process included visiting potential residents and identifying the help and support that they needed before they moved into the home. One visitor spoken to during the site visit about the move of her relative into the recalled what had happened. • “Anna visited him when he was in hospital before he moved here ….”.. Where a local authority had been involved in the move of one of the individual’s into the home through the care management arrangements a copy of that authority’s own assessment of the needs of that individual had been obtained. The home’s pre-admission assessments were complemented by more thorough and comprehensive assessments of a resident’s needs when they actually moved into the home. There was documentary evidence that assessments of residents needs were reviewed regularly and revised as necessary when an individual’s circumstances had changed. The home does not provide intermediate care. Sunnycroft DS0000059328.V319925.R02.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 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home had systems in place to ensure; the personal and healthcare needs of residents were met and medication was managed safely and effectively. Among other things staff working practice helped to ensure that residents’ privacy and dignity was promoted. EVIDENCE: The home had a written procedure concerning the planning of residents care. It stated among other things the following: “Each service use must have an individual care plan in place… after one month the manager should set individual goals with the service user… after the first three months the manager is responsible for reviewing the care plan to ensure that it is working effectively … the manager should then allocate a key worker to carry out monthly reviews …”. Sunnycroft DS0000059328.V319925.R02.S.doc Version 5.2 Page 11 There was evidence from documents and discussion with residents and visiting relatives that the home adhered to these procedures. The care plans were examined of the same sample of 3 residents as in the section above at page 10. The documents examined were detailed and the plans were based on the assessments the home carried out in order to identify what help individuals needed (see page 10). Assessments included a range of potential risks to residents e.g. pressure sores; falls; moving and handling; unguarded radiators; use of passenger lift. The plans examined set out the actions staff had to take and what specialist equipment was needed to provide the support and assistance each person required. There was evidence from documentation and discussion with residents and relatives that wherever possible individuals and/or their representatives had been involved in developing the plans and agreed with the contents. Where care plans referred to the use of equipment or how a specific need was to be met this was observed to be available, provided or in place e.g. Zimmer frame; plate guard and slip mat. Records indicated that care plans were reviewed at least monthly and daily notes referred to the actions taken by staff to provide the needs set out in those plans. Staff spoken to knew the needs of the individuals whose records were sampled and they were able to describe the contents of the care plans. Comments from residents and visitors about the abilities of staff the care and support that they provided included: • “They are very good. If I need help then they help me” (resident). • “They help me with personal things, like bathing. They are very good and know what they are about” (resident). • “They seem very kind to him and they look after him well ” (visiting relative). • “The staff seem to know what is going on they seem quite good - They call us appropriately. I have no concerns” (visiting health care professional). • “They help me go to the toilet and have a bath, and to get dressed and undressed - I feel safe enough, but I do think that they err on the side of caution.” (resident). • “I like to be independent, but you get help if you need it” (resident). Care plans examined were not simply task focussed but also included references to the fundamental principles that underpin social and health care such as privacy, dignity and choice and entries in plans illustrating this included the following: • “Ensure privacy and dignity at all times”. • “Prompt to go to toilet every 3 hours”. • “Promote independence and choice”. • “Encourage X to do as much as she can”. Sunnycroft DS0000059328.V319925.R02.S.doc Version 5.2 Page 12 The records examined indicated that a range of healthcare professionals visited the home and that arrangements were made for treatment for residents when it was necessary, including attendance at outpatient clinics. Residents said that they saw and received treatment from among others, doctors and podiatrists. Records examined also indicated that residents were weighed regularly and if significant weight loss occurred then remedial action was taken by the home through a referral to an appropriate health care professional. It was noted that some individuals had as a result been prescribed nutritional food supplements. The home’s registered manager described relationships with visiting health care professionals as “good” and referred to the use of domiciliary services provided by the “flying dentist” and “the outside clinic” (optician). She also referred to the specialist help and support the home received from locally based community psychiatric nurses not only with individual residents but also providing training fro staff in dementia care. A visiting health care professional spoken to during this site visit also confirmed that there was a positive relationship with the home (see above). The home had written policies and procedures concerned with the management and administration of medication. Reference material about medication was readily available. Medication was kept in a locked cupboard and where required in a specific container in a refrigerator. If needed any controlled drugs could be stored securely in a cupboard specifically used for that purpose. It is however recommended that the registered persons obtain written confirmation from a pharmacist that the cupboard that is used for storing controlled drugs complies with regulations and guidance issued by the Royal Pharmaceutical Society of Great Britain. The home operated a monitored dosage system. A branch of a large national retail pharmacy chain provided most prescribed medication every 28 days in blister packs for each person concerned. Other medicines that could not be put into blister packs because they could spoil, such as liquids or those that were to be taken only when required were dispensed from their original containers. Staff that dispensed medication had to have been deemed competent by the home’s registered manager who had attended a “train the trainers” course in “medication management” organised by the local authority adults services department for providers in the independent sector. The home’s registered manager stressed that the pharmacy also provided training for the staff. One care assistant spoken to said, “I give medication to residents, and I was given assistance with this until I was happy about doing it”. Records were kept of the ordering, receipt, administration and the disposal of medicines and these were accurate and up to date. Good practice concerning the management and administration of medication noted during the fieldwork consisted of the dating of medicine containers when they were opened. Sunnycroft DS0000059328.V319925.R02.S.doc Version 5.2 Page 13 The home’s written policy and procedures about the management of medication included reference to the right of residents to self-medicate. At the time of this site visit no resident was managing their own medication. Some residents were accommodated in singe rooms and others in shared accommodation. Those spoken to that occupied single rooms said they appreciated the privacy that these afforded. There was screening provided in shared rooms in order to promote privacy and residents spoken to said that it was used. It was also apparent from speaking to residents that staff usually knocked before entering their rooms. A visiting health care professional commented stressed that staff in the home always ensured that individuals’ privacy was promoted when she examined her patients. Residents and relatives spoken to described the staff as respectful and polite. Residents also referred to staff working practices that ensured that their modesty was preserved when they were helped with personal care tasks. Sunnycroft DS0000059328.V319925.R02.S.doc Version 5.2 Page 14 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): 11, 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home organised social activities that provided stimulation and it also promoted residents self-determination, enabling residents to exercise choice as far as was reasonably possible about all aspects of their daily life. Residents were able to maintain links with relatives and representatives. The dietary needs of residents were well catered for with a balanced and varied selection of food available that met most tastes and choices. EVIDENCE: The home employed one of the care staff working in the home to organise 3 activity sessions every week in which residents could participate. Arrangements were also made by the home for visiting entertainers and organisations that could provide interest and stimulation for residents, such as music and exercise. The leisure interests and preferences of residents were noted in their records including the specific needs of some individuals arising from disabilities such as visual impairment. Sunnycroft DS0000059328.V319925.R02.S.doc Version 5.2 Page 15 There was evidence from a tour of the building that some individuals’ leisure pursuits or lifetime interests were reflected in the décor and personal items in their bedrooms. Residents spoken to say that they had the opportunity to participate in a range of organised activities if they wished and some indicated that they enjoyed them. Residents were notified of the activities that were arranged. The ready availability of board games, and puzzles was noted during a tour of the premises. Most residents spoken to indicate that their life style preferences were respected and that routines in the home were flexible and relationships were informal. Comments from residents about the activities that were organised, their ability to exercise choice and day-to-day routines in the home included: • “Sometimes we have entertainment, someone brings dogs in - we have singers and other things. Life is quite relaxed there don’t seem to be any rules. I can get up and go to bed when I want”. • “The do have some activities. They had a soiree consisting of musical entertainment, which was very popular. Something happens most days, we pick up what it is” - they organised the “Talking Echo” for me”. • “I read a lot and we have a visiting library, but this book is my own. We have music sometimes, someone playing an instrument, a choir and somebody helping with exercises. They come and tell me when breakfast is ready. I go to bed and get up when I want. If I were to walk in the garden they would not object”. Residents and relatives spoken to confirmed that there were no restrictions concerned with visiting the home and relatives said that they were always made welcome. There was a deliberate intention to keep the premises as homely as possible and avoid the use of large notice boards and posters or leaflet/pamphlets to convey information to residents and their relatives. Consequently the home provided essential information by writing annually to residents and their next of kin. In August 2006 the letter included reference to: • • • • • Regular inspection visits made to the home by the Commission for Social Care Inspection and how copies of reports of those inspections could be obtained. The ready availability of the home’s Statement of Purpose. How independent advocacy and advice services could be obtained. The steps that the home would take to ensure that residents could exercise their civic rights. How complaints or comments about the service the home provided could be made. Sunnycroft DS0000059328.V319925.R02.S.doc Version 5.2 Page 16 At the time of this fieldwork/site visit no resident was managing his or her own financial affairs. The responsibility had been delegated to either relatives or representatives. Residents were able to bring personal items into the home including furniture and it was apparent from discussion with residents and observation during a tour of the building that many individuals had taken trouble to personalise their bedroom accommodation (see also above). Sensitive information that the home held about residents was kept secure and the home had written policies and procedures about maintaining confidentiality and residents rights to access their personal files and case notes. One resident spoken to was well aware that she could see information held about her. Residents were generally complimentary about the food provided and confirmed that they had 3 meals a day and could have snacks and drinks at other times. The menus and records of food provided indicated that the food was nutritious and there was a range of meals provided with some choice available. In addition special diets and individual preferences and needs were catered for e.g. diabetics and vegetarian. Fresh ingredients were used in the preparation of meals and the ready availability of fluids was noted. Residents could choose where to eat but most preferred to eat in the dining room. The menu of the day was made available to residents. Individuals’ food preferences, dislikes, food related allergies and their nutritional and dietary requirements were recorded in their care plan Information about residents individual dietary requirements was also readily available in the kitchen. The main meal of the day was observed and it was unhurried and staff were sensitive when providing assistance and support and also when managing behaviour that could be challenging, such as wandering. Comments from residents about the food provided included the following: • “The food is excellent, if you don’t like it they give you something else instead”. • “The food is monotonous, but despite that I have no complaints about it”. • “I can’t grumble about the food”. • “The food is good” • “The food is superb, I have no complaints whatsoever about the food. They get to know the foibles of people and accommodate them accordingly. The cook is tremendous.” Sunnycroft DS0000059328.V319925.R02.S.doc Version 5.2 Page 17 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, 17 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home had a clear and satisfactory complaints procedure to address the concerns of residents and relatives/representatives. Robust procedures were in place to protect service users from the risk of abuse and to promote their legal rights. EVIDENCE: The home had a written policy and procedures about how complaints could be made about the service that it provided that contained references to the right to complain directly to the Commission for Social Care Inspection (CSCI) and the timescale in which the home would respond to a complaint. The brochure that the home made available to potential and existing residents also included the following paragraphs: “We welcome formal and informal feedback from our residents and their representatives. Camellia Care operates a complaints procedure a copy of which is available on request. All complaints will be investigated promptly with the intention of resolving them within 28 days”. All residents and relatives spoken to were confident about raising any concerns with the home’s manager. Sunnycroft DS0000059328.V319925.R02.S.doc Version 5.2 Page 18 The home kept records of complaints that detailed the issue, and set out any agreed action to remedy the matter and its outcome. There had been no complaints made to the home since the last inspection visit on 28th November 2005. The CSCI had received no complaints about the home during the same period. The annual letter sent to relatives and residents in August 2006 (see section above) set out the home’s approach to the promotion of residents legal and civil rights. It stated: “We register all residents on the Register of Electors at the annual update, unless requested not to do so … Party political material sent to the home will be made available to residents” The home had written procedures available with adult protection. These were intended to provide guidance and ensure as far as reasonably possible that the risk of residents suffering harm was prevented. They included references to among other things, whistle-blowing, stringent staff recruitment to ensure no one unsuitable to work with vulnerable people was employed, staff training and also to role of the local authority adult services department as the lead agency in any investigations of alleged abuse. Staff spoken to said that they received training about protecting vulnerable adults and an examination of staff training records confirmed this. They were also able to demonstrate an awareness of the different types of abuse and the action they would take if they suspected or knew that it had occurred. Sunnycroft DS0000059328.V319925.R02.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home’s environment was safe and reasonably maintained. There was an infection control policy and procedures in place. Staff practice could be further improved to ensure that as far was reasonably possible residents were protected from the risk of infection. EVIDENCE: At the time of the fieldwork visit the exterior and interior of the premises, its décor, furnishings, fittings and equipment were with some minor exceptions generally in reasonable repair. The home’s brochure issued to potential residents referred communal areas available to residents as including a conservatory. This had however been demolished because of a structural defect. The responsible individual Sunnycroft DS0000059328.V319925.R02.S.doc Version 5.2 Page 20 representing the company that owned the home stated that the necessary repairs “had been completed” and that an architect was working on plans to replace the conservatory with “additional living space”. At the time of the site visit a specialist contractor had just finished cleaning the carpets in 3 bedrooms. The responsible individual representing Sunnycroft Residential Care Home Ltd, in response to a question about how repairs and the maintenance of the premises were managed said that a handyperson was available on a contractual basis and who was in the home regularly and that in addition that when problems were identified they were quickly sorted out. It was suggested at that time that some of the furniture in the communal lounge was looking worn. A slight odour in one of the first floor bedrooms was also discussed with the home’s registered manager, who said that despite investigation its source/cause was unknown. During a tour of the premises it was noted that signs had been installed that included symbols that may help individuals with age related mental health problems such as dementia orientate themselves and find their way around the building. The home had written procedures in place concerned with infection control that included advice about hand washing the latter was clearly on display in the staff WC. It was noted that in accordance with best practice all communal WCs that were seen were provided with liquid soap dispensers (that were full and working). The use of paper towels was recommended to promote more effective infection control as the use of ordinary towels can lead to cross infection. The responsible individual representing Sunnycroft Residential Care Home Ltd said that consideration would be given to this. Protective clothing was readily available and staff were observed using gloves and aprons appropriately. The home’s laundry was appropriately sited and equipped and effective procedures were in place for the management of soiled laundry items. Comments from residents and relatives about the accommodation, condition of the premises and cleanliness of the building included the following: • “My accommodation is very good, it is lovely and very comfortable. I have a lovely view over the fields. They keep it clean, they are always cleaning”. • “I think they keep it up as much as they can”. • “I think that they look after the building and keep it very clean”. • “He has a single room and it is kept very clean”. Sunnycroft DS0000059328.V319925.R02.S.doc Version 5.2 Page 21 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 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There was an appropriate and satisfactory level and mix of staff that ensured the needs of residents were met. The home had staff recruitment, training and development procedures that ensured that service users were protected and supported. EVIDENCE: The care team working in the home comprised, 14 care assistants and of these 10 (i.e. 71 ) had obtained a qualification equivalent to at least National Vocational Qualification (NVQ) at level 2. At the time of this site visit the care staff rota setting out the minimum number deployed at any time in the home was as follows: 08:00 to 14:00 3 14:00 to 17:00 2 17:00 to 20:00 3 20:00 to 08:00 2 (one sleeping) The home also employed: 1 x cook 2 x cleaners Sunnycroft DS0000059328.V319925.R02.S.doc Version 5.2 Page 22 All residents and relatives spoken to were complimentary about the staff and their abilities (see also at section about Health and Personal care above at page 12 above). Residents, staff and relatives spoken to about their perceptions of the adequacy of staffing levels indicated that generally the number of staff deployed in the home was sufficient and comments included the following: • “I think there are enough girls here to look after us, they seem to know what they are doing” (resident). • “I believe that there are enough staff, there are never any problems .I feel safe here” (resident). • “There are 3 in the morning plus cleaner cook and Anna, and 2 in the afternoon and another on at 5:00 pm to help with tea and baths. There are 2 at night. I think it is plenty and I was surprised as I have worked in other homes” (member of staff). • “Sometimes I think it is understaffed but there is always at least 2 on duty, but on occasions it seems too much for them (visiting relative). • “I think the staffing level is just right” ((member of staff). The home’s written procedure concerning staff recruitment stated: “An appropriate disclosure will be requested from the Criminal Records Bureau for all new employees. At the time of writing, the employee can begin work before the disclosure has been received, although the position cannot be made permanent without sight of a valid disclosure”. It was recommended that this be updated and amended to include the expectations set out in the document published by the Department of Health, “Protection of Vulnerable Adults Scheme” (16/05/2006). Including reference to the exceptional circumstances at paragraph 38 of the document, in which a care worker may be employed before an enhanced CRB certificate has been obtained, providing 2 references have been obtained and a POVAfirst check has been completed. Records were examined of 3 staff that had been employed to work in the home since the last visit to the establishment on 28th November 2005. It was apparent that in all cases either a Protection of Vulnerable Adults (POVAfirst) check had been completed or an enhanced certificate from the Criminal Records Bureau (CRB) had been obtained before the person had started work in the home. It was suggested that where verbal references had been obtained that the details/content were recorded and the name of the referee included and not simply the date on which it was obtained. There was evidence from documents and discussion with staff that all new staff received comprehensive induction that satisfied the requirements of the Sunnycroft DS0000059328.V319925.R02.S.doc Version 5.2 Page 23 training body for the social care workforce i.e. Skills for Care (previously the Training Organisation for Personal Social Services [TOPSS]). Training included viewing videos then completing workbooks/questionnaires about a range of subjects e.g. food hygiene; infection control; first aid; abuse; dementia care; health and safety; and fire safety. The home’s registered manager was an accredited moving and handling trainer and had also attended “train the trainer” courses organised by the local authority adults services department for the independent care homes sector in the following subjects in order that she could “cascade” training to staff: • Dementia Care • Medication management • Infection control • Abuse Staff training needs were identified through appraisals and individual supervision sessions and staff spoken to confirmed that they received regular formal and individual supervision from the registered manager. Staff comments about their induction and further training opportunities included: • “I am doing NVQ at the moment and should finish in August. My induction training included being shown the bath hoist and getting into it gradually. I have done fire safety training, I had to watch a video and fill in a questionnaire”. • “There have been courses here about dementia and we have had nurses come and talk - We get trained by Anna about medication and she explains what people are on”. • “I have had fire safety training, food hygiene, dementia, abuse, moving and handling the latter by Anna and X through Mulberry House”. Sunnycroft DS0000059328.V319925.R02.S.doc Version 5.2 Page 24 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, 25 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home’s manager provided effective leadership There were systems and procedures in place for monitoring and maintaining the quality of the service provided and promoting the safety and welfare of everyone living and working in the home. EVIDENCE: The home’s registered manager had previous experience of managing services for older people before her employment at Sunnycroft. She had been responsible for day-to- day operation of the home for some 4 years. In addition to her practical experience and knowledge she had obtained relevant formal qualifications, and had a Diploma in Social Work and a National Sunnycroft DS0000059328.V319925.R02.S.doc Version 5.2 Page 25 Vocational Qualification at level 4 in management and care and the Registered Managers’ Award. From discussion with the registered manager, and from observation and discussion with staff, residents, relatives and a visiting health care professional it was apparent that the registered manager was highly respected, organised; well motivated; enthusiastic; concerned; sensitive and empathetic. Comments arising from discussions with staff, residents, relatives and a visiting health care professional the registered manager were all very positive and included the following: • “Anna (the registered manager) is lovely - she is absolutely superb” (resident). • “Everybody loves her, she is so nice with the patients and is one of the nicest persons I have met” (resident). • “She is really good, really helpful. She will put her foot down if she needs to” (staff member). • “Anna is brilliant, she is very fair and consistent. She is also understanding and knows what she is talking about” (staff member). • “Anna is lovely and she is very supportive, if there is anything wrong she will help you through it” (staff member). • “Anna is excellent - I usually deal with Anna and she is great” (visiting health care professional). • “Anna is lovely, she is always concerned about them. You know what is going on because she telephones. She is very caring” (relative). The home had a system in place for monitoring the quality of the service that was based on the use of questionnaire every year to obtain the views of residents and relatives. The outcome of the survey was published in a brochure made available to potential residents and in a letter sent out annually to residents and their next of kin (see above in the sections about; “Daily Life and Social activities; and Complaints and Protection). The home had a range of written policies and procedures that were readily available for reference and advice. Copies were available in the office and the staff rest room. There were no outstanding requirements from previous inspections of the home. Comments from residents about living in the home and the perceptions of relatives, as well as the views of staff about working in the home included the following: • “I am glad that I went here” (resident). • “There are some lovely people here to give them credit” (resident). • “All in all I would say that I was very content” (resident). • “It is really nice, it is friendly and there is a good atmosphere. The staff get on fairly well” (member of staff). • “I really like it, it has a nice atmosphere, it is very friendly” (member of staff). • “We liked the home because it was small and friendly (relative). Sunnycroft DS0000059328.V319925.R02.S.doc Version 5.2 Page 26 The home did not look after any money on behalf of or for any resident, but if individuals made use of any services that were not included in the home’s fees such as hairdressing, their relatives or representatives were invoiced accordingly. Records examined indicated that most of the home’s equipment, plant and systems were checked and serviced at appropriate or recommended intervals i.e. passenger lift and hoists; fire safety equipment portable electrical equipment; hot water system; etc. There was a fire risk assessment for the premises The one exception noted was the home’s electrical wiring system that according to the records examined was last checked in 1996 when a recommendation was made that it should be checked again in 5 years i.e. 2001. It is recommended that the electrical wiring system is checked without delay to ensure that it remains safe. Records were kept of accidents. Staff said that they attended regular and compulsory fire and other health and safety training and this was confirmed from an examination of staff training records. Not all radiators in the home were guarded but where this had not been done risk assessments had been completed. The home’s registered manager was an accredited moving and handling trainer and there were hoists and other equipment (e.g. raised WC seats, grab rails) in the home to promote a safe environment and working practices. Sunnycroft DS0000059328.V319925.R02.S.doc Version 5.2 Page 27 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 N/A 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 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 4 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X N/A X X 3 Sunnycroft DS0000059328.V319925.R02.S.doc Version 5.2 Page 28 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. Refer to Standard Good Practice Recommendations Sunnycroft DS0000059328.V319925.R02.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Sunnycroft DS0000059328.V319925.R02.S.doc Version 5.2 Page 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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