Inspection on 20/02/06 for Sunnymeade

This inspection was carried out on 20th February 2006.

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

Sunnymeade 21/05/08

Sunnymeade 15/05/07

Sunnymeade 22/08/06

Sunnymeade 25/10/05

Sunnymeade 24/02/05

Sunnymeade 29/07/04

Sunnymeade 10/03/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Sunnymeade Helliers Close Chard Somerset TA20 1LJ Lead Inspector Rachel Doyle Unannounced Inspection 20th February 2006 11:15 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 Sunnymeade DS0000016081.V280009.R01.S.doc Version 5.1 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. Sunnymeade DS0000016081.V280009.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Sunnymeade Address Helliers Close Chard Somerset TA20 1LJ 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) 01460 63563 01460 68217 Somerset Care Limited Mrs Nicola Susan Passant Care Home 50 Category(ies) of Dementia - over 65 years of age (16), Old age, registration, with number not falling within any other category (50) of places Sunnymeade DS0000016081.V280009.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. The service users admitted in the category DE will be accommodated in the units named Kingfisher and Azalea. 25th October 2005 Date of last inspection Brief Description of the Service: Sunnymeade is operated by Somerset Care Ltd, a large provider of residential and domiciliary care in Somerset. Sunnymeade is a 50 bedded purpose built care home, situated in a residential area of Chard. It has five units of eight places all on the ground floor. It also has some first floor accommodation, which service users must be able to climb stairs to reach. It is set in mature gardens, which have been provided this year with greater disabled access provision. The service is well established and provides personal care for Older Persons. The Company has plans for a major alteration to one part of the home and bedrooms within that area in order to enhance and improve services. The gardens will also be landscaped and improved as part of this building work, although no start date has been set yet. Sunnymeade DS0000016081.V280009.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place from 11.15-15.00 on Monday 20th February 2006. The inspector was welcomed by the manager and staff and was able to inspect relevant documents, case-tracking four residents and move around the Home freely. The inspector spoke to 8 residents in depth, joining some residents for lunch, and spent time with 3 residents who were not fully able to understand the inspection process. The inspector spoke to one relative, three staff members and the manager. The inspection focussed on the key National Minimum Standards, which had not been assessed during the previous inspection and any which were the subject of requirements and/or recommendations. The day care service was also in use. This runs Monday to Friday for up to 8 residents with allocated carers. At the time of arrival residents were relaxing in the lounges in each unit, some playing carpet bowls, and the reception smoking area and chatting to staff. There was a lively atmosphere with people coming and going. Some residents commented that ‘there’s always things happening here’, ‘staff are very attentive and respectful’ and that ‘everything is fine’. What the service does well: All residents spoken to praised the care that they received from the staff and said that they were happy living at the Home. One commented that it was a ‘home from home’ and that staff were ‘wonderful’. A relative said that they were always welcomed and that all the staff were very kind. Staff are keen to ensure the wellbeing and comfort of residents and were seen to treat them with respect and kindness coupled with knowledge of their needs. Activities are varied and well organised and involve the local community, families and friends. Residents said that they could choose how to spend their day. Staff were positive about working in the Home and said that they felt that the manager was very approachable. The Home is comfortable with a homely domestic décor and although the manager is aware that there are improvements to be made, which are included in the maintenance programme, the Home was clean, free from offensive odours and a pleasant environment for residents. Residents were enjoying watching the activities of the doves in the dovecote and the view into the garden from large patio doors in each unit. Sunnymeade DS0000016081.V280009.R01.S.doc Version 5.1 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. Sunnymeade DS0000016081.V280009.R01.S.doc Version 5.1 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 Sunnymeade DS0000016081.V280009.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 The Home’s assessment process is thorough and ensures that the service is able to meet prospective residents’ needs. EVIDENCE: Four pre-admission assessments were looked at. There is a clear format, which includes activities of daily living and social needs. The manager was about to visit a prospective resident at the hospital on the day of the inspection and the supervisor was also going along to learn about the process. The manager also visits prospective residents at their home for assessment. All residents spoken to felt that the Home had the information that they needed to be capable of meeting their needs on admission. The manager said that they liaise with relevant health care professionals to achieve a full picture of prospective residents’ needs prior to admission and records were comprehensive. Sunnymeade DS0000016081.V280009.R01.S.doc Version 5.1 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 10 The staff have a good understanding of the health and personal care needs of residents although improvements should be made in record keeping. Residents’ privacy and dignity are well maintained and promoted by staff. EVIDENCE: Four care plans were looked at. These contained lots of detail of residents’ identified needs and how these were to be met. In general care plans were well written and comprehensive with key-worker input. The plans were obviously used by staff that were knowledgeable about residents needs. At times daily notes were written too briefly without evidence of follow up, such as ‘pain unbearable, cannot get out of bed’, or mental health needs and actions were vague. Short-term issues were not always clearly defined with action plans and could get lost within the daily reporting. There was no clear evidence that residents had been involved in the care planning process with all residents and the relative spoken to being unclear as to what the care plan was. However, risk assessments, reviews, social histories, preferences and use of the pre-admission assessments were excellent giving a holistic picture of the resident as an individual. Throughout the inspection residents were treated with respect and their privacy maintained. All residents spoken to praised the Sunnymeade DS0000016081.V280009.R01.S.doc Version 5.1 Page 10 staff saying that privacy and dignity were respected at all times. A relative said that ‘staff were all very caring and welcoming.’ One resident thought that staff had been particularly wonderful during a bereavement and felt that staff were ‘generally wonderful in this very friendly home’. Sunnymeade DS0000016081.V280009.R01.S.doc Version 5.1 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 15 Meals are nutritious and well balanced offering a healthy and varied diet for residents in a congenial setting. EVIDENCE: The inspector took lunch with 5 residents in the large airy dining room. All units have lovely dining areas and staff were seen to be very attentive offering choice and assistance in a caring way. The meal was cold lamb or chicken or chicken and mushroom pie with jacket potatoes and a choice of desserts. There were 2 cooks and a kitchen assistant who were aware of residents’ preferences. All residents spoken to say that the food was very good and catered for specialist diets. Relatives are offered tea and coffee and there is a relaxed atmosphere. Residents and relatives can also help themselves to refreshments in the unit kitchenettes or staff will make hot drinks as residents wish. Sunnymeade DS0000016081.V280009.R01.S.doc Version 5.1 Page 12 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Not judged on this occasion. EVIDENCE: Not assessed on this occasion. Please see previous reports. Sunnymeade DS0000016081.V280009.R01.S.doc Version 5.1 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Not judged on this occasion. EVIDENCE: Not assessed on this occasion. Please see previous reports. Sunnymeade DS0000016081.V280009.R01.S.doc Version 5.1 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 29, 30 The procedures for the recruitment of staff are not robust and therefore do not provide adequate safeguards for residents. Residents benefit from skilled and friendly staff who have a good understanding of their needs but staff are not always employed or deployed throughout the units in sufficient numbers to meet the needs of residents at all times. EVIDENCE: All residents praised the care that they received from staff. There is an excellent rapport between staff and residents. The Home’s staff team has changed recently due to staff turnover and difficulties with staff recruitment. The manager has recently held an open day. There is a long-term core of long standing staff that know the residents well. However, during the inspection four residents, staff and a relative commented that the Home was currently short staffed. The relative said that there are often no staff in one 8 bedded unit for long periods so they made residents drinks themselves. Needs of residents in this unit would suggest that staff supervision was indicated due to risk assessments, mobility and capacity. Four residents said that they have to wait for assistance if they need two staff to help as each 8-bedded unit has one carer allocated and staff often have to assist in the other units. This had been the case recently whilst staff had been providing intensive care for a terminal resident. A resident praised the devoted care given to residents when they are ill. One staff member said that it was frustrating to have to wait for help if a resident needed two staff to mobilise, especially in the mornings. Not all Sunnymeade DS0000016081.V280009.R01.S.doc Version 5.1 Page 15 residents are able to use a call bell, although these are available in each area and some residents have pendant call bells. During the inspection a resident needing supervision, who was going into other residents’ rooms, had to wait for a carer as they were with another resident. Another resident was in bed and unable to ring the bell. The relative said that a carer had not been in for some time. The manager said that they regularly do a resident dependency audit but did acknowledge that meeting all residents’ needs all of the time could be a problem with one staff member on each unit as dependency needs had increased over time. It is noted that staff were doing an excellent job caring for residents within the constraints of staff numbers at this time but evidence would suggest that the Home cannot always meet residents needs in a timely way. Four staff recruitment files were looked at. There were some gaps or inadequate application form employment histories, lack of photographic identification in three files, one staff member had commenced work prior to a satisfactory CRB being received and references were not always robust. This must improve. There is a good interview format and once employed excellent probationary period reports and follow up training. Staff training is good with regular supervision sessions. All mandatory training is up to date and staff feel that they are offered regular relevant training. Staff certificates are proudly displayed in the hallway and there are training incentives. Sunnymeade DS0000016081.V280009.R01.S.doc Version 5.1 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Not judged on this occasion. EVIDENCE: Not assessed on this occasion. Please see previous reports. It is noted that residents’ monies are now kept in separate pouches and there are clear individual records. Sunnymeade DS0000016081.V280009.R01.S.doc Version 5.1 Page 17 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 2 8 X 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X X X X X X X X X STAFFING Standard No Score 27 1 28 X 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X X X X X Sunnymeade DS0000016081.V280009.R01.S.doc Version 5.1 Page 18 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP27 Regulation 18 (1) Requirement Timescale for action 20/04/06 2 OP29 19 You shall ensure that at all times suitably qualified, competent and experienced persons are working at the Home in such numbers as are appropriate for the health and welfare of residents. Dependency levels and Home layout should be taken into account. You shall not employ a person to 20/04/06 work at the Home unless they are fit to work at the Home and you have obtained documents specified in Schedule 2. 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 OP7 Good Practice Recommendations It is recommended that residents and/or representatives are included in the care planning as they wish and that this is recorded and that care plans reflect short term needs and action plans clearly to ensure that staff are able DS0000016081.V280009.R01.S.doc Version 5.1 Page 19 Sunnymeade to meet residents’ needs fully. This is carried over from the previous inspection. Sunnymeade DS0000016081.V280009.R01.S.doc Version 5.1 Page 20 Commission for Social Care Inspection Exeter Suites 1 & 7 Renslade House Bonhay Road Exeter EX4 3AY National Enquiry Line: 0845 015 0120 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 Sunnymeade DS0000016081.V280009.R01.S.doc Version 5.1 Page 21 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!