Inspection on 23/01/06 for Sunnymeade

This inspection was carried out on 23rd January 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Sunnymeade 22/08/07

Sunnymeade 22/02/07

Sunnymeade 26/07/05

Sunnymeade 30/11/04

Sunnymeade 07/05/04

Sunnymeade 07/01/04

Similar services:

The Vicarage

Fairfields Country Rest Home

7 Hyde Road

5 Seafield Road

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

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

CARE HOMES FOR OLDER PEOPLE Sunnymeade 323 Tavistock Road Derriford Plymouth Devon PL6 8AE Lead Inspector Kim Fowler Announced Inspection 23rd January 2006 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Sunnymeade DS0000003470.V278582.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 DS0000003470.V278582.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Sunnymeade Address 323 Tavistock Road Derriford Plymouth Devon PL6 8AE 01752 781811 01752 781811 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs Wendy Karen Dunn Care Home 30 Category(ies) of Dementia - over 65 years of age (30), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (30), Old age, not falling within any other category (30), Physical disability over 65 years of age (30) Sunnymeade DS0000003470.V278582.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Age 60 Date of last inspection 26th July 2005 Brief Description of the Service: Sunnymeade is a detached property standing within its own grounds in the residential area of Derriford and is privately owned and managed by Ms Wendy Dunn. The Home is currently registered to provide residential accommodation for a maximum of 30 persons over the age of 60 who may also have a physical disability, dementia or mental disorder. The home is in the process of being remodelled with a major refurbishment and improvement plan that should be completed soon. Accommodation currently is provided on two floors with a stair lift providing access to the 1st floor. There are two lounges on the ground floor, one of which is a designated smoking room. The newly built dining room is currently doubling up as a sitting room. Living rooms are in the process of being re allocated pending the completion of the changes. There is a call bell system throughout the home. The changes include the provision of more single bedrooms on the ground and first floors, with some having en suite facilities. Service Users are enabled to access any health or social care services they require and various social activities are arranged by the home. The rear gardens have been thoughtfully landscaped to provide level access to well lit paved and bricked walkways, lawns, seating areas and raised flower- beds and a fountain. Some new ensuite rooms are now ready for occupation and residents currently living in the home have been given the choice of moving into these rooms. Sunnymeade DS0000003470.V278582.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over 4 1/2 hours and was a planned Announced inspection. A full tour of the premises took place and 9 service users, 2 visitors and the Owner were spoken with during this inspection. What the service does well: 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 Sunnymeade DS0000003470.V278582.R01.S.doc Version 5.1 Page 6 contacting your local CSCI office. Sunnymeade DS0000003470.V278582.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 DS0000003470.V278582.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): 1/3/5 Information provided to the prospective service user assist them to make an informed choice of a care home. EVIDENCE: The homes Statement of Purpose and Service Users Guide have not changed since the last inspection but the owner is aware that this document will require changes after the completion of the building work and the increase in number of service user registered at the home. Case tracking provided evidence on 3 service user files. One file read was for a service user who had only been at the home for a short time. The preadmission assessment was read and was completed with input from the service user. Any referral via the Care Management system comes with a Care Manager pre-admission assessment before admission. All information required to meet this standard were recorded on individual files including mobility and health care needs. Sunnymeade DS0000003470.V278582.R01.S.doc Version 5.1 Page 9 Risk assessments and pressure sore risk assessments were recorded on relevant files. The owner informed the inspector that the service user, family and friends visit the home before moving in. Several service users and visitors spoken with during this inspection confirmed they had visits the home several times before moving in. Sunnymeade DS0000003470.V278582.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7/8/9/10 The staff and manager provide excellent personal and health care support to the service users in the home. EVIDENCE: Case tracking on service users files provided evidence of completed comprehensive assessments. These care plans set out the care being carried out by the care staff and included personal care as well as social and health care requirements. Included in each care plan read was a completed Manual Handling and pressure sore risk assessment. The home has a key worker system in place and these key workers discuss with the homes team leader and changes in the service user and this recorded onto care plan and updated regularly. Each service user who has a visit and input from the District Nurse has an individual file completed by the District Nurse and is available for staff access when needed. Each care plan clearly records the personal care input provided by the care staff in the home. Sunnymeade DS0000003470.V278582.R01.S.doc Version 5.1 Page 11 The home has a District Nurse referral book and recorded into this is any information relating to individual service user. The District Nurse then will see the service user and monitor any health care needs requested. Evidence was seen recorded on a care plan of visits by chiropodist and hospital appointments attended by the service user. A list of the prescribed medications is recorded into individual care plan and evidence was seen of discontinued medication being recorded and signed and who stopped the medication. The home has a section in each service users file on Doctor Notes and Multidisciplinary visits and any changes in medication are recorded in these notes. The medication being administered by a staff member was observed during this inspection and observed was that the home uses a nomad system. The homes pharmacist is due to visit and carry out their yearly assessment. All service users spoken with agreed that their personal and health care needs are met and that the staff maintains their privacy and dignity at all times. Sunnymeade DS0000003470.V278582.R01.S.doc Version 5.1 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12/13/14/15 The service users at Sunnymead can be confident that the home offers good wholesome meals and family are welcome at all times. EVIDENCE: Displayed on the homes notice board is recorded the activities arranged by the home and the date of these activities. This notice had several sessions booked included music and exercise and some of the service users spoken with confirmed that these sessions took place. These activities are also recorded into the home daily diary. The owner confirmed that trips out are more difficult due to the needs of some of the service users but several of the service users request to go out and this is arranged by the staff in the home. The interests of the service users in the home were seen recorded into individual care plans. Evidence was seen recorded into individual files of family involvement and there usual visiting times including one service user whose family visit daily. During this inspection 2 family members were visiting and confirmed with the inspector that they do visit the home regularly and at any time. Several service users confirmed that they go out with their relatives, families or friends and also on occasion with staff. Sunnymeade DS0000003470.V278582.R01.S.doc Version 5.1 Page 13 The owner confirmed that the home does not manage any main finances for any of the service users and will only hold a small amount of money for every day use. Case tracking provided evidence on individual files that several family members hold power of attorney for their relative. Money for one service user held was checked and was well documented and correct at this inspection. Evidence was seen while visiting service users in their rooms that all contained personal possessions and an inventory was held on file. The home has a 4 weekly menu and a copy was given to the inspector. The home employs a full time cook 7 days a week. The cook also prepares the evening tea meal for staff. Hot and cold drinks and snacks are available though out the day on request. Also recorded on one service user file was that a special diet is catered for and evidence was seen of this diet at the main lunch meal served during the inspection. Sunnymeade DS0000003470.V278582.R01.S.doc Version 5.1 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16/18 Sunnymead’s service users can be confident that their complaints or concerns will be listened to and acted upon. EVIDENCE: The Commission had received a complaint from an outside agency. Information provided from the home and on discussion with the owner during the inspection confirmed that this complaint had been dealt with in the timescale stated. The owner confirmed that they had met the complainant and resolved the issues raised. Records seen and sent to the Commission provided evidence that complaints are listened to and taken seriously and acted upon. The home complaint procedure is displayed on the homes notice board and also in the homes Service Users Guide. The homes designated complaints file was read and the complaint received by the Commission was well documented with the outcome recorded. Several service users spoken with confirmed that they were aware the home had a complaints procedure but had not needed to use this. Several service users also stated that they felt able to approach the owner if needed. The home has the no secrets guidelines and Adult Protection Policy in place for staff reference. None of the current staff employed at Sunnymead have completed the Devon Adult Protection course. Sunnymeade DS0000003470.V278582.R01.S.doc Version 5.1 Page 15 Sunnymeade DS0000003470.V278582.R01.S.doc Version 5.1 Page 16 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): 19/21/22/23/24/25/26 Sunnymead continues to maintain a clean and suitable environment for its stated purpose and the service users can be assured that they will live in a attractive, modern, spacious and comfortable home on completion of the refurbishment. EVIDENCE: The home presently has 20 resident service users, they are registered for 30 but this is to allow for the major refurbishment presently being carried out. The work already completed was inspected and was completed to a very high standard. Some of the current service users will move into this new wing while the remaining building is also upgraded. Two new sluice rooms are being added during the ongoing upgrade work and the majority of the new bedrooms will have a walk in shower and toilet. The home has a new lift and plan to fit a stair lift in the new wing so all parts of the home will be accessible for all service users. Sunnymeade DS0000003470.V278582.R01.S.doc Version 5.1 Page 17 The home has several hoists in place and the owner is a Manual Handling trainer and is due to re-train the staff. All new ensuite rooms have grab rails and assisted toilets. The extension and upgraded parts of the house completed are designed to cater for service users with a physical disability. All new room’s will met or exceed the required minimum standard in size. The home plans to have 4 shared rooms to cater for people who request to share. All the rooms seen were excellent and furnished to a high standard. New rooms have low surface temperature radiators and the older rooms have radiator covers or risk assessments in place until their upgrade. A full tour of the premises found the home to be clean bright and free from odours. Sunnymeade DS0000003470.V278582.R01.S.doc Version 5.1 Page 18 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): 27/28/29/30 Ongoing staff training is encouraged enabling service users to receive the best possible service. EVIDENCE: The home currently has 20 service users resident and there are 3 staff am but only 2 on pm due to a staff vacancy. The owner is here Monday to Friday to assist if required. There is also a team leader on each shift. Both of the homes 2 domestic staff have completed their NVQ and carry out care work when needed. A requirement from the previous inspection that that an extra member of staff be on duty after 6pm until residents go to bed, to ensure that residents’ emotional as well as their physical wellbeing is assured is carried over. All team leaders are NVQ trained and some staff is having NVQ training via Achievement Training Company. Case tracking on staff files show that each contained 2 references as well as completed CRB checks. The staffs individual contracts were seen held on file and signed by the staff. Fire Certificates for training recently completed were seen as evidence and an external trainer carried this out. The homes care manager and owner is trained in D32/33 to assist the staff to complete their NVQ work. Sunnymeade DS0000003470.V278582.R01.S.doc Version 5.1 Page 19 The home has a designated training file in recorded was evidence of courses booked and these included Slips & Falls, Manual Handling and Food Hygiene. This information was also displayed on the staff notice board. Sunnymeade DS0000003470.V278582.R01.S.doc Version 5.1 Page 20 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): 31/32/33/34/35/36/37/38 A competent manager who has the respect of the staff team and is highly thought of by the service users manages Sunnymead. EVIDENCE: The owner is a qualified Registered Nurse and also has her Registered Managers award and D32/33 to assist with staffs NVQ work. The owner has owned the home for 6 years and has many years experience in working in care. The service users and visitors spoken with during this inspection agreed that the owner is approachable and that the home is well run. The homes Quality Assurance system was well documented and it was evident that this had recently been completed for the service users in the home. The owner plans to extend this to include visitors, family and professionals. The Sunnymeade DS0000003470.V278582.R01.S.doc Version 5.1 Page 21 blank questionnaires for these surveys were already held on file ready to pass out. The completed quality assurance questionnaire by the service users are held on file and the owner has been giving individual feedback to service users but will feedback to service users in a future service user meeting. Records seen were correct and recorded information on service users money received from family were well documented and receipts in place. One service users money was checked and was correct at this inspection. The homes Insurance certificate was in place and Finance and Business plans are available to the Commission on request. The staff supervision records were seen and recorded. Some staff also had appraisals in place. All records seen and read during this inspection were updated accurate and well kept. Fire safety training had been completed and Manual Handling, Food Hygiene, Health and safety and Falls Prevention courses are also booked and due to be carried out soon. The home has a new boiler system in place due to the extension work and the manager assured the inspector that this is regularly maintained and checked due to the ongoing refurbishment work. The home has risk assessment file in place for the environment and individual risk assessments for service users held on their files. The radiators are either low surface or covered except the old part of the building and these are due to be altered soon, but risk assessments are in place for the uncovered radiators. The homes record of any accident and incident were held in a designated file and evidence was seen of this forms being completed and case tracking provided evidence that this information was also recorded into individual service users files. Sunnymeade DS0000003470.V278582.R01.S.doc Version 5.1 Page 22 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 3 X 3 X 3 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 X 18 3 4 3 3 3 3 4 3 4 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 4 3 3 3 3 3 3 Sunnymeade DS0000003470.V278582.R01.S.doc Version 5.1 Page 23 Are there any outstanding requirements from the last inspection? YES 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)(a) Requirement A third member of staff must be available from 6pm until residents have gone to bed to ensure staff have the time to spend with confused and unsettled residents as well as carrying on the routine evening tasks. This requirement is carried over from the last inspection. Timescale for action 31/03/06 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 18 38 Good Practice Recommendations All staff should have the Adult Protection training. All accidents and incident should be followed up with a statement stating outcomes and treatments required. Sunnymeade DS0000003470.V278582.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 DS0000003470.V278582.R01.S.doc Version 5.1 Page 25 - 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!