Inspection on 17/12/05 for Sunnyside

This inspection was carried out on 17th December 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 9 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Sunnyside 14/08/06

Sunnyside 21/09/05

Sunnyside 21/10/04

Sunnyside 27/04/04

Sunnyside 01/10/03

Sunnyside 19/06/02

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

CARE HOME ADULTS 18-65 Sunnyside 83 Marine Approach South Shields Tyne And Wear NE33 2TE Lead Inspector Mr Steve Tuck Unannounced Inspection 17th December 2005 11:30 Sunnyside DS0000000262.V273896.R01.S.doc Version 5.0 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 Sunnyside DS0000000262.V273896.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Sunnyside DS0000000262.V273896.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Sunnyside Address 83 Marine Approach South Shields Tyne And Wear NE33 2TE 0191 455 1609 NO FAX 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) Mr Jeffrey Best Mr Jeffrey Best Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Sunnyside DS0000000262.V273896.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st September 2005 Brief Description of the Service: Sunniside can provide personal care for three people who have a learning disability. The property is a traditional terraced house with a combined living dining room and kitchen on the ground floor, one single and one shared service users bedroom on the first floor and staff accommodation on the second floor. The home is situated close to the centre of South Shields and within easy reach of a range of amenities, some of which are within walking distance. The beach, high street shopping outlets, churches and some public houses are nearby and there is also a small ‘corner shop’ next door. Public transport is accessible in the locality. The Registered Provider who is also the current manager purchased the house in order to provide accommodation and personal care for 3 men with learning disabilities who had lived in residential hospitals for most of their lives. The service is not suitable for those people who have a physical disability or cannot climb stairs easily. The service cannot provide for those people who require nursing care. Sunnyside DS0000000262.V273896.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over 5 hours and was a scheduled unannounced inspection. The inspection process involved spending time talking to all of the people who live in the home as well as the current registered manager. Relatives of service users who were visiting were happy to pass on their views of the services offered at the home. A sample of records were examined including care plans. A tour of the building took place which included all communal areas and service users bedrooms. Observations were made of the support the manager offered to service users at teatime and throughout the day. The judgements made are based on the evidence available on the day of the inspection. What the service does well: What has improved since the last inspection? The manager has established an ongoing social work support from South Tyneside council who are responsible for the placement of all three service users at the home. Consequently assessments have been carried out by a social worker, which confirms their needs, and that they are appropriately placed at the home and the manager and staff are taking steps to further develop care plans. Sunnyside DS0000000262.V273896.R01.S.doc Version 5.0 Page 6 Records of medication coming into the home have been improved and the complaints procedure now has a timescale in which service users or other complainants can expect a response from the manager. The manager has made arrangements for sufficient staff to be available who can meet the assessed personal care and lifestyle needs of service users and additional staff are available for emergencies or training. 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. Sunnyside DS0000000262.V273896.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Sunnyside DS0000000262.V273896.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 and 5 Discussion has taken place which has enabled service users to make a choice about where and with whom they like to live. Service users support needs have been identified which confirms that the home can meet them and helps staff to plan their care. Service users right to continue to live at the home are protected. EVIDENCE: Since the previous inspection, all service users have had their needs identified by a social worker from South Tyneside MBC who has arranged for services to be provided at this home. This confirms that the home is able to meet the current needs of all three service users and established an ongoing contact with the home owner / manager. Although service users have not yet had an opportunity to access independent advocacy (there is a waiting list) the social worker has explored the opinions of service users who have all confirmed that they prefer to continue live together, share their lives and experiences and live with Jeff Best and the staff. The social worker has made statements in the assessment to this effect. Where service users families are involved, they strongly support the placement of their relatives at the home. One relative said ‘it’s just like family life here.’ All service users have a written contract, which outlines their rights and the responsibility of the proprietor and these have also been signed and agreed by relatives where available. Sunnyside DS0000000262.V273896.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 The manager and deputy have made progress in recording the measures staff take to support the health and personal care needs of service users. However this work is not yet completed therefore making it difficult for staff to consistently meet their needs. EVIDENCE: The manager and deputy have only recently received the assessment from the local authority social worker, therefore this had not yet been used to improve care planning and the completion of this development is still within the timescales set at the previous inspection. There is evidence that manager and deputy have continued to improve the standard of care planning at the home using the lifestyles mapping approach, although these are not yet complete. The manager demonstrated an in depth knowledge of service users needs aspirations and life histories and demonstrated well thought out ways in which they support service users, for example those with communication difficulties. However, examination of records indicates that these are not always recorded in the service users’ plan of care. Sunnyside DS0000000262.V273896.R01.S.doc Version 5.0 Page 10 Service users are supported by staff to take appropriate risks, for example to promote their independence. And although some of these are now recorded in service users files, there are areas of good practice which have yet to be recorded there. Sunnyside DS0000000262.V273896.R01.S.doc Version 5.0 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16 and 17 Service users are provided with a range of activities within the home and in the local and wider community so that they can lead valued active fulfilled lives. People who live at the home are respected, and routines are flexible. This can help to promote service users’ choices and preferences. Service users are supported to keep in contact with their relatives and friends and are able to spend time together outside of the home. Tasty, proficiently cooked meals are provided with choices available, offering a good balanced diet, which contributes to the promotion of healthy eating. Service users are involved in menu planning, which helps to ensure that they are offered meals, which they prefer. EVIDENCE: Each service user has a weekly timetable of activities taking place at home as well as those run by external day services provided by the local authority. This includes leisure activities, employment workshops and training as well as taking part in college courses. Service users have also had a caravan holiday this year where they enjoyed shopping and walking in the North West of England. Sunnyside DS0000000262.V273896.R01.S.doc Version 5.0 Page 12 Whilst at home service users’ have particular interests and preferred activities at home for example drawing or particular types of film or television. Service users indicated that they liked to be able to choose the activity they are interested in. The manager and staff promote family contacts and have maintained family relationships or re-established them where these have been previously lost. The owner and staff continue to promote these relationships and understand their importance for service users.’ On returning to the home from an excursion with relatives, one service user indicated that he had enjoyed this time with them. Staff and the manager routinely encourage service users to take decisions and choices about their lifestyle, although sometimes service users find it hard to make decisions or, for example to take part in new activities. The manager gave examples how he motivates and supports service users to make informed choices and promote their independence for example to use the local corner shop to purchase individual items. Sunnyside DS0000000262.V273896.R01.S.doc Version 5.0 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Service users health care needs are identified and arrangements are made to help ensure they are promoted and met. Medication administration procedures ensure that service users health care needs are addressed and they get the treatment that they require. However some of these need to be recorded. EVIDENCE: Due to their levels of need, service users are not able to administer their own medicines, and staff therefore assist in this area. Staff at the home have undergone training in relation to medication administration and medication is securely stored with accurate records kept. As mentioned at previous inspection, the manager has ensured that he has obtained advice and training to ensure that service users needs can be met. For example he has undertaken training and verification by medical personnel for the diabetes treatment of one service user. Where the service user attends day services, the manager has taken steps to ensure that the service user is not at risk and that it is acceptable for treatment to take place on his return home. Although the manager has discussed and agreed these actions with a medical consultant specialist he has not yet documented these judgements and procedures in the service user’s records. Sunnyside DS0000000262.V273896.R01.S.doc Version 5.0 Page 14 The manager and staff demonstrate that they are tactful in promoting service users medical care needs in privacy which is often difficult due to the open plan design of the home use of shared bedrooms. Sunnyside DS0000000262.V273896.R01.S.doc Version 5.0 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Complaints in the home are handled objectively and openly with the manager and staff encouraging service users and their families to offer comment on the services that are offered. Although staff have undertaken training, the home does not have documented adult protection procedures, therefore if abuse is suspected or witnessed then appropriate action may not take place to safeguard service users. EVIDENCE: There is a clear complaints procedure in place at the home which gives acceptable timescales for a response by the manager. Observations of the manager’s day-to-day practices indicated that they routinely ensure that service users views are asked for and their choices promoted. Although there have been no instances of alleged or proven abuse at the home, robust procedures, which link with the local authority statutory procedures and ensure that service users are protected should abuse be observed or suspected, have yet to be devised. Staff have undertaken training which would enable them to recognise and respond should they suspect or witness abuse. Sunnyside DS0000000262.V273896.R01.S.doc Version 5.0 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 27 and 30 The home is clean, warm and well maintained offering service users a homely environment in which to live. Although some service users share a bedroom which makes it difficult to agree the level and type of furnishing and decoration. EVIDENCE: The home is domestic in size, decor and equipment providing a homely environment typical of others in the neighbourhood and suitable for the ‘family’ style of service which is being promoted there. All communal areas and some service users bedrooms were viewed during the inspection. Some of the communal areas have been redecorated and a programme of routine maintenance and replacement is in operation. All areas in the home were clean and pleasant with décor and furnishings reflecting the tastes of service users and the manager. One service user indicated that he likes his room which has been individually decorated to reflect personal lifestyles, tastes and interests. Where rooms are shared, ongoing negotiation takes place involving service users and the manager regarding, for example the availability of seating and a table as well as room decoration and use. When service users are at the home they have full access to their own rooms and all communal areas where they can to Sunnyside DS0000000262.V273896.R01.S.doc Version 5.0 Page 17 pursue daytime activities e.g. drawing or watching television. Sometimes service users prefer the companionship of the manager and visitors which generally takes place on the ground floor. There is a spacious bathroom on the first floor which can be accessed independently by service users. However although staff service users are always supervised whilst bathing, water temperatures from the bath were above 43°C which could cause injury to them. Sunnyside DS0000000262.V273896.R01.S.doc Version 5.0 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32 and 33 Service users are supported by competent, experienced and qualified staff and consequently service users needs can be met. EVIDENCE: The registered manager has taken steps to ensure that there are safeguards in place which will ensure that there are sufficient staff available to meet the assessed needs of service users. The service has been designed to promote, as far as is practicable, a ‘family’ care environment for people who have previously lived in long stay residential hospital and up until recent years the manager lived on the premises with his family. Since moving out, the manager has designed a staffing shift pattern where staff work at the home for a continuous period of time (with their agreement). This has therefore minimises the numbers of staff coming into the home on a weekly basis and helped service users to maintain positive relationships with the staff who support them. This has been a successful approach as service users demonstrably get on well with staff and talk positively about the staff who will support them throughout the coming week. The manager has recruited a staff team whose personal lifestyle can fit in around the demands of the service and offer a degree of flexibility. However additional staffing are available on an emergency basis to cover for staff sickness or holiday leave. Emergency staff are trained in the ethos and approach that the home maintains and are known well by service users. Sunnyside DS0000000262.V273896.R01.S.doc Version 5.0 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 42 and 43 Although he has much experience, the manager has not undertaken training which verifies that he has the skills to organise and structure the regime of care at the home and meet service users welfare and lifestyle needs. The manager and staff ask service users for their views and to make choices about their care. However this is not yet a structured approach to improving the quality of care at the home. EVIDENCE: The manager has not undertaken NVQ level 4 training in Management and in Care and is planning to step down from his current position as registered manager in the near future. It is planned that the current deputy manager who has undertaken NVQ training in Management and in Care at Level 4 will then apply to the Commission for an assessment of her fitness to become the registered manager at the home. The manager plans to formalise the processes which he and staff use to promote and improve the quality of service at the home. Sunnyside DS0000000262.V273896.R01.S.doc Version 5.0 Page 20 Records are available which indicate that training and practice has been undertaken regarding the actions staff must take in the event of a fire at the home. Sunnyside DS0000000262.V273896.R01.S.doc Version 5.0 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 X X 3 Standard No 22 23 Score 3 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 2 X 2 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 2 X 2 X X 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X 3 3 X 3 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Sunnyside Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score 1 X X X X 3 3 DS0000000262.V273896.R01.S.doc Version 5.0 Page 22 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 YA6 Regulation 15 Requirement Care plans must continue to develop so that they are sufficiently detailed to guide staff practice in meeting service users needs and record the work they currently undertake. Service users’ care plans must be fully reviewed if their needs change or at least every six months. The registered manager must ensure that service users have access to an independent advocate who can act in their best interests. Where service users are taking risks for example to promote their independence these must be recorded in service users records. The owner must ensure that the procedures are in place which detail the action to be taken to support the diabetes needs of one service user are recorded in the service users plan. The manager must ensure that procedures for responding to suspicion or evidence of abuse or neglect are in place which meets with current guidance. DS0000000262.V273896.R01.S.doc Timescale for action 11/02/06 2. YA6 15 11/02/06 3. YA7 12 02/03/06 4. YA9 13 11/02/06 5. YA20 13 11/01/06 6. YA23 18 21/01/06 Sunnyside Version 5.0 Page 23 7. YA25 16 8. YA27 13 9. YA37 9 The manager must assess the risk of providing sufficient furniture in service users’ bedrooms. (Previous timescale 11/12/05) The manager must ensure that bath water is delivered at a safe working temperature. (Previous timescale 11/11/05) The owner must appoint a manager who has the qualifications, skills and qualities to successfully develop and manage the care of service users at the home. (Previous timescale 11/12/05) 21/01/06 11/11/05 11/02/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Sunnyside DS0000000262.V273896.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection South of Tyne Area Office Baltic House Port of Tyne Tyne Dock South Shields NE34 9PT 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 Sunnyside DS0000000262.V273896.R01.S.doc Version 5.0 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. 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