Inspection on 21/09/05 for Sunnyside

This inspection was carried out on 21st September 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 16 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Sunnyside 14/08/06

Sunnyside 17/12/05

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 21st September 2005 10:30 Sunnyside DS0000000262.V250268.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.V250268.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.V250268.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.V250268.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st October 2004 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. Service users are currently supported by the manager deputy and one member of staff. 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.V250268.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection process involved spending time talking to all of the people who live in the home as well as the owner and staff. 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 staff and owner offered to service users at lunchtime 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? A Statement of Purpose and Service User Guide have been developed which tells present and perspective service users of the service they can expect at the home. A record of the meals provided for service users is now kept and the deputy manager has began to develop care plans for service users. Sunnyside DS0000000262.V250268.R01.S.doc Version 5.0 Page 6 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.V250268.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.V250268.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 and 2 A range of information is available about the home, however service users are not empowered to make an informed decision about where they live. Assessment information from social workers which tells the home of the service user’s needs and how these are to be met, is poor making it difficult to ensure that the needs of service users are met. EVIDENCE: The manager and deputy have redesigned the homes’ Statement of Purpose and Service User Guide to ensure that they contain sufficient information to outline the services that are provided at the home. However the manager does not have ongoing contact with service commissioners, service users have not had annual social work contact or access to advocacy support to assist them to make choices about where and how they live. Social work assessment information is held on service users files. However this has not been reviewed for over five years and does not identify service users’ current areas of need. Sunnyside DS0000000262.V250268.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 and 9 The measures staff take to support the health and personal care needs of service users is not fully recorded in the individual plan of care therefore making it difficult for staff to consistently meet their needs. EVIDENCE: Whilst the manager and deputy have worked to improve the standard of care planning at the home using a lifestyles mapping approach, service users’ records which were examined indicated that service user plans do not yet adequately describe the actual support and intervention which is currently carried out. The manager and deputy know service users well and demonstrated that they have 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. Service users are supported by staff to take appropriate risks for example to promote their independence and some of these are now recorded in service users files. Sunnyside DS0000000262.V250268.R01.S.doc Version 5.0 Page 10 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 and 15 Service users are provided with a range of activities within the home and in the local community so that they can lead valued active fulfilled lives. Service users are supported to keep in contact with their relatives and friends and are able to spend time together outside of the home. EVIDENCE: When they are at home service users tend to live on the first floor of the home in and around their own rooms. All service users have 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. One service user who returned home after attending day services indicated that he had enjoyed the days activities. Service users have also had a caravan holiday this year where they enjoyed shopping and walking in the North West of England. 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. Sunnyside DS0000000262.V250268.R01.S.doc Version 5.0 Page 11 The owner 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’. Sunnyside DS0000000262.V250268.R01.S.doc Version 5.0 Page 12 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 generally ensure that service users health care needs are addressed. However, some improvement needs to be made in this area. EVIDENCE: 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. However where externally provided day services are used, the facility for diabetes monitoring and treatment is not in place. 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. 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. However records are not available which indicate the numbers of medication which has been prescribed and entered the home. This makes it difficult to carry out an accurate audit of medication held. Sunnyside DS0000000262.V250268.R01.S.doc Version 5.0 Page 13 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 to offer comment on the services that are offered. However the timescales in which the owner must respond is not clear so service users or their families may not know how soon they will have a response. The 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 although the timescales for a response by the manager is not currently stated. Observations of the manager and deputy’s day to day practices indicated that they routinely ensure that service users views are ascertained and 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. All staff have not yet undertaken training which would enable them to recognise and respond should they suspect or witness abuse. Sunnyside DS0000000262.V250268.R01.S.doc Version 5.0 Page 14 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. But 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. All communal areas and all service users bedrooms were viewed during the inspection. Some of the communal areas have been redecorated and refurbished since the last inspection and a programme of routine maintenance and replacement is in operation. A new kitchen has also been installed. All areas in the home were clean and pleasant with décor and furnishings reflecting the tastes of service users and the manager. Service users indicated that they liked their rooms, some of which have been individually decorated to reflect their 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 prefer to use their own rooms to pursue daytime activities e.g. drawing or Sunnyside DS0000000262.V250268.R01.S.doc Version 5.0 Page 15 watching television and therefore spend most of the time on the first floor. The manager is therefore considering making an additional extra seating area to give service users more choice. There is a spacious bathroom on the first floor which can be accessed independently by service users. However water temperatures from the bath were above 43°C which could cause injury to service users. Sunnyside DS0000000262.V250268.R01.S.doc Version 5.0 Page 16 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 and qualified staff. However there are insufficient staff employed at the home to ensure that service users needs can be consistently met. EVIDENCE: All staff and the manager have achieved a minimum of an NVQ level 2 qualification. Records indicate that staff and the manager have also undertaken for example, Fire Protection Training, Food Hygiene, Person Centred Planning and Managing Challenging Behaviour courses. The staff team consists of three people including the manager who are available at the home to support service users care needs, 24 hours per day for seven days each week. In practice this means that staff and the manager work excessively usually alone, and without satisfactory arrangements being available to cover staff emergency sickness or holiday leave. Sunnyside DS0000000262.V250268.R01.S.doc Version 5.0 Page 17 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 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 skills. EVIDENCE: The owner 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 home has appropriate insurance cover in place and the manager has forwarded copies of accounts information which demonstrates that the home is currently operationally viable. Records are not presently available which indicate that training has been undertaken regarding the actions staff must take in the event of a fire at the home. Sunnyside DS0000000262.V250268.R01.S.doc Version 5.0 Page 18 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 2 1 X X X Standard No 22 23 Score 3 1 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 X 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 X 17 Standard No 31 32 33 34 35 36 Score X 3 1 X X X CONDUCT AND MANAGEMENT OF THE HOME X 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 2 3 DS0000000262.V250268.R01.S.doc Version 5.0 Page 19 Yes Are there any outstanding requirements from the last inspection? 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 YA1 Regulation 12 Requirement The manager must ensure that service users are enabled and supported to make an informed decision about where they live The manager must ensure that all service users have an up to date, detailed assessment of their current needs which has been carried out by persons who are suitably qualifies or suitably trained to do so. The manager must ensure that all service users have an up to date, detailed assessment of their current needs which has been carried out by persons who are suitably qualifies or suitably trained to do so. 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. Where service users are taking risks for example to promote DS0000000262.V250268.R01.S.doc Timescale for action 01/01/06 2 YA2 14 11/12/05 3 YA6 14 11/12/05 4 YA7 15 11/02/06 5 YA7 15 11/02/06 6 YA9 13 11/02/06 Sunnyside Version 5.0 Page 20 7 YA20 13 8 YA20 13 9 YA22 22 10 YA23 9 11 YA23 18 12 YA25 16 13 14 YA27 YA33 13 18 15 YA37 9 their independence these must be agreed with key stakeholders and recorded in service users records. The owner must ensure that clear procedures are in place which detail the action to be taken to support the diabetes needs of one service user. And that these are agreed with externally provided day services. The owner must ensure that accurate records of all medication prescribed, held and handled by the home are maintained. The manager must ensure that the complaints procedure has a timescale of 28 days in which action is taken. The manager must ensure that records accurately reflect the levels of medication entering, held and administered at the home. The manager must ensure that procedures for responding to suspicion or evidence of abuse or neglect are in place which meets with current guidance The manager must assess the risk of providing sufficient furniture in service users’ bedrooms The manager must ensure that bath water is delivered at a safe working temperature. The manager must ensure that sufficient, suitably qualified and experienced staff are working at the home as are appropriate for the needs of service users. 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. DS0000000262.V250268.R01.S.doc 11/11/05 11/11/05 11/11/05 11/10/05 11/11/05 11/12/05 11/11/05 01/01/06 11/12/05 Sunnyside Version 5.0 Page 21 16 YA42 23 Records must be kept of fire protection training undertaken by staff. 11/11/05 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.V250268.R01.S.doc Version 5.0 Page 22 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.V250268.R01.S.doc Version 5.0 Page 23 - 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!