Inspection on 01/09/05 for Sunnyside Nursing Home

This inspection was carried out on 1st 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 but made no statutory requirements on the home.

Other inspections for this house

Sunnyside Nursing Home 27/08/08

Sunnyside Nursing Home 30/11/07

Sunnyside Nursing Home 15/05/07

Sunnyside Nursing Home 27/06/06

Sunnyside Nursing Home 17/01/06

Sunnyside Nursing Home 31/03/05

Sunnyside Nursing Home 08/11/04

Sunnyside Nursing Home 10/08/04

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

CARE HOMES FOR OLDER PEOPLE Sunnyside Nursing Home 6-8 Oxford Road Dewsbury West Yorkshire WF13 4LN Lead Inspector Tracey South Lynda Jones Unannounced 1 September 2005 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 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. Sunnyside Nursing Home 20050901 Sunnyside IR OP J51 v229058 s45066.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Sunnyside Nursing Home Address 6-8 Oxford Road Dewsbury West Yorkshire WF13 4LN 01924 462951 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Northfields Care Homes Ltd Care home with nursing 35 Category(ies) of 35 x Dementia (over 65 years) registration, with number of places Sunnyside Nursing Home 20050901 Sunnyside IR OP J51 v229058 s45066.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Conditions of this registration are listed on the registration certificate displayed at the service. Date of last inspection 31 March 2005 Brief Description of the Service: Sunnyside is owned by Northfield Care Homes Ltd and provides nursing and accommodation for up to 35 people with dementia related care needs.The home is situated on the outskirts of Dewsbury, within easy access to the town centre. The home consists of a large detached building made up of two Victorian semi detached houses and a modern extension. There are single and double bedrooms available. There are four lounges, a dining room and a sun lounge. There is a passenger lift, which serves the ground and first floor. There are attractive gardens to the front of the house and car parking facilities for visitors. Sunnyside Nursing Home 20050901 Sunnyside IR OP J51 v229058 s45066.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out over 7 hours by 2 inspectors. Not all of the requirements and recommendations made in the last report were followed up at this inspection. These will be checked on future visits. There were 23 residents living at the home on the day of the inspection. Four of those residents live in a separate unit within the home. The unit provides nursing care for up to 5 people with challenging behaviour and is staffed by 2 members of staff over a 24 hour period. A tour of the home was undertaken and a small number of bedrooms were seen. Care documentation and personnel files were examined. The acting manager and five members of staff were spoken to. What the service does well: What has improved since the last inspection? Thorough pre-admission assessments are carried out prior to prospective residents being admitted to the home. Information contained in the assessment is passed onto senior members of the team prior to the new resident moving in. Relatives are encouraged to complete personal history details about residents. The purpose of this is to inform staff of the likes, dislikes and preferences of the resident. The information provided by one relative gave a good account of the resident including their hobbies and interests. Care plans are showing signs of improvement and provide information about the needs of that person. Care plans are being reviewed regularly. Assessments are in place in respect of each resident and are kept under regular review. Sunnyside Nursing Home 20050901 Sunnyside IR OP J51 v229058 s45066.doc Version 1.40 Page 6 Staff personnel files are well organised and there was evidence that the necessary employment checks are carried out prior to new staff starting work at the home. There is a positive attitude towards staff training and a number of training courses have taken place within the last four months. Further training has been organised to take place during September 2005. Some improvements have been made to resident’s bedrooms. New carpets have been fitted to at least 4 bedrooms and new duvet covers, pillowcases and curtains were also seen in place. All bedrooms doors on the first floor have now been fitted with privacy locks. New carpets have been laid to the corridor areas of the ground floor accommodation. There is an acting manager in post creating stability for the staff team. Each member of the trained staff has an allocated area of responsibility. 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 Nursing Home 20050901 Sunnyside IR OP J51 v229058 s45066.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Sunnyside Nursing Home 20050901 Sunnyside IR OP J51 v229058 s45066.doc Version 1.40 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 standard(s) 3 Prospective residents are fully assessed before they move into the home. EVIDENCE: Management staff, including the registered owner, are responsible for carrying out pre-admission assessments prior to new residents moving into the home. The information contained in the assessment is then passed onto other members of the senior team. The assessments examined during this inspection contained detailed information about the resident, including their likes and dislikes. Despite this, the like and dislikes of one resident had not been transferred onto the care plan or any other care documentation. Staff must take care not to lose such important information once the pre-admission assessment has been completed and the resident has moved into the home. It was evident that the main issues detailed in the pre-admission assessments, form the basis of the initial care plan. Sunnyside Nursing Home 20050901 Sunnyside IR OP J51 v229058 s45066.doc Version 1.40 Page 9 One resident had recently been admitted in an emergency. It was encouraging to note that a pre-admission assessment had been completed and the resident had been visited by one of the trained staff before being admitted to the home later that day. Sunnyside Nursing Home 20050901 Sunnyside IR OP J51 v229058 s45066.doc Version 1.40 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 standard(s) 7,8, 10 A good start has been made in formulating care plans that provide detailed information about the needs of residents. Residents receive treatment and support from other health care professionals. EVIDENCE: All care plans have undergone a review due to requirements made in the last inspection report. Care plans examined during this inspection were found to be more detailed than on previous inspections and contained specific information about the resident. Care plans provide information to staff on how to look after each resident including the level of support they require. The needs of the residents are highlighted under such headings as, maintaining a safe environment, mobilising, personal care, eating and drinking, eliminating, sleeping, communication and behaviour. There is very little emphasis on the social care needs of residents and the acting manager needs to explore this further. It would useful to use the information provided by relatives, when addressing the social care needs of residents. Staff on the unit were able to demonstrate some knowledge of resident’s past hobbies and interests but there was little evidence of this in writing. Sunnyside Nursing Home 20050901 Sunnyside IR OP J51 v229058 s45066.doc Version 1.40 Page 11 Care staff and nursing staff are responsible for writing daily reports in respect of each resident. It was noted that there were gaps in entries made. There were days when no report had been written by the care staff in respect of the morning or afternoon shift. The manager needs to address this issue. A number of health care assessments are completed when a new resident is admitted to the home. These assessments are then kept under review. Not all case files provide up to date information relating to the nursing needs of individual residents. For example, one resident suffering from a pressure wound was provided with specialist equipment although it was not clear when. There was no information as to the progress of the pressure wound, although there was a Waterlow Assessment in place, which had been reviewed. This was discussed with the acting manager and it was agreed that the trained staff should implement a wound chart and record when the treatment of a pressure sore begins. The records should be maintained until the sore is healed. Fluid and turning charts are used to monitor those residents who are ill and nursed in bed. All staff involved in the care of these people must ensure that the charts are completed in full. It was noted whilst carrying out a tour of the home, that one chart had not been completed since the first entry made that day, despite the person needing turning every two hours. There was evidence in case files that residents receive visits from their GP and other health care professionals as required. All bedrooms on the first floor have now been fitted with privacy locks. The majority of bedroom doors are kept locked during the day to prevent residents walking into each other’s rooms. Screening is available in those bedrooms shared by two people. Staff were observed using the preferred term of address to residents. Written evidence of this was noted in the case files examined. Induction training includes the importance of treating people with people dignity and respect. Sunnyside Nursing Home 20050901 Sunnyside IR OP J51 v229058 s45066.doc Version 1.40 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 standard(s) None of these standards were assessed on this inspection. EVIDENCE: Sunnyside Nursing Home 20050901 Sunnyside IR OP J51 v229058 s45066.doc Version 1.40 Page 13 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 standard(s) None of these standards were assessed on this inspection. EVIDENCE: Sunnyside Nursing Home 20050901 Sunnyside IR OP J51 v229058 s45066.doc Version 1.40 Page 14 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 standard(s) 19,21,22,24,25,26 Progress has been made in trying to make bedrooms a homely environment for residents. Some work is required to complete the redecoration of the toilet facilities. EVIDENCE: The grounds to the home are pleasant and well maintained. The location of the lounges and dining room enable residents to look out onto the garden area at the front of the home. There are areas within the home that are in need of redecoration, in particular two toilets on the ground floor. This has been mentioned in previous inspection reports. One bathroom on the ground floor has been refurbished and is awaiting the installation of a hoist to assist residents. The hand towel dispenser in the bathroom containing the brown suite was on the floor and not fixed to the wall. The pull cords in at least two toilets on the ground floor, require replacing with new longer length cord. Sunnyside Nursing Home 20050901 Sunnyside IR OP J51 v229058 s45066.doc Version 1.40 Page 15 Specialist equipment such as hoists, handrails, wheelchairs, specialist mattresses and cushions were observed in place. Corridor areas are wide, allowing easy access for wheelchair users. There is a ramp to the entrance of the building. New carpets have been fitted to the corridor areas on the ground floor accommodation. The reception area is now more spacious due to the removal of the reception desk furniture. The unit used to care for those residents with challenging behaviour has 5 single bedrooms, a kitchen area, activities area, a large lounge and toilet and shower facilities. The unit is separated from the rest of the home and can be accessed through digital locked doors. The main part of the home has 3 lounges, a dining room, and a small sun lounge. Communal areas looked tidy, although a large television set with the screen facing toward the wall was noted in the end lounge. If the television is not being used it should be removed. There was also a portable television on the floor in the unit. Surplus items of equipment should be stored away appropriately if not in use. Bedrooms are located on both the ground and first floors. The lighting on the corridor outside room 28 was not working. This was pointed out to staff during the inspection. It was also noted that in room 10 there was no cover to the over sink light. New carpets, bedding and curtains were seen in the four bedrooms looked at. The matching linen and curtains brighten up the bedrooms. It was noted that in bedroom 12 the sink had pulled away from the wall. This needs attention. A strong odour was present in one bedroom. Personal possessions were observed in place in those bedrooms seen. Sunnyside Nursing Home 20050901 Sunnyside IR OP J51 v229058 s45066.doc Version 1.40 Page 16 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,29,30 Employment checks are being carried out prior to new staff starting work. The appointment of a training and development manager has brought about positive changes towards the development of staff through training. EVIDENCE: There are currently 23 residents living at the home and the staffing levels are: AM – 1 trained nurse and 4 care staff PM – 1 trained nurse and 3 care staff NIGHTS – 1 trained nurse and 2 care staff The separate challenging behaviour unit is staffed by 2 care staff 24 hours a day. The personnel files were checked in relation to 3 new employees. The necessary employment checks had been carried out prior to them starting work. There was one discrepancy regarding a reference but staff explained the circumstances behind this. The personnel files were found to be well organised and two of the three files examined had the necessary documentation in place. The staff responsible for recruiting new staff should ensure that all files contain the necessary documentation in accordance with the regulations. Induction records were examined, not all had been completed. Induction training should take place within the first six weeks of employment, which meets National Training Organisation (NTO) workforce training targets. It would be useful for the purpose of inspection that the start date of new employees is recorded each staff file. Sunnyside Nursing Home 20050901 Sunnyside IR OP J51 v229058 s45066.doc Version 1.40 Page 17 There is a positive attitude towards training and development. The appointment of a Training and Development Manager has brought about a review of policies and procedures within the home. Staff spoken to were positive about undertaking training in order to develop their skills further. One member of staff said she was looking forward to participating in the challenging behaviour training scheduled in September 2005. Two of the trained staff are currently undertaking a management course. Further training has been scheduled for September 2005 and includes Protection of Vulnerable Adults and fire training. Sunnyside Nursing Home 20050901 Sunnyside IR OP J51 v229058 s45066.doc Version 1.40 Page 18 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,33,38 Monthly checks are carried out to monitor the quality of the service provided. EVIDENCE: There is no registered manager in place at the home, although Mr Rod Turner has been appointed as the acting manager. An application to register Mr Turner should be submitted to the CSCI. Mr Turner has previous experience of working with older people with dementia related illnesses. The manager is supported by trained staff as well as the Quality Assurance Manager and Training and Development Manager. Regulation 26 visits take place on a regular basis and reports are submitted to the Commission. Management meetings take place on a regular basis involving all managers within Northfield Care Homes Ltd. Regular meetings have also taken place, within the organisation, in relation to the issues at Sunnyside arising from previous inspections and complaint’s investigations, the minutes of those meetings have been forwarded to the CSCI. Sunnyside Nursing Home 20050901 Sunnyside IR OP J51 v229058 s45066.doc Version 1.40 Page 19 Staff receive health and safety training and are made aware through assessments such as movement and handling and risk assessments of the correct procedures to follow. Fire training also takes place and 3 sessions are due to take place in September 2005. Fire activation points are checked on a weekly basis but there was no evidence of a recent fire drill. Fire drills must take place at least twice a year to include all staff. A fire drill must take place immediately. Accidents involving residents and staff are reported and recorded. The Commission is notified of incidents and accidents in accordance with the regulations. Sunnyside Nursing Home 20050901 Sunnyside IR OP J51 v229058 s45066.doc Version 1.40 Page 20 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 1 8 1 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 x COMPLAINTS AND PROTECTION 2 2 1 3 x 2 2 2 STAFFING Standard No Score 27 3 28 x 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x 2 x 3 x x x x 1 Sunnyside Nursing Home 20050901 Sunnyside IR OP J51 v229058 s45066.doc Version 1.40 Page 21 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 OP7 Regulation 15 Requirement Care plans should include the social care needs of residents. Daily reports should be written to include details of the morning, afternoon and night shift to evidence continuity of care. Daily reports should include how the resident has spent their day, including any social contacts made. Trained staff must ensure they record information as to the treatment they provide to residents. Wounds charts must be implemented when treatment of pressure sores begins. Progress must be monitored and recorded in writing. Fluid balance and turning charts must be completed in accordance with the residents assessed needs. The registered owner shall make arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the care home. Staff must sign for all medication they administer contemporaneously to avoid 20050901 Sunnyside IR OP J51 v229058 s45066.doc Timescale for action Immediate 1 September 2005 and thereafter. 2. OP8 12 Immediate 1 September 2005 and thereafter. 3. OP8 12 4. OP9 13 Immediate 1 September 2005 and thereafter Not assessed during this inspection. Sunnyside Nursing Home Version 1.40 Page 22 mistakes being made. 5. OP19 OP21 23 The redecoration of the two toilets on the ground floor accommodation must now take place. (Previous timescale not met). The sink in bedrom 12 must be repaired as a matter of urgency. A fire drill must take place immediately followed by at least two drills per year and must include all staff. 30 November 2005 15 September 2005 Immediate and at least twice yearly thereafter. 6. 7. OP21 OP38 23 23 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. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. Sunnyside Nursing Home Refer to Standard OP21 OP21 OP25 OP25 OP26 OP20 OP29 OP30 OP31 Good Practice Recommendations The hand towel dispenser in the bathroom containing the brown suite should be fixed to the wall. New pull cords should be replaced in the toilet areas. The lighting outside bedroom 28 needs attention to ensure it is in good working order. The over sink light in bedroom 10 requires a cover in place. Any unpleasant odours should be dealt with immediately, those areas identified as problem areas should be cleaned on a regular basis. Surplus items of equipment should be stored away appropriately and not kept in communal areas. For the purpose of inspection it would be useful if the start date of new staff is recorded on the persons staff file. Records to demonstrate that new staff have received induction training within the first six weeks of employment should be maintained in respect of all staff. The proposed manager should submit an application for registration to the CSCI. 20050901 Sunnyside IR OP J51 v229058 s45066.doc Version 1.40 Page 23 Commission for Social Care Inspection Park View House Woodvale Office Park Woodvale Road Brighouse HD6 4AB 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 Nursing Home 20050901 Sunnyside IR OP J51 v229058 s45066.doc Version 1.40 Page 24 - 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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