Inspection on 14/03/07 for Sunnyside Nursing Home

This inspection was carried out on 14th March 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Sunnyside Nursing Home 13/03/09

Similar services:

Snydale Care Home

Abbey The

Larchfield Manor

Hawkhills

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

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

CARE HOMES FOR OLDER PEOPLE Sunnyside Nursing Home 41 Marshall Terrace Leeds Yorkshire LS15 8EA Lead Inspector Catherine Paling Key Unannounced Inspection 14th March 2007 09:15 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Sunnyside Nursing Home DS0000067965.V327984.R01.S.doc Version 5.2 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. Sunnyside Nursing Home DS0000067965.V327984.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Sunnyside Nursing Home Address 41 Marshall Terrace Leeds Yorkshire LS15 8EA 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) 0113 260286 Bluebell Care Services Ltd Mrs Pauline Margaret Breslin Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (19), Terminally ill over 65 years of age (1) of places Sunnyside Nursing Home DS0000067965.V327984.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection New Service Brief Description of the Service: Sunnyside has been registered as a care home since 1988. The current owner, Bluebell Care Services Ltd became the registered provider in August 2006. Personal care with nursing is provided at the home with fifteen places for longterm care and five places for intermediate care. The intermediate care residents are supported by the community intermediate care team and normally are able to return to their own homes. Permanent accommodation is provided in both single and shared rooms. There are paved sitting areas in an attractive garden for the residents use. The home is well placed to access the busy local amenities in the Crossgates area of Leeds. There is car parking available for visitors to the home. Information about the service is provided for prospective residents and their families in the form of a statement of purpose and service user guide. The current charges range from £505 to £570 per week with additional charges made for chiropody, physiotherapy and hairdressing. This information was provided as part of the pre-inspection questionnaire in February 2007. Sunnyside Nursing Home DS0000067965.V327984.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. In April 2006 the Commission for Social Care Inspection (CSCI) made some changes to the way care services are inspected. They are now judged against outcome groups. The inspection report is divided into separate sections for each outcome group for example, Choice of Home. An overall judgement is made for each outcome group based on the findings of the inspection. The judgements reflect how well the service delivers outcomes to the people using the service. The judgements categories are “excellent”, “good”, “adequate”, and “poor”. The judgements are recorded within the main body of this report. More detailed information about these changes are available on our website – www.csci.org.uk Information about the home is gathered from a variety of sources, one being a site visit. Additional site visits may be made that will concentrate on specific areas such as health care or nutrition called random inspections. One inspector carried out this unannounced inspection on 14th March 2007 and was at the home from 09.15 until 17.15. The purpose of this inspection was to assess all the key standards (the key standards are identified in the main body of the report) and to assess how the needs of people living in the home are being met. The methods used at the inspection included looking at care records, talking to residents and visitors, observing care practices, talking to staff and management, looking at the environment and looking at other paperwork including staff records. The home provided some information to the CSCI in advance of the inspection. Comment cards were left at the home for residents and their relatives. Survey cards were sent out in advance of the visit to General practitioners and other visiting healthcare professionals. A number were returned and overall gave a positive view of the service provided. What the service does well: The home provides a small, homely and welcoming environment for the residents, their family and friends. Residents are able to have visitors at the home at any time and several are able to go out with family or friends. Staff are friendly and respectful and are provided with clear leadership and guidance from the experienced manager. Sunnyside Nursing Home DS0000067965.V327984.R01.S.doc Version 5.2 Page 6 There is an effective intermediate care service provided at the home and most of the people who receive this manage to return home. Care is taken to make sure that detailed information about the residents is provided in individual care plans. The manager makes sure that healthcare needs are met appropriately. Residents said that they felt well looked after and could choose how they like to spend their day. All of the residents spoken to said they are treated with respect and that staff are always there to listen if they have any concerns or worries. Most residents were happy with the meals served at the home although some were unaware of the choice available. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Sunnyside Nursing Home DS0000067965.V327984.R01.S.doc Version 5.2 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 Sunnyside Nursing Home DS0000067965.V327984.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is enough information available to allow prospective residents to decide if they want to live at the home. Residents moving into the home either for intermediate care or permanently can be assured that their needs can be met. EVIDENCE: Information is provided for current and prospective residents in a Statement of Purpose and Residents’ Guide. Additional information is provided for intermediate care clients who may be admitted to the home for recuperation or rehabilitation. All permanent residents have their care needs fully assessed by the manager before they are admitted to the home. The pre-admission information is Sunnyside Nursing Home DS0000067965.V327984.R01.S.doc Version 5.2 Page 9 sufficiently detailed to enable the manager to decide whether care needs can be met at the home. Those residents admitted for intermediate care do not always have their needs assessed by the manager before admission. In these situations the manager has to rely on the information provided by other healthcare professionals involved in care. The intermediate care consultant sees people in hospital and passes as much information about the person to the home’s manager. Social work assessments and information from other interested parties all form part of the pre admission information. The manager will not agree an admission unless she is sure that care needs can be met. The intermediate care team (ICT) visit their residents almost every day and progress is discussed at a regular weekly meeting. The consultant responsible for the care of these clients also visits the home each week. A good proportion of residents coming to the home for intermediate care do return to their own home. Sunnyside Nursing Home DS0000067965.V327984.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff are aware of residents’ needs making sure these are met. Residents are treated with respect and their privacy and dignity maintained at all times. EVIDENCE: Individual care records are in place for the permanent residents. Each resident has a ‘pen picture’ providing very detailed information about the individual, their current condition, and their care needs. The specific care plans are person centred and have detailed instructions for care staff on what interventions are needed to support the residents in their daily lives. Care plans are very detailed but where there have been changes it was not always easy to access the current information. For example, some plans were three years old and with the inevitable additions and updates some of the current information was not easy to identify. Sunnyside Nursing Home DS0000067965.V327984.R01.S.doc Version 5.2 Page 11 Review of the care plans was not always being done monthly and the daily monitoring sheet in place for each care plan was not always being completed daily. The recording system does provide the opportunity for good comprehensive information about each resident but could do with reviewing and refining so that the most relevant information is accessible and regularly reviewed. The manager agreed that she needs to make sure that all the staff understand the agreed frequency of recording on the monitoring sheet and of the full review of the care plan. Social care plans were seen but these also needed to be regularly reviewed and kept up to date. One social plan referred to a resident’s religious needs but it was not clear whether arrangements were in place for them to receive communion. In addition there was one reference to a bereavement, over a year ago, without any indication of how the resident had coped and what support they may have needed. There was a range of risk assessments carried out for residents that were regularly reviewed. Where risk had been identified there was information on how the risk was being managed. This had not always been updated. For example, one resident had needed nutritional supplements initially. This plan had not been updated to reflect that these were no longer necessary. Records were seen of general practitioner visits as well as from other healthcare professionals. The records for the ICT clients are different and contain instructions and other information from the ICT staff who visit the home most days to support these clients. The consultant who is part of the intermediate care team visits the home regularly to see the ICT clients. He also provides a valuable resource for the manager for the permanent residents at the home. There were some gaps in recording on the medication administration record (MAR) without any explanation for the omissions. Drug update was provided for some staff via the local Primary Care Trust (PCT) in 2006. The manager is currently trying to arrange further update. The manager was given contact details to get a copy of the Royal Pharmaceutical Guidelines for the Administration of Medicines in Care Homes. These guidelines provide detailed advice and guidance for all aspects of the management of medication within care homes. Staff were seen to treat the residents with respect. The residents’ dignity and privacy was maintained at all times and staff were seen knocking on bedroom doors before entering. Sunnyside Nursing Home DS0000067965.V327984.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are encouraged to be part of the decision making process and make choices about their lifestyle. They are supported to maintain contact with family and friends and visitors are welcomed at the home. A good, varied and nutritious diet is provided to residents. EVIDENCE: Visitors are welcomed at the home at any time and several visited during the day of the visit. One visitor who is at the home every day said that they ‘couldn’t praise it high enough’. Several residents go out with family and friends, making use of the nearby shops and other amenities. A diary is kept of some of the social events but these records need to be developed to give a more accurate reflection of what individuals like to do with their time. There are social care plans in records but review of these was not up to date. Many of the residents and staff take part in an annual charity walk and residents decide where they will donate the money they raise. There are also outings and entertainers for residents to enjoy. On the day of the visit Sunnyside Nursing Home DS0000067965.V327984.R01.S.doc Version 5.2 Page 13 residents were taken through a range of armchair exercises by a physiotherapist. The manager has been working at developing links with the local community via Crossgates Good Neighbours. Although there is enthusiasm about this there has been a problem with a suitable venue. Residents are supported to make choices in their daily lives. One resident said ‘they look after us very well’; ‘every little wish and want’. Residents were satisfied with care although some said that they sometimes had to wait to be taken to the toilet. The spouse of one resident said that they had wanted somewhere small and homely and easy to visit and that Sunnyside ‘ticked all the boxes’. There is a four week menu rota. There was no choice on the menu and comments received indicated that alternatives were not always available. Other comments were that the food is ‘first class’. The location of the kitchen means that the residents can smell the meal cooking which was appetising. Residents were seen to be enjoying their meals. The food was well presented and looked appetising. Sunnyside Nursing Home DS0000067965.V327984.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and their relatives are confidant that their views will be listened to and action taken if necessary. Residents are protected from abuse and their rights are respected at all times. EVIDENCE: There is a clear and robust complaints procedure in place. A copy of this is displayed in the entrance area. It was suggested that it should be re-produced in larger print to make sure that the information is accessible to those who may need it. No complaints have been received at the home since the current provider was registered in August 2006. There is an adult protection procedure in place. Information should be added to make sure that staff know who to contact for advice, should it be necessary. The whistle blowing procedure also needed to be more detailed. Adult protection training is included in the annual training programme. The manager has received training with the local authority adult protection unit. Sunnyside Nursing Home DS0000067965.V327984.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a safe and well maintained environment. EVIDENCE: The home is decorated and furnished to a good standard. The provider also has arrangements in place for ongoing maintenance. There is a paved area that is accessible for residents with raised flowerbeds. There are enough toilets and assisted bathing facilities for the residents in spacious communal sanitary facilities. There are good standards of infection control. A recent outbreak was very well managed by the staff at the home with the support of the infection control nurse and public health staff. Residents’ bedrooms are well furnished and there was plenty of evidence of people having their own possessions around them. Residents are able to lock Sunnyside Nursing Home DS0000067965.V327984.R01.S.doc Version 5.2 Page 16 their doors but staff can access the room in case of an emergency. A lockable cupboard is provided in each room for residents to store any valuables. As part of a longer-term plan for the development of the service the staff facilities have been converted into a single room and one of the shared rooms is now for single occupancy. The laundry is well equipped and there is seven day staff cover. It was clean and well organised. Sunnyside Nursing Home DS0000067965.V327984.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are supported and protected by the recruitment procedures in place. Staffing numbers and skill mix make sure that the residents’ needs can be met. EVIDENCE: The duty rotas show that there are enough staff on duty to meet the needs of the residents. The hours worked by the manager were not indicated and should be included on the rota. The nurses and the care staff are supported by a team of ancillary staff including domestics, laundry staff and a full time chef. The majority of the care staff who work on the day shift have achieved a National Vocational Qualification (NVQ) in care at level 2. The manager said that two of the night carers had also expressed an interest in doing NVQs. There is a training plan in place for 2007. It includes details of induction training and statutory training. Additional training is also being made available for staff in such topics as nutrition, dementia and continence management to make sure that staff have the skills and knowledge to meet the needs of the residents. Sunnyside Nursing Home DS0000067965.V327984.R01.S.doc Version 5.2 Page 18 Trained staff were being provided with the support and opportunity to maintain their skills and professional competence to practice. Individual staff files were looked at for recently employed staff and overall satisfactory recruitment practices are followed with the required checks in place. There were no photographs in the files and no copy of a contract in one of the files. The references provided by a recently employed nurse were both colleagues rather than previous employers. Sunnyside Nursing Home DS0000067965.V327984.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed, the interests of the residents are seen as very important to the manager and staff and are safeguarded at all times. EVIDENCE: The manager is an experienced RGN who has managed the home for a number of years giving continuity and stability at the home. She has an NVQ at level 4 in management and provides clear direction and leadership to staff. She is a good communicator and is a very visible presence at the home to residents and visitors. As part of the quality assurance monitoring systems the manager is introducing the ‘Essence of Care Programme’ at the home. This is joint work Sunnyside Nursing Home DS0000067965.V327984.R01.S.doc Version 5.2 Page 20 with the community matron who is looking at specific areas of work with care homes for example, providing training and ways of admission to hospital for the residents. The current area under scrutiny at the home is nutrition. The monitoring of the service is then linked to the training plan. There is also an annual survey of users’ views that will be carried out in July and August of each year. The provider visits the home very regularly. The home’s records of the formal visits as required under Regulation 26 indicate that these reports are not always being carried out monthly. The home manages some small amounts of residents’ personal allowances. Clear records are kept. It was recommended that two signatures be recorded for all transactions. The manager has established formal communication systems with staff and relatives and notes are kept of these meetings. A meeting was held in December to review some difficulties with communication regarding ICT clients. A system of regular meetings was to be established. Records are kept of any accidents to residents. Sunnyside Nursing Home DS0000067965.V327984.R01.S.doc Version 5.2 Page 21 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 X 3 HEALTH AND PERSONAL CARE Standard No Score 7 2 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 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X X X X 3 Sunnyside Nursing Home DS0000067965.V327984.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? N/A 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 OP33 Regulation 26 Requirement A report of the monthly visit to the home must be made so that the CSCI can be sure that the services and facilities at the home are being monitored. The reports must be sent to the CSCI. Timescale for action 04/06/07 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 Refer to Standard OP7 OP15 OP18 Good Practice Recommendations The manager should make sure that information within care records is relevant and easily accessible. The manager should make sure that residents are aware of alternatives at mealtimes. The adult protection procedure should be more detailed to include clear guidance and contact numbers for staff. The whistle blowing procedure should also have detail of who to contact. The CSCI should be informed of any alterations to the DS0000067965.V327984.R01.S.doc Version 5.2 Page 23 4 OP19 Sunnyside Nursing Home accommodation, even when the registration is not affected, to be sure that the environment continues to meet the regulations. Sunnyside Nursing Home DS0000067965.V327984.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Aire House Town Street Rodley Leeds LS13 1HP National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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. 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