Inspection on 17/01/06 for Sunnyside Nursing Home

This inspection was carried out on 17th January 2006.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

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 01/09/05

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 Unannounced Inspection 17th January 2006 09:30 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 DS0000045066.V254475.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Sunnyside Nursing Home DS0000045066.V254475.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Sunnyside Nursing Home Address 6-8 Oxford Road Dewsbury West Yorkshire WF13 4LN 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) 01924 462951 Northfields Care Homes Ltd Care Home 35 Category(ies) of Dementia - over 65 years of age (35) registration, with number of places Sunnyside Nursing Home DS0000045066.V254475.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Can accommodate one named service user under 65 years of age category DE. Can accommodate one named service user aged under 65 years of age category DE MD PD. One named person aged under 65 years (DE) Date of last inspection 1st September 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 DS0000045066.V254475.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out over 6½ hours. There were 31 residents living at the home on the day of the inspection. The manager, 4 staff and 2 relatives were spoken to during the inspection. Care documentation such as care plans, health assessments and medication records were examined. This is the second statutory inspection to take place at the home. An additional visit took place on 6th December 2005. The purpose of the visit was to follow up on the requirements made in the last inspection carried out on 1st September 2005. What the service does well: What has improved since the last inspection? Good progress has been made with care plans. Further improvements are still required to ensure the person’s social care needs are included. Wound charts are now being implemented for those residents receiving treatment for pressure sores. More emphasis is being made on the need to engage residents in more meaningful and stimulating activities. Regular outings to the local pub and shops are now taking place. Recruitment procedures appear more thorough. The necessary employment checks are carried out prior to new people starting work at the home. New employees receive adult protection training as part of their induction. Sunnyside Nursing Home DS0000045066.V254475.R01.S.doc Version 5.1 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 Nursing Home DS0000045066.V254475.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Sunnyside Nursing Home DS0000045066.V254475.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 The home undertakes pre-admission assessments to ensure that the needs of the prospective resident can be met. EVIDENCE: The home continues to carry out pre-admission assessments prior to new residents being admitted to the home. The purpose of the assessment is to ensure that the home is able to meet the needs of that person. The home has a contract with Leeds City Council whereby a number of beds are allocated for the council’s sole purpose. The management staff at Sunnyside explained how they are expected to admit new residents within 24 hours of their decision to take the person. With such short timescales as this, it is difficult for the home to ensure planned admissions take place. Two new residents were admitted on the day of the inspection, not all care staff were aware of the admission until that morning. One resident follows a Kosher diet and although the manager explained his needs would be catered for, no preparation for this had been made prior to his admission. Sunnyside Nursing Home DS0000045066.V254475.R01.S.doc Version 5.1 Page 9 The home must find a way to ensure that planned admissions do take place in the interests of the new resident and the staff who are expected to meet the needs of that person. Sunnyside Nursing Home DS0000045066.V254475.R01.S.doc Version 5.1 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 Progress continues to be made in ensuring that care plans contain detailed information about the resident’s needs. Not all staff are following the home’s medication procedures and errors are being made. EVIDENCE: Care plans continue to be developed in accordance with requirements and recommendations made in previous inspection reports. The staff must ensure that reviews and amendments to the care plan are signed and dated upon completion. The social care needs of the resident must be included in the person’s care plan. Such information can be found in the community care assessment as well as the personal history profile completed by relatives. Care staff must ensure that when writing up the daily report they include details of any diversion techniques used when dealing with residents who display challenging behaviour. Those daily reports examined, provided details of outbursts of aggression but not how the care staff had dealt with them. Providing a detailed account of the techniques used will assist other care staff in dealing with challenging behaviour. This will be of benefit to the resident and staff involved. Sunnyside Nursing Home DS0000045066.V254475.R01.S.doc Version 5.1 Page 11 A requirement was made in the last report about the need to implement wound charts when treating people with pressure sores. One case file provided evidence that this has been addressed. Another case file contained a wound chart that had not been signed or dated and neither did it include any information of the treatment or current status of the wound. The nursing staff need to be more consistent with their approach in maintaining such documentation. The nursing staff are reminded to record the outcome, that is, when the pressure wound has healed. A number of health care assessments are completed when a new resident is admitted to the home. Whilst it is unrealistic to expect all assessments to be completed immediately, as the staff require time to get to know the person, it is expected that risk assessments are put into effect immediately. For example one resident moved into the home on 13.1.06 and the Community Care Assessment dated 28.12.05 recorded that the gentleman was at risk from falling, due to him trying to walk unaided. The resident was reported as falling twice within 24 hours of admission yet the falls risk assessment was not completed until 17.1.06. This must be addressed with the nursing staff responsible for implementing such documentation. This is not the first time this issue has been raised with the home. During the visit to the home on 6th December 2005 it was noted that medication records were not fully complete. Some staff had not signed for medication they had given to residents. Not all medication had been booked in upon receipt. Similar problems were noted during this visit. The manager must implement an auditing system to ensure all staff sign for medication as it is given and that all stocks kept in the home can be reconciled with the records kept. Sunnyside Nursing Home DS0000045066.V254475.R01.S.doc Version 5.1 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 Relatives and friends are able to visit the home at any reasonable time. Residents are able to bring their personal possessions with them when they move into the home. Residents receive a well balanced diet. EVIDENCE: Two staff are currently undertaking “Activities for People with Dementia” training. Activities are now being provided on a more structured basis. Staff explained how outings to the local pub and shops take place. Due to the complex needs of residents at Sunnyside, such outings take place on a one to one basis. Relatives are able to visit the home at any reasonable time. Evidence that relatives do visit the home at various times during the day was seen whilst examining the visitor’s book. Residents are able to bring their own personal possessions with them at the time they move into the home. Evidence of this has been seen on previous inspections. Residents receive a well balanced diet. A good choice of meals are available at both lunch and tea-time. The meal being served on the day of the inspection Sunnyside Nursing Home DS0000045066.V254475.R01.S.doc Version 5.1 Page 13 was turkey or sausage, potatoes, onion rings and mixed vegetables, with Semolina for dessert. Diabetic diets are catered for. Sunnyside Nursing Home DS0000045066.V254475.R01.S.doc Version 5.1 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 The home as a clear complaints procedure in place. Staff are trained to deal with adult protection issues. EVIDENCE: The complaints procedure is clearly displayed in the home. Leaflets are available in the foyer, advising people how they are able to make a complaint and how and when their complaint will be dealt with. The home has received 2 complaints since the last inspection in September 2005. Both complaints had been dealt with appropriately. All new staff receive adult protection training as part of their induction. The manager explained how the majority of existing staff have also undertaken adult protection training. All new staff are checked against the Protection of Vulnerable Adults register before they start work at the home. Sunnyside Nursing Home DS0000045066.V254475.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of these standards were assessed on this occasion. EVIDENCE: Outstanding requirements and recommendations have been brought forward from the previous inspection report. Sunnyside Nursing Home DS0000045066.V254475.R01.S.doc Version 5.1 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 29 Good progress has been made in ensuring that thorough recruitment procedures are undertaken when employing new staff. EVIDENCE: There was evidence in place to confirm that recruitment procedures are more robust than previously indicated in earlier inspections carried out in 2005. All new staff must undergo a face-to-face interview, if successful, employment checks are carried out in accordance with the person’s application form. This includes obtaining 2 written satisfactory references as well as a satisfactory CRB (Criminal Records Bureau) disclosure. Sunnyside Nursing Home DS0000045066.V254475.R01.S.doc Version 5.1 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 35 Resident’s financial interests are safeguarded. EVIDENCE: The manager explained that there is no one currently living at the home that has the capacity to deal with his or her own financial affairs. Small amounts of monies are held on behalf of some residents. Those monies are held securely and records are maintained of all transactions made. Receipts are kept for any money spent. Two resident’s monies were checked, one was correct, a small discrepancy was found relating to the second amount. The manager was asked to look into this. Sunnyside Nursing Home DS0000045066.V254475.R01.S.doc Version 5.1 Page 18 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 x x 2 x x N/a HEALTH AND PERSONAL CARE Standard No Score 7 1 8 1 9 1 10 X 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 X X X X X X X 2 STAFFING Standard No Score 27 X 28 X 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X 2 X X X Sunnyside Nursing Home DS0000045066.V254475.R01.S.doc Version 5.1 Page 19 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 OP7 Regulation 15 Requirement Care plans must 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. (brought forward from last inspection report dated 1st September 2005) Amendments and reviews to the care plans must be signed and dated upon completion. 2. OP9 13 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 mistakes being made. (brought forward from last inspection report dated 1st September 2005). Timescale DS0000045066.V254475.R01.S.doc Timescale for action 17/02/06 06/12/05 Sunnyside Nursing Home Version 5.1 Page 20 of 6.12.05 not met. 3. OP19 23 The toilet/shower room in the challenging behaviour unit requires repainting. New flooring is required in the toilets near to bedrooms 12 and 14. (brought forward from last inspection report dated 1st September 2005). Timescale of 17.1.06 not met. 4. OP8 12 Wound charts must be 17/02/06 implemented when treatment of a pressure wound commences. Records should include when the wound has healed. Nursing staff must sign and date the documentation. Health care assessments must 17/02/06 be completed in respect of all new admissions. When residents are seen as being “at risk” the appropriate risk assessment must be completed immediately. An auditing system needs to be 17/02/06 introduced to ensure all medication stocks can be easily reconciled with the records kept. 17/03/06 5 OP8 12 6 OP9 13 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. Refer to Standard OP26 Good Practice Recommendations Any unpleasant odours should be dealt with immediately, in the appropriate manner. (brought forward from last inspection report dated 1st September 2005). Staff should record any techniques they use when dealing DS0000045066.V254475.R01.S.doc Version 5.1 Page 21 2. OP7 Sunnyside Nursing Home 3 4 OP3 OP35 with people with challenging behaviour. The manager should ensure that planned admissions take place even when dealing with such short timescales as imposed by particular local authorities. Resident’s monies should be correct at all times. Any discrepancies should be dealt with immediately. Sunnyside Nursing Home DS0000045066.V254475.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Brighouse Area Office 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 DS0000045066.V254475.R01.S.doc Version 5.1 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. 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