Inspection on 30/10/06 for Sunnyside Nursing Home

This inspection was carried out on 30th October 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 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 26/10/08

Sunnyside Nursing Home 17/11/05

Sunnyside Nursing Home 22/11/04

Sunnyside Nursing Home 28/09/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Sunnyside Nursing Home 140 High Street Iver Buckinghamshire SL09QA Lead Inspector Christine Sidwell Unannounced Inspection 30th October 2006 10:00 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 DS0000019254.V309566.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. DS0000019254.V309566.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Sunnyside Nursing Home Address 140 High Street Iver Buckinghamshire SL09QA 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) 01753 653920 Mr Arshad Gamiet Mrs Mariam Gamiet Mrs Wendy Marsh Mrs Mariam Gamiet Care Home 32 Category(ies) of Dementia (0), Old age, not falling within any registration, with number other category (32) of places DS0000019254.V309566.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Elderly Physically Frail Elderly Mentally Infirm Date of last inspection 17th November 2005 Brief Description of the Service: Sunnyside Nursing home is a privately owned home registered to provide accommodation and 24hr nursing care for up to thirty-two elderly persons who may be physically or mentally frail. The home offers a respite care service when vacant beds are available. The home is a detached large Victorian style building with a modern extension to the rear of the property. It has pleasant gardens and there is car parking to the front. The home is situated close to the local amenities within the village of Iver. Available communal space consists of three lounge areas on the ground floor and another lounge on the first floor. There is also a small dining area on the ground floor. The home has nine double rooms, five single rooms and three triple rooms. There are plans in place for development of the home and to reduce the number of shared rooms to improve the environment. The fees range from £550 to £750 per week. Information about the home can be obtained by phoning or visiting the home. DS0000019254.V309566.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over a period of three days and included an unannounced one-day visit to the home. Prior to the visit all previous information about the home was reviewed. Comment cards were sent to residents and their families and to other professionals who have contact with the home. Ten family members and seven residents responded. The care of four residents was case tracked. Residents, family members, staff and the manager were spoken to on the day of the unannounced visit. The home’s approach to equality and diversity was observed. What the service does well: There is information available to residents and their needs are assessed before they move to the home to ensure that their needs can be met. Residents personal, healthcare and medication needs are met in a timely, confidential manner. Those spoken to said that they were happy in the home and those who returned the questionnaires said that they felt well cared for and staff treated them well Residents are helped to exercise control over their lives and activities are provided to bring variety to residents days. The meals are of a high standard, meeting residents nutritional needs. Residents said that they enjoyed their meals. The complaints and safeguarding policies and procedures work well and residents feel that their concerns would be addressed. Families were aware of the complaints procedures. There have been no concerns, complaints or allegations raised with the Commission for Social Care Inspection. There is a major rebuild and refurbishment plan underway to improve the environment and facilities for residents. New bedrooms and communal areas are to be built. T kitchen and bathrooms are to be refurbished and a lift is to be to be installed. The recruitment and training procedures work well ensuring the staff have the right attitude and training to meet the needs of frail, elderly residents. There is a good training programme and the home has received the Investors in People award. The management arrangements are good providing residents with a safe and continually improving care service. There is an experienced manager and the proprietors play full role in the management of the home. DS0000019254.V309566.R01.S.doc Version 5.2 Page 6 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. DS0000019254.V309566.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 DS0000019254.V309566.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6 Quality in this outcome area is good. This judgement was made using available evidence including and unannounced visit to the service. There is information available to residents and their needs are assessed before they move to the home to ensure that their needs can be met. EVIDENCE: There is a statement of purpose and service users guide, which has been updated in the last year and contains the information specified in the National Minimum Standards. The care of four residents was case tracked. The records showed that all residents had been visited at home or in hospital prior to their move to the home and an assessment of their needs had been undertaken. A family member visiting on the day of the unannounced visit to the home confirmed that the home had been thorough in assessing her relatives needs and that they had had the opportunity to visit and to meet the staff before their family member moved in. She said that she had visited a number of homes and had found the staff here the most helpful when it came to deciding whether the home could meet her relatives needs. One resident said that she had visited the home prior to moving and that she was happy here. The home does not offer intermediate care. DS0000019254.V309566.R01.S.doc Version 5.2 Page 9 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 and 10 Quality in this outcome area is good. This judgement was made using available evidence, including an unannounced visit to the service. Residents personal, healthcare and medication needs are met in a timely, confidential manner. EVIDENCE: The care of four residents was case tracked and their care plans were examined. The manager or the senior nurse completes the initial assessment for potential residents and from this a plan of care is developed. There was evidence in the care plan that following the first four weeks stay at the home a review is held and the care plan is discussed and reviewed. The care plans contained details of the residents preferred daily living routines individual likes and dislikes. There is evidence in care plans that residents are involved in drawing up the care plan and that they agreed with its contents. All care plans are stored in safe and secure areas and there is documentation to demonstrate that care plans are reviewed monthly. Residents were observed to have had assistance with their personal hygiene and to be wearing their own clothes. The residents spoken to said that carers were kind when assisting them with personal care. DS0000019254.V309566.R01.S.doc Version 5.2 Page 10 Residents are registered with a local GP Practice who visits the home weekly and as needed. Residents can register with their own GP if this is practical and agreeable to both parties. All have access to local NHS Services. Risk assessments are in place for pressure area care, prevention of falls, manual handling and smoking. Continence assessments had been undertaken. Tissue viability assessments are in place for each service user. Two residents had pressure damage at the time if the visit. They had been seen by the tissue viability nurse and the dietician, had a care plan and the appropriate interventions had been undertaken. There is a policy/statement regarding pressure area care that gives clinical guidelines for staff to follow. Risk assessments were seen for moving and handling needs, the use of bed rails, and nutritional status. A domiciliary optical service visits the home on a six monthly basis. Referrals for a hearing test go through the service users G.P. or the home can contact the King Edward Hospital directly. The home works closely with the dietician and nutritional risk assessments are in the care plans of service users. Residents are weighed monthly and action taken if weight changes are noted. A chiropodist visits the home on a six weekly basis. Dental services are accessed in the local village and they will visit service users in the home. There are no service users who are able to administer their own medication. Medication is kept in secure trolleys. There is a fridge in the clinical room for the storage of certain medicines and regular temperature records are kept for this. Photographs of service users, on medication charts, are used for identification. Qualified nurses administer all medications in the home. There is a medication policy in place. Records of all medication received and returned are kept and when the medicines are returned the pharmacist signs stamps the book to verify the return. The home uses controlled drugs, and the controlled drugs register was checked. This was completed with two signatures, was legible and up to date. All controlled drugs are stored in a metal cupboard, which complies with the Misuse of Drugs Regulations 1973.The home use oxygen cylinders and there is a separate policy and procedure for this. The manager is aware of the need to retain medication for a period of seven days after a service user has died. One residents spoken to say that she received her medication regularly. Residents receive care from staff and health care professionals in complete privacy. Adequate screening observed ensures complete privacy for the service users. Staff were observed during the inspection to knock on service users bedroom doors before entering. The homes statement of purpose includes information about maintaining the privacy of service user’s. Residents can have a key to their rooms if they wish. Preferred terms of address are recorded in residents care plans. Staff were observed to be speaking to residents with respect. DS0000019254.V309566.R01.S.doc Version 5.2 Page 11 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 and 15 Quality in this outcome area is good. This judgement was made using available evidence, including an unannounced visit to the service. Residents are helped to exercise control over their lives and activities are provided to bring variety to residents days. The meals are of a high standard, meeting residents nutritional needs. EVIDENCE: DS0000019254.V309566.R01.S.doc Version 5.2 Page 12 Care plans show routines of daily living and include bathing, rising and retiring times. Religious preferences are recorded in care plans and residents interests are recorded in the initial assessment. Examples given of social activities that take pace in the home are a monthly church service, music sessions and the hairdresser visits regularly. The seven residents who returned the comment cards said that they home provided suitable activities. Residents are able to receive visitors in the privacy of their own rooms and are able to choose whom they see and do not see. There are no restrictions on visiting, and this is documented in the residents guide. Involvement by local community groups includes the local church, scouts group, regular visits by the hairdressers and barbers and various visiting entertainers. Residents and/or their families are encouraged to look after their own financial affairs whenever possible. The home does not act as appointee for any residents. Residents are encouraged to personalise their rooms and many had chosen to do so. There is a four-week rotating menu. Residents are informed daily about the meal for the day. The chef said that an alternative would be offered if the resident did not like the days meal. Lunch on the day of the unannounced visit was casserole with two vegetables and potatoes followed by lemon meringue pie. An apple meringue pie was available for diabetic residents. The residents spoken to say that they enjoyed the meals. Of the residents who returned the comment cards all but one said that they enjoyed the food. DS0000019254.V309566.R01.S.doc Version 5.2 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 the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement was made using available evidence, including an unannounced visit to the service. The complaints and safeguarding policies and procedures work well and residents feel that their concerns would be addressed. EVIDENCE: There are complaints policies procedures in place. A record of complaints made was seen. Action plans were recorded following a complaint. Two residents were asked whether they felt that staff listened to them and both said that they would. Eight family members returned the comment cards and all were aware of the complaints procedure. There are protection of vulnerable people policies and procedures in place. The staff spoken to were aware of what constitutes abuse and were unhesitating in stating that they would report any concerns to the manager. The staff training records showed that most but not all staff had had training in the safeguarding of vulnerable adults. The manager said that there were plans for further training this year. The residents who returned the comment cards all said that they felt well cared for and that they liked living in the home. The Commission for Social Care Inspection has not been notified of any concerns, complaints or allegations of abuse. DS0000019254.V309566.R01.S.doc Version 5.2 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 the following standard(s): 19 and 26 Quality in this outcome area is adequate. This judgement was made using available evidence, including an unannounced visit to the service. There is a major rebuild and refurbishment plan underway to improve the environment and facilities for residents. EVIDENCE: A tour of the building was undertaken. The current accommodation is in need of substantial refurbishment and upgrading in some areas if it is to provide a comfortable and inviting place for residents to live. The proprietors have begun a major investment plan to build additional ensuite bedrooms, communal areas and replace the kitchens and some bath and shower rooms. The plan includes replacing the existing stair lift with a passenger lift. The rebuild has begun and there is a plan to minimise the impact on residents during the building works. When the new rooms are built residents will move to those and the existing rooms will be upgraded. The overall plan will result in an increase of eight residents to the home. It is expected that phase 1 of the rebuild and refurbishment will be completed by December 2006 and the entire programme be completed by October 2007. DS0000019254.V309566.R01.S.doc Version 5.2 Page 15 There are infection control policies in place and some but not all staff have had training in this topic. The laundry is small but contains washing machines capable of dealing with soiled linen and clothes. The laundry assistant was aware of the need to separate soiled clothing and had good systems n place to do this. Posters were displayed in the home emphasising the importance of hand washing. DS0000019254.V309566.R01.S.doc Version 5.2 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): 27, 28, 29 and 30 Quality in this outcome area is good. This judgement was made using available evidence, including an unannounced visit to the service. The recruitment and training procedures work well ensuring the staff have the right attitude and training to meet the needs of frail, elderly residents. EVIDENCE: There is a staff record. This showed that there are two qualified nurses on duty between 07:30 and 19:30 Monday to Friday and one qualified nurse on duty between these times at the weekend. They are supported by six or seven carers. There is one qualified nurse and two carers on duty at night. Four of the twenty- seven staff had left during the last year, a turnover rate of 14 . Eleven of the eighteen care staff hold the National Vocational Qualification in Care at Level 2 or above, 61 . This meets the standard that 50 of care staff hold this qualification. The recruitment files of the four last staff members to be appointed were seen. They all had completed application forms and interview records. Two references had been sought and Criminal Records Bureau (CRB) checks had been undertaken. There was evidence that staff had undertaken an induction programme. All had photographic evidence of identity. One work permit status was unclear and the manager agreed to verify this. There is a comprehensive training programme and the records showed that most staff, but not all, had had the mandatory training. Dementia Care training has also been offered. The training records are maintained on a tick box spreadsheet. The manager should date these records to show that the required annual updates are undertaken. DS0000019254.V309566.R01.S.doc Version 5.2 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): 31, 33, 35 and 38 Quality in this outcome area is good. This judgement was made using available evidence, including an unannounced visit to the service. The management arrangements are good providing residents with a safe and continually improving care service. EVIDENCE: The manager started at the home in April 2004 and holds the National Vocational Qualification in Management at Level 4. The staff spoken to said that she was approachable. There are clear lines of accountability in the home and the roles of the proprietors and manager are explicit. The manager undertakes a number of quality assurance audits, for example audits of the care plans and medication records. There is an intention to provide a monthly report for the provider although this does not happen every month. The responsible individual visits the home regularly. While the day to day care of residents is delegated to the home manager, another Director is permanently based at the home, attends on a daily basis and is fully involved in its DS0000019254.V309566.R01.S.doc Version 5.2 Page 18 management and operation. Records are now kept regarding those visits on a monthly basis, as was required at the last inspection. The requirements of previous inspections are now being met. The home has recently achieved the Investors in People award in recognition of the work they undertake to include staff in business planning and training to meet the needs of residents. There are three monthly resident and family meetings and questionnaires are distributed on a six or twelve monthly basis. The home does not act as appointee for any residents. Some residents wish to keep money in the home and this kept for safekeeping by the manager. Records were seen to verify that receipts are given and the monies checked were correct. There are health and safety policies and procedures in place. The maintenance records were up to date. The environmental health officer had last visited in January 2006 and her requirements had been implemented. There were records to show that fire training had been undertaken and that there was a recent fire drill. The staff spoken to were aware of the fire evacuation procedure. The proprietor was aware of the increased risk of fire during the building works and had taken steps to ensure that interim fire procedures were in place when necessary. Records of accidents and injuries are kept. DS0000019254.V309566.R01.S.doc Version 5.2 Page 19 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 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 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 2 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 3 X 3 X X 3 DS0000019254.V309566.R01.S.doc Version 5.2 Page 20 Are there any outstanding requirements from the last inspection? No 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. Standard Regulation Requirement Timescale for action 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 OP30 Good Practice Recommendations The training records should be updated and dated to ensure that all staff have the basic training and mandatory annual updates. DS0000019254.V309566.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection Burgner House 4630 Kingsgate Cascade Way Oxford Business Park South Cowley Oxford, OX4 2SU 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 DS0000019254.V309566.R01.S.doc Version 5.2 Page 22 - 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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