Inspection on 12/01/06 for Sunnyside Residential Home

This inspection was carried out on 12th January 2006.

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 Residential Home 31/07/07

Sunnyside Residential Home 15/06/06

Sunnyside Residential Home 10/03/06

Sunnyside Residential Home 28/02/05

Sunnyside Residential Home 02/09/04

Similar services:

Chirnside House

Sunny Bank (P.R.S.) Ltd

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Ashwood Court Unit 1

Langrigg House

Parkside

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

CARE HOMES FOR OLDER PEOPLE Sunnyside Residential Home 37 Ullet Road Liverpool Merseyside L17 3AS Lead Inspector Les Smith Unannounced Inspection 12th 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 Residential Home DS0000025381.V278146.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 Residential Home DS0000025381.V278146.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Sunnyside Residential Home Address 37 Ullet Road Liverpool Merseyside L17 3AS 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) 0151 733 7070 Mr Wood Mrs Wood Mr Wood Care Home 17 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (1), Old age, not falling within any of places other category (17), Physical disability (17), Physical disability over 65 years of age (17) Sunnyside Residential Home DS0000025381.V278146.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Two named service users under 65 years old, within the overall number of 17. 28th February 2005 Date of last inspection Brief Description of the Service: Sunnyside is a residential care home providing 24 hours personal care and accommodation for 17 older and disabled persons. Sunnyside is located in a quiet residential area of Liverpool close to Sefton Park. The home is within easy access to bus routes, churches, shops and other local amenities. The home is a three-storey building with gardens to the front and rear of the premises. Communal space comprises of two lounge areas and a spacious dining room. Bedroom accommodation is situated on all three floors, which are serviced by a passenger lift. All the bedrooms are single with high quality furniture and fittings. Fifteen bedrooms have en-suite facilities and all bedrooms are connected to a staff call system. Sunnyside Residential Home DS0000025381.V278146.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over a period of 6 hours. Ranges of records such as care plans, staff personnel files, policies & procedures and medication charts were examined. Several staff on duty, including kitchen staff, and a number of patients was spoken to during the course of this inspection. What the service does well: 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. Sunnyside Residential Home DS0000025381.V278146.R01.S.doc Version 5.1 Page 6 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 Residential Home DS0000025381.V278146.R01.S.doc Version 5.1 Page 7 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): 1,2,3,4,5 Prospective residents can be confident that their needs will be assessed to ensure that their needs can be met prior to admission to the home. EVIDENCE: The home has a combined Statement of Purpose and Service User Guide, which is available to all residents. The document lacks detail in some areas and does not contain all the information required as detailed in schedule 1. A random selection of residents’ files were examined and found appropriate signed Statements of Terms and Conditions that meet the standard. The manager carries out pre-admission assessments on all prospective residents. Pre-admission documentation is satisfactory and assessments from social services are also obtained wherever possible. Prospective residents are assured of the homes capacity to meet their needs through information in the literature provided and visits to the home when Sunnyside Residential Home DS0000025381.V278146.R01.S.doc Version 5.1 Page 8 they have the opportunity to discuss relevant matters with other residents, staff and the management of the home. Prospective residents and their relatives are encouraged to visit the home as often and for as long as they wish in order to assess the suitability of the home. Prospective residents visiting the home are encouraged to stay for a meal and partake in any activity or social interaction they wish. Sunnyside Residential Home DS0000025381.V278146.R01.S.doc Version 5.1 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): 7,8,9,10 Care plans have been developed to meet residents’ assessed needs but still fall short of the standard required in order to meet the residents’ personal, health and social needs. Medication management was compliant with current good practice requirements and guidelines. EVIDENCE: Examination of a sample of residents’ care plans demonstrated that care plans show how assessed needs are to be met. Care plans appear to have been developed and improved since the last inspection but the process is fragmented with a number of files making up the plan. This results in duplication of information and makes the process burdensome. Risk assessments have been devised but are inadequate both in content and format. Care plans are reviewed regularly but the evaluations are inadequate and on two files examined were noted to be identical and did not include any reference to the care planned or given. Sunnyside Residential Home DS0000025381.V278146.R01.S.doc Version 5.1 Page 10 It was evident from the files examined that health needs are fully met. References were seen in the files of GP visits, referrals to continence advisor and other members of the multi-disciplinary team. There are no residents’ self-medicating at the home. Examination of the MAR sheets and other records showed that that all medication received into the home, administered and returned is in accordance with good practice guidelines. All staff that administers medication has received relevant training. The local pharmacist makes regular checks on medication procedures. The drug trolley is kept in the kitchen dry store and it is recommended that an alternative location be found. Four residents were spoken to and all informed the inspector that they were very happy and that all staff members were very caring and that their privacy and dignity was respected at all times. Sunnyside Residential Home DS0000025381.V278146.R01.S.doc Version 5.1 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): 12,13,14,15 Residents’ lives are enhanced and enriched by promotion of individual choice and retention of contact with friends and family together with a wide range of social and recreational activities. The meals at Sunnyside are good offering both choice and variety whilst catering for special or cultural needs. EVIDENCE: Daily routines at Sunnyside are as flexible as possible and residents confirmed that they have autonomy and choice in respect to how they spend their day. The exercising of this choice was clearly evident throughout the day. A senior carer undertakes the role of activities co-ordinator for 4 hours per week. Activities include reminiscence, pampering, sing-alongs and bingo. Shopping trips, visits to local pubs and a local club were lunch and entertainment are provided are also on the agenda. No record of participation in activities is kept and it is recommended that participation is recorded in the care plan. This would allow for a picture of likes and dislikes to be built up and a tailoring of such activities to meet individual preferences. Sunnyside Residential Home DS0000025381.V278146.R01.S.doc Version 5.1 Page 12 Residents are positively encouraged to maintain their links with family, friends and the local community. This is demonstrated by the external social activities and the open visiting policy at the home. Residents are able to see visitors in the communal areas or their own room as they wish. Meals may be taken in the main dining room or in personal rooms according to preference. On the day of inspection the inspector observed the mid-day meal being served. Meals were well presented and appeared to be wholesome and nutritious. The inspector was informed that meals served to residents’ in their rooms had a tray with the main course, desert and cup of tea all served at the same time. This is not good practice and meals should be served one course at a time. The kitchen was found to be clean and organised. Refrigerator temperatures were recorded but no temperatures were recorded for the freezer. The food stores were clean and well stocked. Sunnyside Residential Home DS0000025381.V278146.R01.S.doc Version 5.1 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): 16,17,18 The home has a complaints policy and procedure in place and residents can be confident that any complaints will be taken seriously. There is a policy for adult protection in place but a lack of training in recognising abusive practices potentially places residents at risk of harm EVIDENCE: Sunnyside has an appropriate complaints policy and procedure in place. There have been no complaints made directly to the home since the last inspection. The complaint procedure is prominently displayed in the entrance hall thereby making it available to anyone visiting the home. The inspector was informed that all residents are registered on the electoral roll and it was confirmed by residents’ spoken to that they are able to vote should they so wish. There is a policy in place for the protection of vulnerable adults and the home has a copy of the Liverpool inter-agency protocol on abuse. However the requirement made at the last inspection for staff to be trained in recognising abusive practices or being placed at risk of harm has not been met. Discussions with staff demonstrated that there was minimal knowledge in relation to recognising types of abuse and associated abusive practices. Sunnyside Residential Home DS0000025381.V278146.R01.S.doc Version 5.1 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): 19,20,21,22,23,24,25,26 The standard of the environment within Sunnyside is good providing a homely and comfortable place to live. EVIDENCE: A tour of the home accompanied by the manager and the following observations were made: All of the individual rooms except two have en-suite facilities. There are two lounges, one of which is a smoking area and a separate dining room. All rooms are furnished with good quality furniture and furnishings and tastefully decorated. It was clearly evident that residents are encouraged to personalise their rooms and a high level of personalisation was seen throughout the home. Two of the en-suite showers had garden chairs being used as shower chairs. These are not designed for the purpose and were clearly not stable in the shower. The inspector was informed that new shower chairs are on order. Sunnyside Residential Home DS0000025381.V278146.R01.S.doc Version 5.1 Page 15 The cleaning material store and hairdressing room were both found to be unlocked. This gave easy access by residents to chemicals, shampoo etc. These doors must be kept locked at all times in order to protect residents’ from the risk such items present. The extractor fans in the smoking lounge and Elmswood were not working. The main lounge had a recliner chair, which had evidence of burn(s), and a second chair had a ripped seat. All communal areas have toilets and washing facilities in close proximity, as do the two rooms without en-suite facilities. Security at the home is enhanced by CCTV cameras situated the entrances although the system was not working on the day of inspection. All rooms are fitted with a nurse call system and other aids such as assisted bathrooms, grab rails, and raised toilet seats are available to help ensure that residents are able to maximise their independence. A lift allows residents’ access to all parts of the home. On the day of inspection the home presented as clean, pleasant and hygienic. Sunnyside Residential Home DS0000025381.V278146.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): 27,28,29 There are sufficient staff employed to meet the assessed needs of the residents but recruitment policies are not robust enough to ensure the protection and safety of residents. EVIDENCE: Care staff are deployed in sufficient numbers and with an appropriate skill mix ratio to meet the assessed needs of the residents’ throughout the day. The nighttime staffing level of one awake and one sleeping is adequate for a low dependency population provided that a robust on call system is in place should a resident be taken ill and have to go to hospital or a member of staff falls ill. Ancillary staff are employed to meet the cleaning and majority of catering needs. Care staff also has to cover the laundry and evening meal catering functions. The home continues to work towards the 50 target for NVQ 2 qualified care staff and now has one with NVQ 4, 3 with NVQ 2 and one currently doing NVQ 3. The personnel file for the most recently employed member of staff was examined and found to be lacking a criminal records check, references and proof of identity. The establishment of sound and robust recruitment procedures will be a requirement of this report. Sunnyside Residential Home DS0000025381.V278146.R01.S.doc Version 5.1 Page 17 The lack of a sound and robust recruitment procedure puts residents at potential risk of harm or injury. Sunnyside Residential Home DS0000025381.V278146.R01.S.doc Version 5.1 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 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): 31,35,37,38 Residents benefit from a manager who is qualified and competent to ensure that the health, safety and welfare of residents is promoted and safeguarded. EVIDENCE: The registered manager Mr Woods is rostered as supernumerary for three days per week. On the other days one of the three assistant managers is in charge of the day-to-day management. This assistant manager is regarded by the staff as the manager and wears a name badge identifying her as the homes manager. A requirement was made at the last inspection regarding this situation and has not been met. Regulation 8(1)(b)(iii) states clearly that where the provider is not, or does not intend to be, in full time day to day charge of the care home then the registered provider shall appoint an individual to manage the home and notify the Commission of the appointment and the effective date. Sunnyside Residential Home DS0000025381.V278146.R01.S.doc Version 5.1 Page 19 It is essential that the current multi-faceted management structure be clarified to enable clear lines of accountability to be established. The ‘manager’ on duty on the day of inspection is qualified to NVQ 4 and demonstrated effective leadership and clearly leads a team that is committed to deliver high standards of care. However, as the registered manager was not on duty this standard cannot be assessed in full. Secure facilities are available for storage of residents’ monies and valuables. A random selection of monies held for residents was checked and found to be correct. It was noted that receipts for cigarettes purchased for several residents were not available as they are bought in bulk and then divided. A receipt for expenditure must always be available the protection of residents and staff. Residents’ records and other information held is kept securely and is readily available to residents’ on request. The inspector could not evidence that fire, manual-handling training had been provided for staff during the last twelve months. There was also no evidence that training had been given in first aid, infection control or health and safety. Loler certificates were available for the lift and hoists. The Loler inspections in February and August 2005 both highlighted work that was required to be carried out to meet the required standard. A quote for the work was obtained in November 2005 but as at the date of this inspection the work had not been carried out. Valid electricity and fire extinguisher certificates were seen and the annual gas inspection was being carried out on the day of inspection. The fire alarm and emergency lighting certificates shown to the inspector expired in July 2005. Valid contracts were seen for the disposal of general and clinical waste. Sunnyside Residential Home DS0000025381.V278146.R01.S.doc Version 5.1 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 2 3 3 3 3 N/A 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 3 18 2 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 2 29 2 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 2 X X 3 X 3 2 Sunnyside Residential Home DS0000025381.V278146.R01.S.doc Version 5.1 Page 21 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 OP1 Regulation 4 Requirement The registered person must update the Statement of Purpose to include all the required information as listed in schedule 1 The registered person must arrange for staff to receive appropriate and relevant training in abuse recognition and prevention The registered person must ensure that all a robust recruitment procedure is put in place and that all documents as per schedule 2 are obtained and kept in personnel files Timescale for action 28/02/06 2 OP18 13(6) 28/02/06 3 OP29 19 28/02/06 4 OP31 8(1)(b)(iii) The registered persons must 28/02/06 ensure that the requirement of regulation 8(1)(b)(iii) &8(2): of the Care Homes Regulation 2001 is met. This regulation states that where the provider is not, or does not intend to be, in fulltime day-to-day charge of the care a manager is appointed and the Commission is notified of this appointment. Sunnyside Residential Home DS0000025381.V278146.R01.S.doc Version 5.1 Page 22 5 OP35 17(2) The registered must ensure that receipts for expenditure of residents’ monies are kept. The registered person must ensure that all staff receive and maintain their knowledge and skills in: food hygiene, moving and handling, first aid and fire awareness by appropriate and relevant training 28/02/06 6 OP38 13(3)(4)(5) 28/02/06 7 OP38 13(4) The registered person must ensure that required safety certificates are obtained and copies forwarded to the CSCI 28/02/06 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 OP9 OP12 Good Practice Recommendations It is strongly recommended that training be sourced for all staff involved in the creation and maintenance of care plans It is recommended that an alternative place to keep the drug trolley is found. It is recommended that participation in social activities be recorded within the care plan. Sunnyside Residential Home DS0000025381.V278146.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Liverpool Satellite Office 3rd Floor Campbell Square 10 Duke Street Liverpool L1 5AS 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. 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