CARE HOMES FOR OLDER PEOPLE
Sunnyside Residential Home Crewkerne Road Chard Somerset TA20 1EZ Lead Inspector
Anita Sutcliffe Unannounced Inspection 3rd March 2006 10:20 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 DS0000057862.V285515.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 DS0000057862.V285515.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Sunnyside Residential Home Address Crewkerne Road Chard Somerset TA20 1EZ 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) 01460 61623 Mrs Shirley Ann Pontefract Mrs Shirley Ann Pontefract Care Home 14 Category(ies) of Old age, not falling within any other category registration, with number (14) of places Sunnyside Residential Home DS0000057862.V285515.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. One named service user under the age of 65 Date of last inspection 6th October 2005 Brief Description of the Service: Sunnyside provides services for up to 14 service users under the registration category of Older People. The registered provider and manager is Mrs Ann Pontefract. The home is close to the centre of Chard. There is a large supermarket nearby and the amenities of the town centre are within walking distance for those physically fit and who have awareness of dangers from traffic. The home provides residential services on two floors. The first floor is accessed by a passenger lift. The registered manager lives on the floor above. Outside there is a drive leading to the front door and car parking area. There is a small garden area with a patio at the end of the drive. This area is protected from the main road by a high hedge. The main garden is at the back of the property with access on both sides. Side paths have been made safe with gates because of the busy road. Sunnyside Residential Home DS0000057862.V285515.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The unannounced inspection began at 10:20 am and lasted 4 hours. Several key standards were inspected. Discussion was held with six service users (residents), two visiting family, all staff on duty and the manager / provider. Most of the home was visited, and fire safety, medication, recruitment and staff training examined. Leaflets, describing the role of the CSCI and including contact details, were left at the home for future use. What the service does well: What has improved since the last inspection? What they could do better:
Neither residents nor staff could think of any way in which the home could improve at this time. They felt that the manager worked in residents’ best interest at all times. Some small changes would further ensure residents’ well fare. Ensuring that all staff receive training in the protection of vulnerable adults from abuse, and that the contact details are available should staff have concerns which they want to discuss outside the home. The inclusion of spent convictions when
Sunnyside Residential Home DS0000057862.V285515.R01.S.doc Version 5.1 Page 6 people apply to work at the home, which should ensure staff are safe to work with older people. The home should also continue their efforts toward proving staff competence through NVQ training or its equivalent and have a system to check their competence in the mean time. 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 DS0000057862.V285515.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 Residential Home DS0000057862.V285515.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): Not inspected on this occasion. EVIDENCE: Sunnyside Residential Home DS0000057862.V285515.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): 9 & 10 Residents at Sunnyside are protected through safe management of medication. Residents are treated with respect and with full regard for their privacy and dignity. EVIDENCE: Residents are supported to look after their own medication if they wish to. The home takes this responsibility if they choose not to or are unable to do so safely. Medicines are handled in a safe way, and records demonstrate an understanding of safe practice. Staff receive training in how to administer and handle medication and there was evidence of GP review as appropriate. Residents confirmed that staff are polite, knock before entering their room, they are treated with respect and that their privacy is upheld. Interaction between residents and staff was friendly and unhurried. Sunnyside Residential Home DS0000057862.V285515.R01.S.doc Version 5.1 Page 10 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 Residents are supported to have a fulfilled life in the manner than suits them. EVIDENCE: Residents were very satisfied with the home, confirming that they are able to make daily lifestyle choices. Comments included: “I can do anything I want”. Staff work hard to meet individual tastes and needs. They were observed assisting and supporting residents to live as they wish. The home provides a programme of activities including arts, crafts and entertainment and the sitting rooms is very homely. The ‘sun lounge’ provides a more private space if preferred. Residents confirmed that the garden is well used in the warmer weather, and spoke of activities enjoyed out side of the home. Visitors are made welcome, work closely with the staff in the best interest of residents, and there are no visiting restrictions. Sunnyside Residential Home DS0000057862.V285515.R01.S.doc Version 5.1 Page 11 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): 18 Residents are protected from abuse, but this could be further guaranteed. EVIDENCE: Staff spoke with confidence about recognising abusive practice and knew what actions to take should they have concerns. However, their knowledge about types of abuse was incomplete. The manager said that full training is being planned, but to date it is limited to a small part of the staff induction when newly employed. The home’s policies on prevention of abuse and ‘whistle blowing’ are openly available and informative, but do not contain contact details for the local authority vulnerable adults team. Staff would then find it easier to disclose concerns outside the home should they feel this is necessary. Residents said that they felt completely safe at the home. Sunnyside Residential Home DS0000057862.V285515.R01.S.doc Version 5.1 Page 12 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 The home is clean, pleasant, well maintained and meets current residents needs. EVIDENCE: The home succeeds in being comfortable, homely and meeting the needs of current residents. It was very clean, fresh, light and pleasant. It is well maintained and has a good standard of furnishings and fittings. Adaptations, such as guards on hot radiators, help to protect the residents, whilst the vertical lift, hand rails, equipment and individual door locks, help to promote independence. Fire safety is correctly managed through staff training and the provision, maintenance and testing of fire safety equipment. The garden includes a pond, apple tree, seating, shrubs and a bird table and residents said that it is well used and enjoyed in the warmer weather. The home has level access throughout, but the garden has some uneven areas which might pose a problem for those less steady on their feet. The manager
Sunnyside Residential Home DS0000057862.V285515.R01.S.doc Version 5.1 Page 13 confirmed that staff are always in the vicinity to help when the garden is being used. Sunnyside Residential Home DS0000057862.V285515.R01.S.doc Version 5.1 Page 14 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): 28, 29 & 30 Residents benefit from experienced and committed staff, but good practice would be further guaranteed through vocational training. Residents are protected by robust recruitment practice, but a small change will further protect them. EVIDENCE: Residents were extremely complimentary about staff at the home with comments including: “Staff are a lovely bunch”, “Staff are marvellous. All so different” and “People are really nice”. They expressed complete confidence in them. However, as yet few care staff have achieved the NVQ level 2 qualification (or equivalent) in care, although encouraged to undertake it. Steps have already been taken toward achieving this. Staff spoke of the training they have received, confirming that all staff are involved and that there is a regular programme of updating knowledge and skills. In addition to health and safety training (moving and handling, 1st. aid, fire safety, infection control) they have received training in the safe handling of medication and positive dementia care. The next training planned is the protection of vulnerable adults from abuse. The recruitment records of two staff members were examined and confirmed that checks have been carried out which assure new staff are safe to work with vulnerable adults in a care home setting. However, applicants are currently
Sunnyside Residential Home DS0000057862.V285515.R01.S.doc Version 5.1 Page 15 not expected to disclose any spent criminal convictions. Doing this further guarantees their suitability for the work. Sunnyside Residential Home DS0000057862.V285515.R01.S.doc Version 5.1 Page 16 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, 32 & 35 The manager provides leadership, knowledge and an approach which promotes residents’ wellbeing. Residents’ financial interests are safeguarded by practices at the home. EVIDENCE: Residents benefit from a caring and very experienced manager. She leads by example and is committed to the provision of a quality life for residents. Staff spoke of the happy atmosphere at the home and good rapport with the manager saying: “It is an actual home, not an institution”. Residents said: “Staff all get on so well”. A visitor commented on how knowledgeable the manager was about health care. Those residents able to look after their own financial affairs are supported to do so. Some ask the home to keep money and valuables for them. The arrangements for this were secure, with records kept of all transactions.
Sunnyside Residential Home DS0000057862.V285515.R01.S.doc Version 5.1 Page 17 Sunnyside Residential Home DS0000057862.V285515.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 X X X X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 2 3 X X X X X X X STAFFING Standard No Score 27 X 28 2 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 4 X X 3 X X X Sunnyside Residential Home DS0000057862.V285515.R01.S.doc Version 5.1 Page 19 Are there any outstanding requirements from the last inspection? NA 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. 2. 3. 4. Refer to Standard OP18 OP18 OP28 OP29 Good Practice Recommendations It is recommended that staff receive training in the protection of vulnerable adults from abuse. Policies on the prevention of abuse and whistle blowing should contain the contact details of the local authority vulnerable adults team. The home should produce a plan as to how it will achieve the minimum ratio of 50 members of care staff qualified to NVQ level 2 (or equivalent) at the earliest opportunity. Disclosure prior to employment should also include spent convictions. Sunnyside Residential Home DS0000057862.V285515.R01.S.doc Version 5.1 Page 20 Commission for Social Care Inspection Exeter Suites 1 & 7 Renslade House Bonhay Road Exeter EX4 3AY National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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