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Inspection on 15/10/08 for Sunrise Operations Purley Limited

Also see our care home review for Sunrise Operations Purley Limited for more information

This inspection was carried out on 15th October 2008.

CSCI found this care home to be providing an Adequate service.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Sunrise Operations Purley Limited 21 Russell Hill Road Purley Surrey CR8 2LF     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Jon Fry     Date: 0 5 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Sunrise Operations Purley Limited 21 Russell Hill Road Purley Surrey CR8 2LF 02086762300 02086762323 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Josephine Garston Type of registration: Number of places registered: Sunrise Operations Purley Limited care home 80 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The Registered Person may provide the following category of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old Age, not falling within any other category - Code OP The maximum number of service users who can be accommodated is: 80 Date of last inspection Brief description of the care home Sunrise Operations Purley Limited provides residential and nursing care for up to 80 older people. The home is in Purley and is a purpose built Victorian Mansion. It is situated close to local shops and transport links. A user guide is available from the home that gives good information about the services provided. Details of fees payable can also be obtained from the home on request. 0 Over 65 80 Care Homes for Older People Page 4 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This unannounced inspection took place over three days in October and November 2008. During this visit we: Talked with twelve people who use the service, four staff members, two visitors, the Manager and the Executive Director. Looked at information kept about the people who use the service and how their needs are to be met. Looked at other records that the service must keep. Looked around the building to make sure it was clean, comfortable and safe. Care Homes for Older People Page 5 of 26 Asked the manager to distribute surveys to the people who live there. We received fifteen completed surveys back. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 7 of 26 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 8 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Good information is available to people about the service provided. Peoples needs are assessed before someone comes to live at the home. Evidence: 90 of the people who returned surveys said that they received enough information to make a decision about coming to live at the home. Comments included I found it by recommendation and I then came to visit and I had a months trial. We saw individuals and their families being shown around the home while we were there. A guide to the home is given to individuals when they come to live there. This gives generally good information about the service provided and the organisation can make this available in other formats such as large print,audio tape and in alternative languages. The manager is in the process of updating some information in the guide and we have recommended that pictures or photographs could be used to make it Care Homes for Older People Page 9 of 26 Evidence: even more user friendly. The home makes sure that it can meet peoples needs by carrying out an assessment of their needs. We looked at the care files kept for three people and saw that the assessments had been fully completed. Profiles are also completed by the person or their representatives and these contain some really good person centred information about the individual, their life and the things that are important to them now. We have recommended that the manager and staff look at the Equality and Diversity prompts published by CSCI. These could be used to develop the assessment process further to make sure that any issues are properly addressed. Care Homes for Older People Page 10 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who live there are treated with dignity and respect. The care plans contain good information about the support each person needs however the systems for monitoring and addressing individual nursing needs were found to be in need of improvement. Evidence: 50 of the people who returned surveys said that they always received the care and support they needed. 33 of people said sometimes and 17 said usually. The people we spoke to were very positive about the staff who work there but a number of individuals felt that there could be more staff on duty. We looked at the care plans for three people. These contain good information about meeting peoples needs and are reviewed regularly. The people who live there and their representatives are part of the care planning process and we saw minutes of family meetings where individuals are encouraged to put forward their views about the care being provided. Care Homes for Older People Page 11 of 26 Evidence: We looked at the records for three people in detail around the care of wounds and found that these were not satisfactory. The records did not show that dressings were being changed at the stated frequency and records for turning people when in bed were not being kept. We asked the home to make immediate improvements and visited again to make sure that the necessary actions had been taken. We saw that practice had been improved and much better records being kept. The home has only recently been registered to care for people with nursing needs and we are concerned that the systems and resources needed are not fully in place. The people we spoke to consistently said that staff treated them with dignity and respect. Their comments included they try to help you as much as they can, helpful and magnificent. Medication is stored in peoples rooms in locked cabinets. The staff give out medication to those who want or need help with this. An additional charge is made for this service. We looked at the medication kept for six people and saw that people get the medication that they are prescribed with good records kept of this by staff. Care Homes for Older People Page 12 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home offers people a varied programme of activities. Individuals generally enjoy the meals provided to them. Evidence: Feedback about the food on offer included the food is good, its not bad, plenty of it, reasonable and the food from the kitchen is very good. Three people individually spoke about the slow service in the dining area each saying that they thought there needed to be more staff on duty at mealtimes. Another person said that there are not enough staff at breakfast. We discussed this with the manager at the time of inspection and have recommended that this area be looked at by the home. We have also recommended that the menus displayed be produced in different formats. Two people commented that these were not easy to read. The monthly activity programme for the home is made available throughout the service and the days events are also clearly signposted. Regular activities include coffee club and crosswords, gardening, afternoon socials, word games and a knitting circle run by a volunteer. Other events include regular cabaret, church services and trips out. Care Homes for Older People Page 13 of 26 Evidence: Comments from the people who live there included I do crosswords, theres plenty to do, there are things to do and plenty to do if you choose to partake. Two people said that they would like more trips out and another person said that they would like to have more Internet sessions. We spoke with the lead activities person who told us about their plans to develop the service for people with nursing needs who may require more one to one sessions with more sensory stimulation. Other developments include more use of volunteers and more social events such as a Halloween party and a masked ball. Care Homes for Older People Page 14 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Complaints procedures are in place and people know how to make a complaint if they are unhappy about the service they are receiving. Staff training and awareness helps to safeguard people from abuse. Evidence: The majority of people we spoke to who live at the home told us that they knew how to make a complaint. Comments included they do listen, Id go to the manager and I have no complaints. Some people we spoke to or who returned surveys clearly did not know who was in charge at the home. 65 of people who completed surveys said that they knew how to make a complaint. 35 however said no to this question. The home should look at making the complaints procedure more accessible for the people who live there. Displayed photographs of key people may also help to clearly communicate who is in charge at any given time. We saw that the home keeps a record of complaints and the action taken to address issues raised. We have recommended that a summary be kept with dates clearly recorded to help keep track of response times and outcomes / lessons learned. One safeguarding issue was being looked into at the time of our visit. We were Care Homes for Older People Page 15 of 26 Evidence: satisfied that the home was co-operating fully with the Local Authority to make sure that this was being properly looked into. We have recommended that the home makes sure that links made with key Local Authority Safeguarding staff continue and clear procedures are in place for how and when to contact them. Care Homes for Older People Page 16 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a very high standard of accommodation for the people living there. Evidence: The home is decorated and maintained to a very high standard. The people we spoke to were happy with their accommodation and comments included a very nice room, its kept clean and I like the size of it. Individual rooms are either single with en-suite facilities or companion which is two rooms side by side sharing a bathroom. People can bring in their own furniture and we saw that peoples rooms were personalised with their own pictures and possessions. There are large sitting and dining areas for the people who live there to use. A garden area is also available with one person commenting on the beautiful gardens we have. Two areas that could be improved were commented on by the people who live there. Two individuals commented in surveys on the laundry service saying that it is unsatisfactory and needs tightening up. Another person spoke of staff not consulting them when they came to put the laundry away. The other issue raised during the inspection was slightly unstable paving outside in the Care Homes for Older People Page 17 of 26 Evidence: garden. This was raised during the residents council meeting that we attended during our inspection. The managers told us that this was being addressed. Care Homes for Older People Page 18 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff receive the training they need to help them meet individual needs. Staff numbers need to be kept under review to make sure that people needs continue to be met. Evidence: The staff are very kind, they dont mind what they do, very nice and very very good were comments from the people who live at the home. 90 of the people who returned surveys said that the staff listened to them and acted on what they said. Three people we spoke to felt that there were not enough staff on duty. Comments included they are overworked, I feel we are understaffed and they need more staff. 67 of people who returned surveys said that there were usually enough staff around with 33 saying sometimes. The staff members we spoke to said that staff numbers were increasing as more people came to live at the home. The organisation needs to closely monitor the staffing levels to make sure that there are sufficient numbers on duty to meet individual needs. This is particularly important given the recent changes to the service and the people with nursing needs coming to live there. We looked at staff training records and saw that individuals have good access to Care Homes for Older People Page 19 of 26 Evidence: training. Courses attended by care staff include Food hygiene, First Aid, dementia care and manual handling. Staff members are also able to access NVQ training. Specialist courses are also being accessed for the nursing staff including wound care. Recruitment records looked at for four members of staff showed that all the necessary recruitment checks take place before someone comes to work at the home. These include Criminal Record Bureau and identity checks. Care Homes for Older People Page 20 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is managed satisfactorily. Regular Health and Safety checks help to protect the welfare of the people living there. Evidence: The manager notified the CSCI that she was leaving the service just as this report was being produced. Another senior member of staff was due to take over as acting manager. The majority of people we spoke to were positive about the way the home was being run but two people spoke about there being too many chiefs and that management was absent at weekends. As stated before, we think that the service should look at making people aware of who is in charge on any given day and that photographs of key people may help to communicate this. The manager spoke about working with staff to manage the changes in the service Care Homes for Older People Page 21 of 26 Evidence: being provided. Feedback from two staff members was positive about the support being provided to them with comments including the management are great and I feel able to go and get support. Both individuals spoke of the big changes in the service catering for people with higher needs but said that training was being provided. As stated previously, we think that the service needs to monitor the staffing levels closely. The home needs to make sure that adequate numbers of trained staff are on duty to meet nursing needs particularly as the numbers of people living there increase. The organisation has systems to ensure quality within the service. Results of a Gallup survey were presented to the people who live there and their family or friends at the time of our inspection and the home had scored well in this. We attended a Residents Council meeting while we were there and discussions included issues raised around the dining and laundry service. A separate dining service committee also meets monthly to discuss meals and mealtimes. Health and Safety is managed well by the service. We saw that good records are kept of these checks to ensure the welfare of people living there. Care Homes for Older People Page 22 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 23 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 1 The Guide to the home could be developed to be more user friendly and include pictures of key people within the service. The home should develop the assessment format to make sure that Equality and Diversity issues are properly addressed. Guidance and prompts published by CSCI may help when looking at this area. It is recommended that the home continues to look at computer / internet access for the people who live there and how this can be developed. The menus should be made available in a large print format to help people read them. The home should look at the mealtime experience to make sure that there are enough staff to serve the food in the dining area. A summary sheet for concerns and complaints should be produced for tracking purposes. The complaints procedure should be made available with photographs of key people included to help people know who they should speak to. Closer links should be maintained with the Local Authority 2 3 3 12 4 5 15 15 6 7 16 16 8 18 Care Homes for Older People Page 24 of 26 Safeguarding Adults team. 9 10 11 19 26 27 The paving areas in the garden should be looked at to make sure that they are stable. The laundry service should be reviewed with the people living there to make sure that this is working satisfactorily. Staffing levels need to be kept under review at all times. The service needs to make sure that all individual needs are being met. Care Homes for Older People Page 25 of 26 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 26 of 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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