Inspection on 20/11/07 for Sussex Clinic

This inspection was carried out on 20th November 2007.

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

Sussex Clinic 11/11/08

Sussex Clinic 20/11/06

Sussex Clinic 11/01/06

Sussex Clinic 17/08/05

Sussex Clinic 05/10/04

Sussex Clinic 06/05/04

Similar services:

Springfield House

Sutton Lodge Nursing Home

The Shelley

Thorndene

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

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

CARE HOMES FOR OLDER PEOPLE Sussex Clinic 44-48 Shelley Road Worthing West Sussex BN11 4BX Lead Inspector Liz Palmer Unannounced Inspection 20th November 2007 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 Sussex Clinic DS0000024221.V349611.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. Sussex Clinic DS0000024221.V349611.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Sussex Clinic Address 44-48 Shelley Road Worthing West Sussex BN11 4BX 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) 01903 239822 01903 249997 carolassadi@ashbourne-group.wanadoo.co.uk Sussex Clinic Limited Post Vacant Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40) of places Sussex Clinic DS0000024221.V349611.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. A maximum of 25 services users who require nursing care may be accommodated. Of whom 6 may have a Physical Disability (PD) and (PD)(E). Date of last inspection 20th November 2006 Brief Description of the Service: Sussex Clinic is a detached; two-storey building that was once previously registered as a private hospital. It is situated approximately ¼ of a mile from the centre of Worthing town with all its amenities and ¼ of a mile from the sea front. It is privately owned and provides residential and nursing care for up to forty residents in the category of Older Persons. Within those registered beds is a provision for up to six persons under the age of 65yrs with a physical disability Accommodation is provided in twenty-four single and nine double rooms. Four of the single rooms and one of the double rooms have en-suite facilities. The rooms are arranged on two floors with a lift giving access to all but two. Two lounges and a separate dining room provide the communal space. There is a generous parking area to the front of the building and a secluded and well-tended garden to the rear, which is suitable for wheelchair users. Mrs Manejeh Shoai - Naini represents Sussex Care Ltd as the responsible person. The Registered Manager’s post is currently vacant The current fees vary from between £331.00 to £600.00 per week. Sussex Clinic DS0000024221.V349611.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection included a site visit to the home over a period of four hours. During this time two staff and four people who use the service were spoken to. Care plans, medication records, policies and staff records were sampled. Other information used to make judgements about the standard of care in the home included one relative’s survey and one survey from people who live in the home, two staff surveys and two professional surveys. One of the professional surveys was from a General Practitioner (GP) and the other was from a care manager. The last inspection report was also taken into account and information received from the home including their Annual Quality Assurance Assessment (AQAA). This was received within the timescale requested by the commission. Information from all these sources has been used to make the judgements in this report. What the service does well: What has improved since the last inspection? Fire training and equipment has improved as requested at the last inspection. Refurbished one bathroom installing new toilet, bath and overhead hoist. The pre-admission assessment form has been reviewed and a different format is now being used on a trial basis. Sussex Clinic DS0000024221.V349611.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Sussex Clinic DS0000024221.V349611.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 Sussex Clinic DS0000024221.V349611.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. JUDGEMENT – we looked at outcomes for the following standard(s): 3. Standard 6 does not apply People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who use the service can be assured that only those whose needs can be met are admitted to the home. No service users are admitted for intermediate care. EVIDENCE: The AQAA states that new service users are admitted only after a qualified nurse has made an assessment of their needs. This is done with the aid and consultation of significant others, and full input and written assessments from relevant care professionals (if appropriate). An assessment of a recently admitted service user was looked at and seen to contain all the relevant information, including, mobility needs, dietary needs and preferences, skin Sussex Clinic DS0000024221.V349611.R01.S.doc Version 5.2 Page 9 condition, nursing needs and hobbies and interests. Risk assessments are included in the initial assessment and cover a variety of risks including pressure areas and falls. Personal details, such as the name of their general practitioner (GP) and their next of kin were included. Sussex Clinic DS0000024221.V349611.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who use the service have their health and personal care needs met in a way that respects their views and upholds their right to privacy. EVIDENCE: Four care plans were looked at. These were drawn up from the initial assessments undertaken prior to moving in. The care plans included details of people’s individual care needs and how these should be met. They also included details of healthcare and nursing care needs. Care plans are reviewed monthly and changes noted. The relative’s survey received by us said that they feel care needs are ‘usually’ met in the home and that they are ‘always’ involved and kept informed of any changes. Sussex Clinic DS0000024221.V349611.R01.S.doc Version 5.2 Page 11 People who use the service are all registered with a local GP. Daily records were sampled and seen to be detailed and reflect care plans. Recordings showed evidence of medical needs being met in a timely and suitable way. Details of follow up and outcomes were recorded. Service users spoken to said they could rely on staff to seek medical help when they needed it. The survey returned by a GP who visits the home expressed no concerns about the home. The survey received from someone who lives in the home said they were satisfied with the care provided and people spoken to on the day all said they felt well cared for and that staff treat them with respect and respected their privacy. For example, knocking on their doors and closing the doors when speaking to them privately or giving personal care. One service user commented that staff always have time for a ‘chat and a laugh’. Another said staff were ‘excellent, patient and they don’t rush’. During the inspection staff were observed interacting with people in a polite, positive and respectful way. The daily log was looked at and several entries by one member of staff were derogatory and disrespectful. This was discussed with the manager who said she was aware and had discussed this with the staff member in question. She agreed to resolve the matter and ensure that people who live in the home are not referred to in this manner. There was no evidence to suggest this had a negative impact on service users or that they were referred to in person in this way. Qualified nurses are responsible for administering medication. The deputy manager was observed administering the lunchtime medication. The storage and recording of medication was sampled. The medication cabinet was seen to be suitably secure, clean and organised. The home uses a monthly blister pack system delivered by a local pharmacy. Records for recording were sampled, there was one instance of tablets being taken from the end of the blister packs rather than starting at the beginning. The deputy manager stated that she was aware of this and could explain the reason. However, she agreed that it left them open to errors and potential harm to service users. The deputy manager agreed to rectify the situation. No other errors or omissions were seen. Sussex Clinic DS0000024221.V349611.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Arrangements for social and leisure activities in the home need to be improved to ensure that people have enough to do and are engaged in activities of their choice. EVIDENCE: Two of the people who live in the home said they had enough to do and could occcupy themselves during the day. They both go out most days, one goes independently. For those living in the home that are not able to do this more organised activities would enhance their social lives. The AQAA states that visitors are welcome in the home and this was confirmed by service users and observed during the inspection. Telephones are available for service users to use and some have their own landlines or mobiles. The AQAA states that the home gets information from service users or significant others with reference Sussex Clinic DS0000024221.V349611.R01.S.doc Version 5.2 Page 13 to past history, including interests and hobbies and that birthdays are celebrated with a special cake. The AQAA acknowledges that recreational activities could be improved in the home and they say that in the next twelve months they will provide ‘further staff training on providing activities and stimulation for service users that will help improve the service users mentally and physically, maintain independence and reduce the risk of falls.’ The AQAA states that menus are discussed with the catering manager and reviewed regularly. It says ‘there are set meal times but these are flexible. We use mainly fresh ingredients in all our meals and the menus are carefully chosen to provide the best nutritional value for our service users. Meals are always presented in an appealing manner, including liquidised meals. An alternative menu is offered if they do not like the meal of the day. People who use services have their likes and dislikes regarding food recorded in their care plans. People spoken to on the day said the food was good, however a service users survey expressed dissatisfaction with food stating that it is not cooked on the premises and is often ‘unappetising and cold’. The lunch time meal was seen waiting on a trolley to be distrbuted to peoples rooms. The deputy manager said the meals are given out before thay get cold. The questionaires sent out to service users by the home showed 85 were ‘completely satisfied’ with the catering and 15 were ‘satisfied’. Sussex Clinic DS0000024221.V349611.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who use the service are confident that they could complain if they needed to. The procedures and training for staff protect them from abuse. EVIDENCE: The home has a complaints procedure, which is given to all service users when they move in. People who use the service said they could talk to the manager or the owner if they had a complaint. Those asked said they had never had cause to complain but had confidence that any concerns they had would be sorted out by the home. One person was able to give examples of minor concerns raised and how they had been addressed satisfactorily. A log of complaints is kept and there was evidence to show that complaints are dealt with appropriately and in line with the home’s procedure. A survey from someone who lives in the home stated they did not know how to make a complaint. This was discussed with the manager. Sussex Clinic DS0000024221.V349611.R01.S.doc Version 5.2 Page 15 Staff are trained in Adult Protection. Those spoken to are generally aware of the home’s policy and their responsibilities within it. No allegations have been made. People spoken to said they felt safe and well protected in the home. Sussex Clinic DS0000024221.V349611.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who use the service benefit from a clean and safe environment. EVIDENCE: During the inspection, the communal areas and some bedrooms were looked at. All areas seen were clean, homely and furnished and maintained to a reasonable standard with the exception of two toilets, which were not clean. The manager arranged for them to be cleaned immediately. A cleaner is employed by the home and was working during the inspection. No offensive odours were noticed in the home. Sussex Clinic DS0000024221.V349611.R01.S.doc Version 5.2 Page 17 The AQAA states that the home has a maintenance person employed and one service user confirmed that they could request repairs and small jobs to be done and this is always accommodated. The maintenance person was putting up new curtains for a service user during the inspection. The grounds and garden is well maintained and accessible to people who use a wheelchair. Staff are trained in all aspects of health and safety and the AQAA states that all safety checks are regularly undertaken, for example for electrical equipment and fire safety. Sussex Clinic DS0000024221.V349611.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The arrangements for recruiting staff protect the people who use the service. The training and support for staff enables them to carry out their roles confidently and competently. However, improvements need to be made to the induction and supervision of staff to ensure consistency in this. EVIDENCE: The two staff spoken to during the inspection were confident and competent at their jobs. They said they liked their jobs and were able to describe the needs and preferences of individual service users. They said there is on going training provided including mandatory courses such as, first aid, food hygiene, infection control, health and safety, adult protection and fire training which are provided to all staff. The staff survey said they received suitable training to enable them to do their job. Staff are supported to undertake National Vocational Qualifications (NVQs). Over 50 of care staff have achieved NVQ level 2, or above and there is always two registered nurses on each shift. Through the surveys and speaking to staff on the day there are mixed views about whether or not there are always enough staff on duty. Evidence shows Sussex Clinic DS0000024221.V349611.R01.S.doc Version 5.2 Page 19 that staffing levels are adequate to provide care to people without rushing, however there may not be time to meet individual needs for recreational activities and socialising. This is being addressed by the home who are planning to employ another member of staff and improve the planned activities in the home. Training records were sampled and were seen to be up to date. During the inspection there were suitable numbers of staff on duty to attend to the needs of service users and spend time with them socially. People living in the home said there were always enough staff on duty and they were never rushed. Staff were observed interacting in a positive and respectful manner at all times. They responded to requests from service users and were caring and polite. All service users met were well dressed, clean and looked well cared for. When asked, they said they felt in safe hands. They spoke highly of the staff making comments such as, ‘they are excellent’. The AQAA states that the home follows thorough recruitment procedures to ensure the protection of people who use the service. The recruitment file of three staff members was looked at. This was seen to contain the records required to meet the standards. For example, an application form, two suitable references, a criminal record check and a protection of vulnerable adults check. With the exception of one file which only had one written reference. The manager stated that office staff took up references and she felt sure the reference might still be on file in the office, which is not based in the home. The manager agreed to look into this and is aware that these records are required to be available for inspection. Evidence of a comprehensive induction programme was seen, however the four looked at were not complete. Staff must receive a full and comprehensive induction programme and the records of this should be complete. Sussex Clinic DS0000024221.V349611.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home is well managed and takes into account the views and interests of people who use the service. EVIDENCE: There is currently no registered manager in post, this was discussed with the proprietor and will be dealt with by an inspector of the Commission separately from this report. The manager who is currently running the home was previously the registered manager, she is temporarily in post until a suitable Sussex Clinic DS0000024221.V349611.R01.S.doc Version 5.2 Page 21 replacement is found. The staff and service users spoken to said they thought the home was well run and had confidence in the manager and the proprietor. The home’s AQAA states that the manager involves the service users in decisions, sets guidelines and explains the necessity for the guidelines. The registered provider visits the home regularly and reports are written. This ensures satisfactory monitoring of the service. They send out questionnaires to all service users, relatives, solicitors, GPs annually and assess all the feedback we receive. A recent summary of these questionnaires was seen and an overall positive response was noted. Publishing these results to the interested parties was discussed and the manager agreed this would be good practise. People who use the service handle their own money or are supported by relatives or solicitors. A record is made of all service users possessions when they are admitted to the home. The home has a staff supervision and appraisal system. Staff spoken to said they receive regular supervision and attend staff meetings. They said they felt well supported and thought the home was well run. The survey returned by a member of staff said they ‘sometimes’ meet with their manager for support and to discuss how they are working. They went on to say they ‘usually’ have the right support, experience and knowledge to meet the needs of people who use the service. The AQAA states that all records are kept up to date and maintained and used in accordance with statutory requirements. Training records and the fire log book were sampled and found to be accurate and up to date. The AQAA also states that accidents, injuries and incidents are recorded and reviewed regularly. The boiler and heating system are regularly maintained and serviced. Legionella testing is carried out annually. The home has a comprehensive health and safety policy. Sussex Clinic DS0000024221.V349611.R01.S.doc Version 5.2 Page 22 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 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 2 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Sussex Clinic DS0000024221.V349611.R01.S.doc Version 5.2 Page 23 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. 1 2 Standard OP26 OP30 Regulation 23 18 Requirement All parts of the care home must be kept clean. Staff must receive structured induction training. Timescale for action 21/12/07 21/12/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Sussex Clinic DS0000024221.V349611.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: 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 © 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 Sussex Clinic DS0000024221.V349611.R01.S.doc Version 5.2 Page 25 - 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. 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