Inspection on 23/10/06 for Sutton Court

This inspection was carried out on 23rd October 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Sutton Court 17/02/09

Sutton Court 22/11/05

Sutton Court 04/07/05

Sutton Court 30/11/04

Sutton Court 20/07/04

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Insight - Eastchurch

Southfields

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Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 Sutton Court 69 Chesswood Road Worthing West Sussex BN11 2AB Lead Inspector Ms B Tye Key Unannounced Inspection 23rd October 2006 09:00 Sutton Court DS0000014762.V318626.R01.S.doc Version 5.2 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 Sutton Court DS0000014762.V318626.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 Adults 18-65. 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. Sutton Court DS0000014762.V318626.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Sutton Court Address 69 Chesswood Road Worthing West Sussex BN11 2AB 01903 234457 01903 211071 courthomes@btopenworld.com 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) Sutton Court Nursing Home Limited Mrs Michelle Jane Pretty Care Home 10 Category(ies) of Learning disability (10) registration, with number of places Sutton Court DS0000014762.V318626.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Up to 10 male and/or female service users in the category learning disability may be accommodated Only persons between ages of 18-65 years of age may admitted Date of last inspection 22nd November 2005 Brief Description of the Service: Sutton Court is a care home registered to accommodate up to ten people in the category LD (Learning Disabilities 18-65 years). The premises is a converted period house close to Worthing town centre, with access to public transport nearby. Accomodation is provided over two floors and all rooms are single occupancy. The servce is privately owned and the registered provider is Sutton Court Nursing Homes Ltd. Mr Ramdin is the registered proprietor and Ms Michele Pretty is the registered manager in charge of the day to day running of the home. Sutton Court DS0000014762.V318626.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place on the 23rd October 2006. Prior to the inspection, information held on file was examined including any official documentation relating to the home. The provider completed a detailed pre inspection questionnaire which outlined all changes to the service since the last inspection. On the morning of the inspection, some residents were dressed and socialising with staff in the lounge area and some were out at college or with staff. During the day the inspector spoke privately to three residents, interviewed two staff and spent some time discussing the service with the manager, Michelle Pretty. Three residents care files were case tracked. Policies and Procedures, Risk assessments, Medication records and all Health and Safety Records were examined. In addition, a tour of the premises was undertaken. Overall quality of care was found to be very good. Administration systems were comprehensive, well ordered and up to date. This is the first inspection of 2006/2007. This is called a key inspection and will determine the frequency of visits/inspections hereafter. What the service does well: The home places value on supporting the residents to develop independent living skills in their every day lives. All the residents attend various college courses, as well as day centres and participate in activities that interest them. Every aspect of each residents care is documented and clear action plans give staff clarity to provide care needs specific to individuals. Risk assessments for each resident promote independent living in line with their assessed capabilities. The Commission received ten comment cards prior to the inspection from residents, relatives and health professionals. All feedback was positive and praised the home. Sutton Court DS0000014762.V318626.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Sutton Court DS0000014762.V318626.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Sutton Court DS0000014762.V318626.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Detailed pre-admission assessments are completed prior to admission to the home and information gained forms the basis of an on going plan of care. Terms and Conditions were available for all residents and held on their files. EVIDENCE: A Statement of Purpose is in place and the Service Users Guide has been updated to include changes to the service. Each document is provided in a format suitable for residents so they are aware of what the service offers prior to admission. Individual care files for three residents were case tracked. Each contained detailed pre-admission information, which was relevant and detailed. Records showed residents had undertaken pre admission assessments with the manager of the service. The manager has completed detailed risk assessments and ensures relevant community resources are available to meet residents identified needs, in addition to the care provided at Sutton Court. Sutton Court DS0000014762.V318626.R01.S.doc Version 5.2 Page 9 Individuals are able to view the home and contribute fully to identifying their care needs and aspirations prior to admission. Terms and Conditions for the home are provided to each resident on arrival. This ensures residents are fully aware of their rights and exactly what the home has to offer them. Sutton Court does not provide intermediate care. Sutton Court DS0000014762.V318626.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Examination of care records confirmed that the home meets individuals changing needs and personal goals appropriately. Care plans seen were comprehensive and in excellent order. Residents are provided with the opportunity for decision making, in line with agreed risk assessments and behavioural plans. EVIDENCE: Care files contain comprehensive information relating to the residents assessed care needs including health, personal and social care. Residents have the opportunity to contribute to the care planning process, which reflect their changing needs, through one to one keywork sessions and formal reviews. Each plan contains detailed risk assessments and behavioural plans, including information relating to individuals personal history, mental, physical health and behaviours. Each care file has risk/behaviour management guidelines. In addition, each resident has in place risk assessments for them and their Sutton Court DS0000014762.V318626.R01.S.doc Version 5.2 Page 11 environment. This promotes independence for residents in line with assessed risk and agreed limitations and ensures the manager and staff can provide care within safe boundaries. The manager stated the staff team is committed, where possible to providing a holistic approach to individuals and resources provided in house and in the wider community are in line with specialist needs. Observations and care files examined by the inspector supported this. The individualised approach and assessment process within the home promotes residents choice and provides an opportunity for decision-making. The inspector examined the daily recording log, which details any significant event, needed to be handed over to other staff at shift change. This ensures consistency for residents in relation to their care needs. Resident’s personal information is held on files in a locked staff office, ensuring confidentiality of personal information, within the home. Sutton Court DS0000014762.V318626.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are supported and encouraged in terms of personal development and activities both at the home and in the wider community. The menu at Sutton Court offers a range of healthy balanced meals. EVIDENCE: An activities programme for residents is planned in advance. Residents go on weekly outings as a group and daily as individuals. A weekly activities programme for each resident has been devised as part of their on going care planning. Residents spoken to by the inspector all confirmed the staff support them to pursue a range of activities and interests. Information in care plans seen, supported this. Sutton Court DS0000014762.V318626.R01.S.doc Version 5.2 Page 13 All activities undertaken by the residents are risk assessed in full and agreed with the resident concerned. This information is held in residents care files and ensures each residents welfare is paramount when undertaking activities in the home and wider community. It was noted the home achieves a good balance between promoting safe boundaries for residents who participate in activities whilst encouraging independence. The home now has a new 8- seater vehicle to transport residents as needed. Residents and information seen on care plans confirmed family contact is promoted. Some residents have home visits on a regular basis. Visitors are welcome to the home and a policy is in place to support this. Minutes for the last residents meeting were examined (28.10.06) and reflected that the residents were supported to discuss any issues of concern and contribute to the decision making within the home. Dietary needs are catered for in line with assessed needs. All information relating to specialist nutritional requirements is recorded on individual care plans. The inspector examined menus for the home. Residents confirmed they liked the food and were consulted on about what they liked to eat. The kitchen area was clean and tidy. Food is stored appropriately and it was noted there was fresh fruit and vegetables, to ensure residents benefit from a healthy balanced diet. Food and hygiene certificates for staff are on display, colour coded boards are used and anti bacterial soap was available at sinks demonstrating an awareness of infection control. The manager of the home has completed Safer food/ Safer business training and has implemented relevant health and safety measures in the home to improve hygiene and safety standards for residents. Sutton Court DS0000014762.V318626.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care records were examined and showed that the health needs of residents are met and reviewed on a regular basis. Medication is stored and labelled appropriately. All staff have received recent training to dispense medication appropriately. EVIDENCE: Healthcare records were examined as part of case tracking. All were found to be detailed and in good order. Holistic needs are incorporated in each plan so in addition to physical health; emotional and psychological aspects of care are identified and reviewed regularly. Residents are registered with the local GP and have access to all NHS entitlements. Records of all dental and GP appointments are held on file. Individual files show residents have access to community health specialists, to ensure all aspects of their health needs are met both by the home and wider Sutton Court DS0000014762.V318626.R01.S.doc Version 5.2 Page 15 community. Sutton Court has good links with the Community Learning Disability Team who offer advice when required. Behaviour management plans and risk assessments have been undertaken for each resident. These enable staff to ensure that residents maintain their independence within agreed limitations. Policies and procedures relating to all aspects of healthcare and medication are in place and up to date. These are reviewed and updated on an annual basis in line with legislation. Each resident is assigned a key worker who provides a one to one session on a weekly basis, or more often if required. These meetings provide residents with the opportunity to talk through all aspects of their care needs and make supported changes where needed. All information from these sessions is recorded in their on going care plan. Records showed that staff have undertaken relevant training to dispense medication safely to the residents. Medication records and storage at the home was inspected and found to be in good order, demonstrating staff are adhering to policy and procedures. Sutton Court DS0000014762.V318626.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has effective systems in place to protect the residents from abuse, neglect and self-harm. EVIDENCE: The home has a detailed procedure for complaints, which is included in the Service Users Guide and Statement of Purpose, providing residents with clear information about how to complain. All complaints information is printed in a format suitable for residents to ensure they are clear about their rights within the home. Staff have completed mandatory training in addition to their induction in relation to Protection of Vulnerable Adults. This reduces risk within the home and ensure staff were clear about reporting procedures should suspicion of abuse arise. Records show staff have received training in dealing with challenging behaviour and working with mental illness. This ensures staff are able to understand and deal effectively with triggers and issues relating to residents behaviour. Residents have regular meetings, which provides them with a forum to talk about anything of concern. Several residents were spoken to during the visit and all stated they felt able to talk to the management or staff members about any issues of concern. Sutton Court DS0000014762.V318626.R01.S.doc Version 5.2 Page 17 Sutton Court DS0000014762.V318626.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home offers a comfortable and clean living space for residents. Residents rooms contain personal possessions and all those seen were clean and homely. EVIDENCE: Areas of the home have recently been redecorated and new furniture purchased for the dining room and lounge. Overall the home offers a homely, comfortable environment. There is a large lounge with TV and stereo equipment and separate ‘quiet space’ for residents. The dining room is opposite a light, brightly decorated kitchen, which all residents have access to for cooking and drink making facilities. Sutton Court DS0000014762.V318626.R01.S.doc Version 5.2 Page 19 Residents rooms were a good size and furnished in their individual styles with personal possessions and pictures. All bedrooms have locks on the door and lockable cabinets for residents to store items of value. A laundry room provides a large washing machine and tumble dryer. Residents do their own washing with assistance by staff if required. Staff clean the house regularly with support from residents. This encourages a sense of ownership and promotes independent living skills. Infection control training is provided to staff and policies and procedures were evidenced. This reduces the risk of infection spreading throughout the home. Staff certificates for food hygiene courses were displayed in the kitchen area. A fire alarm and emergency lighting system is in place. Records showed these are checked and serviced on a regular basis to ensure the safety of staff and residents. The inspector viewed detailed risk assessments for all aspects of the environment, which ensures potential hazards are identified and minimised where possible. A requirement has been made for the water temperatures in the home to be regulated, as they were found to be too hot. Prior to this report being published this requirement had been addressed and met. A recommendation was made to replace the upstairs bathroom lino, which was torn and cracked in some places. Prior to this report being published this recommendation had been addressed and met. Sutton Court DS0000014762.V318626.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The staff employed to work at Sutton Court have all been recruited and trained to meet the assessed needs of the residents. Residents benefit from a well supported and skilled staff team. EVIDENCE: Feedback from residents, staff interviews and observations led the inspector to conclude that the staff functioned effectively as a team to ensure the residents needs are met appropriately. Three staff files were examined, they contained all the relevant checks and information needed to meet the standards. All staff have CRB checks which reduces risk to vulnerable residents and ensures staff are able to competently fulfil their roles. The home currently has a full staff compliment and does not use agency workers. This provides consistency of care to residents. Sutton Court DS0000014762.V318626.R01.S.doc Version 5.2 Page 21 Records show that staff receive regular supervision and support every two months. This gives staff members the opportunity to reflect on their practice and identify areas of personal development. Staff attend regular meetings which are recorded. This forum enables them to have input about decision making processes in the home and discuss issues relevant to practice as a team. All staff have undertaken either LDAF training and a full induction within the home. The manager has devised a new training schedule for staff from October 2006. Each staff member will now attend a monthly training day. This covers mandatory training and includes additional specialist topics in line with the needs of the resident group. Over 50 of the staff team have completed or are undertaking NVQ Level 2 & 3. Sutton Court DS0000014762.V318626.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. From the evidence gathered for the inspection and the subsequent visit to the home it is concluded that the overall conduct and management served the best interests of the residents and the staff who work there. EVIDENCE: All safety records at the home including, fire records, training, incident and accident logs, water temperatures, maintenance book and the financial records were examined. They were all up to date and in good order promoting the welfare and safety of the residents. All incidents are recorded fully in the homes log, individual files and the Commission had been notified of these as appropriate Sutton Court DS0000014762.V318626.R01.S.doc Version 5.2 Page 23 Good practice in the home was evident. This was supported by efficient administrative and daily recording systems. The manager has set up effective monitoring systems to ensure staff are consistent in their practice and recording. The home has detailed risk assessments for individuals and their environment. These are updated on a regular basis, ensuring residents can maintain their independence within agreed limitations. Financial records for the residents are up to date and in good order. The manager and individuals sign off any transactions as they occur ensuring records relating to monies are up to date and correct. The manager of the home attend regular meetings with the Registered provider and her peers within the organisation, to discuss and monitor issues of on going practice in relation to staff and residents. The home has up to date policies and procedures in line with current legislation to safe guard the rights and interests of the staff and residents. Information relating to residents is available in Makaton and symbol format to ensure residents are clear about their rights within the home. Discussions and observations confirmed staff are given clear direction in their roles and good working practices are promoted through staff support and training. A Quality Assurance review has been undertaken. Sutton Court is part of a larger organisation that has standard feedback forms for involved professionals, residents and interested parties. All feedback received by the commission confirmed the service offers a good standard of care to its residents. Sutton Court DS0000014762.V318626.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 3 2 3 3 X 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 X 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 X 3 X X 3 X Sutton Court DS0000014762.V318626.R01.S.doc Version 5.2 Page 25 NO Are there any outstanding requirements from the last inspection? 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 YA24 Regulation 12(a) Timescale for action To make provision for the health, 31/10/06 safety and welfare of residents by addressing unregulated hot water taps in bedrooms. Requirement RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA24 Good Practice Recommendations To replace cracked lino in upstairs bathroom in order to prevent the spread of infection within the home. 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