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Inspection on 04/07/05 for Sutton Court

Also see our care home review for Sutton Court for more information

This inspection was carried out on 4th July 2005.

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.

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

What the care home 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. All the parents spoken to stated their relatives had `come on leaps and bounds` since their arrival at the home and that they had exceeded expectations in their capabilities. One parent stated she never imagined her daughter would attend college and yet she had recently watched her receive a college certificate, which made her `so proud`.

What has improved since the last inspection?

Since the last inspection the home has undergone redecoration of residents rooms and communal areas. Residents were involved in choosing their colours of preference, which gives them a sense of ownership of their environment.

What the care home could do better:

The inspector noted the upstairs landing carpet was badly stained and needed replacing. Staff records indicated that although the home runs regular training days not all staff had completed mandatory training such as POVA and food hygiene. However, the training schedule showed staff were due to undertake these in the coming months. This will be monitored at the next inspection.

CARE HOME ADULTS 18-65 Sutton Court 69 Chesswood Road Worthing West Sussex BN11 2AB Lead Inspector Mrs B Tye Unannounced 04 July 2005. V236619 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 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 Stationary 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 H60-H11 S14762 Sutton Court V236619 040705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Sutton Court Address 69 Chesswood Road, Worthing, West Sussex, BN11 2AB Telephone number Fax number Email 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 234457 01903 211071 courthomes@btopenworld.com Sutton Court Nursing Home Limited Mrs M J Pretty Care Home (CRH) 10 Category(ies) of Learning Disability (LD) - 10 registration, with number of places Sutton Court H60-H11 S14762 Sutton Court V236619 040705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. Up to 10 male and/or female service users in the category learning disability may be accommodated. 2. Only persons between ages of 18-65 years of age may be admitted. Date of last inspection Brief Description of the Service: Sutton Court is a care home registered to accomodateup to 10 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 servcie is privately owned and the registered provider is Sutton Court Nursing Homes Ltd. Mr Ramdin is the registered proprieter and Ms Michelle Pretty is the registered manager in charge of the day to day running of the home. Sutton Court H60-H11 S14762 Sutton Court V236619 040705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 4 hours. Prior to inspection information held on file was reviewed, including the last two inspection reports and any official documentation relating to the home over the last six months. Sutton Court currently has 10 residents and the inspector was able to speak to six of these during the inspection. Three members of staff were interviewed and a tour of the premises was undertaken. Case files, health and safety records and office systems within the home were examined. Following the inspection the inspector spoke to three sets of parents to gain their views about the standard of care provided at the home. What the service does well: What has improved since the last inspection? Since the last inspection the home has undergone redecoration of residents rooms and communal areas. Residents were involved in choosing their colours of preference, which gives them a sense of ownership of their environment. Sutton Court H60-H11 S14762 Sutton Court V236619 040705 Stage 4.doc Version 1.40 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. Sutton Court H60-H11 S14762 Sutton Court V236619 040705 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Sutton Court H60-H11 S14762 Sutton Court V236619 040705 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1 - 5 Residents are able to visit the home and are assessed prior to admission. Individuals needs and aspirations are recorded as part of the care planning process and evidence of contributions from residents, relatives and involved professionals was seen on files. Residents are kept fully informed about the way their care is provided and have received contracts and the necessary documents relating to the home. The service users guide is also available in Makaton to assist residents understanding of services available at the home. EVIDENCE: Pre-admission information for each resident forms the basis of their on-going care plan. Evidence of additional information from involved professionals such as social workers and GP’s seen on file. These help to build a clear picture of individual needs and daily routines. The pre-admission assessment is undertaken by senior staff to ensure the prospective service users needs can be met and the dynamics within the resident group remain stable. Prospective residents and their families are welcome to visit the home prior to admission. One parent spoken to confirmed her son was able to chose his own room before he moved in. This aided his move to the home and helped him to develop a sense of belonging. Sutton Court H60-H11 S14762 Sutton Court V236619 040705 Stage 4.doc Version 1.40 Page 9 All information relating to the service is clearly written in the Service Users Guide and Statement of Purpose. A contract of Terms and Conditions for each resident is signed on admission, this ensures residents and their families are fully aware of their rights within the home. The home does not offer intermediate care. Sutton Court H60-H11 S14762 Sutton Court V236619 040705 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6 - 10 Residents are consulted on all aspects of daily living and their needs and preferences are clearly outlined in individual care plans. Detailed risk assessments and positive relationships with staff enable residents to make safe choices about their daily lives and increase their independent living skills. Residents attend regular reviews and participate in residents meetings, which allows them to be involved in decisions about the care they receive and the way the home is run. EVIDENCE: Staff spoken to on the day of inspection, were aware of individual needs of the residents and how to meet them. This was supported by detailed care plans seen on file and observations by the inspector. Care plans were very detailed, and related to all aspects of health, personal and social care needs. The plans were clear and easy to follow which means staff can transfer the information into daily practice. The inspector viewed minutes of residents review meetings. Residents attendance at regular reviews allows them to be involved in the decision making about their care and ensures information is up to date and accurate. Sutton Court H60-H11 S14762 Sutton Court V236619 040705 Stage 4.doc Version 1.40 Page 11 The inspector noted there was detailed information on each file relating to specialised needs of individuals such as epilepsy and diabetes. This was supported by evidence of staff training, ensuring all aspects of individual care needs are being met appropriately within the home. Residents spoken to by the inspector were vocal about their needs and seemed fully aware of what was going on within the home. Residents are encouraged to make decisions by staff about their lives. Risk assessments seen on file support this process and promote individuals to live as independently as possible. All information relating to residents care is stored securely in the staff office to ensure confidentiality. Sutton Court H60-H11 S14762 Sutton Court V236619 040705 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11 - 16 Residents enjoy a flexible routine within the home and appropriate activities and opportunities for personal development are provided. Residents are able to go out independently or with staff to local community events, day centres, college and leisure activities. EVIDENCE: The home owns an 8 seated car which provides transport for residents to go out to college, day trips or private appointments. A weekly programme of residents daily routines and activities was displayed on the notice board. This included college attendance, day centres and leisure activities such as swimming, bingo, music and dance and horse riding. The manager stated the home was flexible and would support residents to pursue any activity of interest. Residents are supported to develop independent living skills within the home such as cooking, washing and tidying their rooms. Assistance and encouragement is provided by staff when required. Sutton Court H60-H11 S14762 Sutton Court V236619 040705 Stage 4.doc Version 1.40 Page 13 Any limitations on residents in terms of their behaviour or health needs are agreed in the care planning and review process with the service users involvement. The parents spoken to by the inspector praised the home for the social and learning opportunities made available to the residents particularly, in respect of college attendance. All said they were made welcome and are able to visit anytime. One resident is taken home by staff, to see his mother on a regular basis, as she is unable to travel. Sutton Court H60-H11 S14762 Sutton Court V236619 040705 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 & 19 Service users receive personal care and support as detailed in their care plans. All the care plans examined showed detailed information and action plans relating to physical and emotional needs of each resident. Observations and feedback from residents and their relatives showed these needs were being met appropriately by the home. EVIDENCE: Policies and Procedures relating to all aspects of healthcare and medication were up to date and in place, which ensures good staff practice is upheld. 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 community. A key worker system is in place to enable residents to talk through day to day issues and any aspect of their care. Staff support individuals to access community agencies when needed and will accompany residents to appointments as required. Sutton Court H60-H11 S14762 Sutton Court V236619 040705 Stage 4.doc Version 1.40 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 & 23 The home has a complaints log in place which is supported by an up to date complaints policy and procedure. A complaints procedure is available to service users and their families in the Statement of Purpose and Service Users Guide. It was clear all residents spoken to felt listened to and able to vocalise any issues of concern or complaint. Parents spoken to stated they felt able to approach the staff and discuss anything they needed to. The home provides mandatory training for all staff in respect of working with vulnerable adults. 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. The complaints log was seen and there have been no official complaints at the home for over a year. Residents have regular meetings which provides them with a forum to talk about anything of concern. In addition to this, the key worker system provides residents with the opportunity to discuss issues on a one to one basis. Records show staff have received training in dealing with challenging behaviour and working with mental illness. The manager stated the home has a No Restraint policy and relies on staff training and knowledge to recognise triggers and calm situations where conflict may arise. Observations, feedback and residents review reports showed this approach is effective and has positive outcomes for service users. Sutton Court H60-H11 S14762 Sutton Court V236619 040705 Stage 4.doc Version 1.40 Page 16 In addition, the majority of staff have completed mandatory training 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. Adult Protection policies and procedures are available to staff alongside County Procedures and guidelines in the staff office. Sutton Court H60-H11 S14762 Sutton Court V236619 040705 Stage 4.doc Version 1.40 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24 - 30 Some improvements have been carried out since the last inspection. The communal areas and residents bedrooms have been redecorated. The inspector noted that the landing carpet upstairs was heavily stained and needed to be replaced. A requirement has been made in respect of this. The home overall offered a comfortable and clean living space and the standards were met, therefore providing a good outcome for residents. EVIDENCE: The home has recently been redecorated and 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. Residents rooms were a good size and furnished in their individual styles with personal possessions and pictures. One resident proudly showed his pictures, whilst another showed his video collection and family photos. Sutton Court H60-H11 S14762 Sutton Court V236619 040705 Stage 4.doc Version 1.40 Page 18 Some residents rooms are sparsely furnished with nothing on the walls. This was due to repeated damage and the need to keep the residents safe. Where this occurred details were recorded on individual care plans. One resident told the inspector she ‘didn’t have a lot because she just smashed it up’ when asked if she would like more furniture she stated ‘ I like it as it is’. Another resident had scribbled all over her newly painted bedroom walls and door. Staff had left it as the resident had said it was her ‘art’ and wanted to keep it. One resident suffers from seizures during the night and has been provided with foam mats around his bed to minimize injury. A monitor has been placed in his room to alert staff to seizures whilst maintaining his privacy. All bedrooms have locks on the door and lockable cabinets for residents to store items of value. There are suitable toilets and washing facililites throughout the building. A laundry room provides a large washing machine and tumble dryer. A fire alarm and emergency lighting system is in place throughout the home. Sutton Court H60-H11 S14762 Sutton Court V236619 040705 Stage 4.doc Version 1.40 Page 19 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31 - 35 The staff employed at Sutton Court have all been recruited and trained to recognise individual needs of residents and work effectively as a team to meet those needs in a professional way. EVIDENCE: Duty rotas seen on the day of inspection indicated staff were on duty in sufficient numbers and with a good gender/skill mix to meet residents needs. On arrival staff check the communications book and diary to get an update of issues relating to the residents and are allocated duties to fulfil during their shift. This provides staff with clear roles and enables them to work efficiently within the home. Training records indicated the majority of staff have completed inductions and a mandatory training programme which includes specialist subjects relating to the residents care needs such as challenging behaviour, epilepsy, mental health issues, assessing risk and adult protection. The rolling training programme ensures by the end of 2005 all staff will have completed relevant training within the home. Sutton Court H60-H11 S14762 Sutton Court V236619 040705 Stage 4.doc Version 1.40 Page 20 The staff spoken to by the inspector were confident in their roles, enjoyed working at the home and very keen to say how supported they felt by the senior staff. Staff attend regular meetings which provides support and enables them to participate in decision making processes about care provision at the home. Sutton Court has an up to date recruitment policy and procedure in place. All staff employed undergo CRB checks which reduces risk to vulnerable residents and ensures staff are able to competently fulfil their roles. Observation and feedback from residents and their relatives conclude the staff and senior management value the residents ability to live life to the fullest extent and are committed in supporting them to do so. Sutton Court H60-H11 S14762 Sutton Court V236619 040705 Stage 4.doc Version 1.40 Page 21 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 38, 41 & 42 Residents benefit from a well run home and are safe guarded by the homes policies, procedures and systems. The health, safety and welfare of residents are promoted and protected through good, clear systems and record keeping. The inspector concluded the management of the home was competent and overall committed to the best interests of the service users. EVIDENCE: The home has comprehensive policies and procedures in place in line with current legislation to safeguard the interests and rights of the residents and staff. Staff are given clear guidance from the systems in place to work effectively with the residents whilst maintaining accountability. The inspector examined all health and safety records including fire checks, accident book, maintenance checks, regulation 22 reports and risk assessments. All were found to be up to date and in good order. Sutton Court H60-H11 S14762 Sutton Court V236619 040705 Stage 4.doc Version 1.40 Page 22 The clear administrative systems promote all aspects of health and safety within the home. This is monitored by the manager and her deputy on a regular basis. It was evident the management style at the home suits the residents and staff team, enabling them to develop within the environment. Residents were seen to be confident in expressing their views and staff responded with consideration and respect, reflecting a positive ethos within the home. Sutton Court H60-H11 S14762 Sutton Court V236619 040705 Stage 4.doc Version 1.40 Page 23 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 3 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Sutton Court Score 3 3 3 3 Standard No 37 38 39 40 41 42 43 Score 3 3 x x 3 3 x H60-H11 S14762 Sutton Court V236619 040705 Stage 4.doc Version 1.40 Page 24 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 24 Regulation 23 (2) Requirement The registered person shall ensure the internal premises is kept clean and in a good state of repair (Upstairs landing carpet) Timescale for action 21st Novenber 2005 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 Good Practice Recommendations Sutton Court H60-H11 S14762 Sutton Court V236619 040705 Stage 4.doc Version 1.40 Page 25 Commission for Social Care Inspection 2nd Floor Ridgeworth House Liverpool Gardens Worthing West Sussex National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Sutton Court H60-H11 S14762 Sutton Court V236619 040705 Stage 4.doc Version 1.40 Page 26 - 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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