Inspection on 31/01/08 for Sutton Court Lodge

This inspection was carried out on 31st January 2008.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Sutton Court Lodge 22/01/07

Sutton Court Lodge 30/01/06

Sutton Court Lodge 28/09/05

Sutton Court Lodge 17/02/05

Sutton Court Lodge 06/09/04

Sutton Court Lodge 17/03/04

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

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

CARE HOMES FOR OLDER PEOPLE Sutton Court Lodge 2 Chesterfield Road Brimington Chesterfield Derbyshire S43 1AD Lead Inspector Susan Richards Unannounced Inspection 09:30 31 January 2008 st 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 Sutton Court Lodge DS0000020101.V354594.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. Sutton Court Lodge DS0000020101.V354594.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Sutton Court Lodge Address 2 Chesterfield Road Brimington Chesterfield Derbyshire S43 1AD (01246) 275703 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) Enable Care & Home Support Limited Vacant Care Home 9 Category(ies) of Learning disability over 65 years of age (9) registration, with number of places Sutton Court Lodge DS0000020101.V354594.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. That the home be registered for one named service user under 65. Date of last inspection 22nd January 2007 Brief Description of the Service: Sutton Court Lodge provides personal care and support for up to nine people aged sixty-five years and over with learning disabilities. The home has an agreed condition to their registration enabling them to accommodate one named person aged under sixty-five years. Sutton Court Lodge is a large detached house located in the village of Brimington, which lies approximately 3.5 miles to the north east of Chesterfield town centre. It is within easy walking distance of a local bus routes and shops and variety of shops and local amenities. Accommodation is to a high standard in terms of cleanliness, homeliness decoration and furnishings and is over two floors. There are two bathrooms and three toilets and a range of environmental adaptations and equipment are provided throughout the home to assist those who may have mobility problems. These include a stair/chair lift. Grab rails, corridor hand rails, an emergency call system and electric seat/hoist to the bath. There is a communal lounge and separate dining room with a loop system fitted in the lounge to assist those who may have hearing difficulties/hearing aids. Key information about the home is provided in formats suitable for people who live there, including fees charged, what they cover and arrangements for payment. Fees charged commence at £1,022 per week per person. This amount does include contributions via the local authority and primary care trust, together with an individual resident contribution of £98.60. There are additional charges for hairdressing, private chiropody, personal toiletries, dry cleaning, transport for holidays and the cost of some social outings. A copy of the most recent inspection report is also available for people to access at the home. Sutton Court Lodge DS0000020101.V354594.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is [3 star]. This means the people who use this service experience [excellent] quality outcomes. For the purposes of this inspection we have taken account of the information we hold about this service. This includes our previous key inspection report of 12 January 2007. At this inspection there were eight people accommodated at the home. We used case tracking as part of our methodology. This involved the random sampling of two people, whose care and service provision was more closely examined, by talking with them, looking at their care planning and associated health and personal care records and their private and communal accommodation. We also sent out written surveys to all residents and to ten staff before our visit to the home. Our Expert by Experience visited the home with us. His brief was to spend time talking people about their daily lives and experiences at the home. In particular to focus on how their individual rights are promoted with regard to their dignity, privacy, choice, respect and as to how they are enabled to maintain their individuality and independence, both in and outside the home. We spoke with staff about the arrangements for their recruitment, induction, training, deployment and supervision. Examined related records and observed some of staffs’ interactions and approaches with people. We spoke with the acting manager about her role and responsibilities for the management and administration of the home and examined associated records. All of the above was undertaken with consideration to the equality and diversity needs of people accommodated at the home. What the service does well: People are very well supported in choosing the home, with good opportunity to visit and ‘test drive’ the home. Their needs are effectively assessed in a manner, which best promotes their personhood. One resident said, ‘I visited here before I came. I have friends here and liked it very much.’ Sutton Court Lodge DS0000020101.V354594.R01.S.doc Version 5.2 Page 6 Our expert by experience said, ‘ the home stands out, as a really well run, happy, friendly place. I feel they should be held up as a excellent example to others.’ Peoples’ health, personal and social care needs are met in accordance with their best interests and choices. They are treated with the optimum of respect and their dignity and privacy upheld. One resident said, ‘Staff help me when I need help and are kind to me.’ The home’s philosophy to enable and empower people to live normal lives. Usually meets with people’s expectations, preferences and individual diversities. People receive a wholesome and balanced diet, in accordance with their wishes and any assessed dietary needs. Residents said, ‘Its good home cooking and we like it.’ People’s rights to complain, raise concerns and to assert their views are sensitively upheld by staff and they are suitably protected from harm and abuse. Peoples’ sense of belonging is well promoted within their environment, which is safe, clean and maintained to a high standard. One person said, ‘I chose to share a room with my friend. ‘We asked for new furniture and wallpaper. Our key worker has helped us to choose this and we are happy it is being done like we want.’ Overall, the home is well managed and run, in a manner that is usually in peoples’ best interests. What has improved since the last inspection? What they could do better: Provide that staffing numbers are always sufficient to ensure consistent staff support for people to access community facilities in accordance with their lifestyle preferences. An example is regular church attendance for those who wish. Sutton Court Lodge DS0000020101.V354594.R01.S.doc Version 5.2 Page 7 The acting manager should submit an application for registration with the Commission to ensure compliance with the provisions of the Care Standards Act 2000. A minimum of 50 of care staff should have achieved or be working towards at least NVQ level 2. Clear policy guidance should be in place for staff to follow in the event of emergencies and crises at the home. This should provide clear and separate reference to night staffing arrangements, which should be risk assessed with regular reviews. 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 Lodge DS0000020101.V354594.R01.S.doc Version 5.2 Page 8 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 Sutton Court Lodge DS0000020101.V354594.R01.S.doc Version 5.2 Page 9 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): NMS 1, 2 & 3. (NMS 6 is not applicable to this service). Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People are very well supported in choosing the home and their needs are effectively assessed in a manner, which best promotes their personhood. EVIDENCE: At our last key inspection we judged that people are provided with the information they need to enable them to make a choice about whether to live at the home. Although we said that prospective residents could not always be assured that their needs would be fully assessed before the moved into the home. We made one requirement at that inspection that, an up to date needs assessment must be completed for all new residents prior to their being Sutton Court Lodge DS0000020101.V354594.R01.S.doc Version 5.2 Page 10 accommodated in the home. This is complied with at this inspection (see below). In our annual quality assurance questionnaire completed by the home, they stated that they ensure suitable admission arrangements for people, including provision of key service information, individual needs assessments and opportunity for people to visit the home before they make a decision as to whether to live there. They say they always seek to improve their service and over the next twelve months aim to continue to promote a person centred approach in respect of individuals’ care and service provision. At this inspection we spoke with people we case tracked about the information they are provided with about the home and also about their needs and if they are discussed and agreed with them. We also looked at their recorded needs assessment information and spoke with staff about these. One of the people case tracked had moved into the home since our last key inspection. This person talked about the arrangements for their admission, the information they were given, which we looked at, and also about their needs and how staff supported them. They said they had chosen the home because they had friend who lived there and they had visited on a number of occasions before they moved there and had time to talk with staff and residents and ‘liked it very much.’ Information provided, including individual terms and conditions of residence, was set out in simple and suitable formats with large print and pictures and photographs. Both residents case tracked had signed their receipt of these. Comprehensive needs assessment information was recorded for both people, including a daily living plan. This was person centred and accounted for people’s stated wishes, preferences and expressed goals along with matters relating to their personal safety and risk. One person we case tracked said they knew some of the people who lived at the home before they came to live there and visited several times before moving in. Both said they had chosen to live there, that they were given information they wanted about the home and that they had a named staff member who acted as their key worker. The manager advised that the service guide was to be revised and republished given internal changes to the décor of the home and in order to reflect these. Sutton Court Lodge DS0000020101.V354594.R01.S.doc Version 5.2 Page 11 Sutton Court Lodge DS0000020101.V354594.R01.S.doc Version 5.2 Page 12 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): NMS 7, 8, 9 & 10 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People’s health, personal and social care needs are met in accordance with their best interests and individual choices. They are treated with the optimum of respect and their dignity and privacy upheld. EVIDENCE: At our last key inspection of this service we judged that people’s written care plans did not always effectively evidence or underpin people’s individual care. We also said that people were cared for respectfully and their privacy upheld. We made requirements at that inspection about ensuring peoples’ written care plans a always properly formulated in accordance with their risk assessed needs and that these are regularly reviewed and kept up to date. These are complied with at this inspection (see below). Sutton Court Lodge DS0000020101.V354594.R01.S.doc Version 5.2 Page 13 In our annual quality assurance questionnaire completed by the home they say that people’s rights are always promoted in respect of their daily living choices and their privacy and dignity and that, they receive the health care and support they need. They say they now ensure that people’s care plans and risk assessments are kept up to date and that over the coming 12 months they will continue to ensure that people’s health and personal care needs are met in accordance with their wishes and risk assessed needs. They also intend to seek and gain knowledge of the Mental Capacity Act. At this inspection we looked at the written care plans of those people case tracked and spoke with them about the care and support they receive, including the arrangements for their health care. We also looked at the arrangements for their medicines via case tracking and the overall systems in place, concerned with the ordering, receipt, storage, administration and disposal of medicines. Our Expert by Experience also spoke with people about how they are supported to make decisions about their lives and their daily living experiences at the home. In particular, he looked at how people’s individual rights are promoted with regard to their dignity, privacy, choice and respect. People’s written care plans were comprehensive and written in accordance with their individually risk assessed needs. They were reflective of individual’s diversity and recognised and specialist guidance concerned with older people and also those with learning disabilities. They were also person centred in their detail and accorded with what people said about the care they receive and what staff said about the care and support they provide for those people. Their health needs and interventions from outside health care professionals, together with outcomes of the latter were also well accounted for. These included routine health care screening/health checks. People spoken with said that they home looked after their medicines, which they preferred. The arrangements for their medicines were satisfactory. Records of administration, receipts and returns were properly maintained and suitable medicines storage facilities provided. Details of regular visits from the local community pharmacy advisor were also provided, which also indicate satisfactory arrangements. Staff confirmed they undertake suitable medicines training and that they are given the information they need to assist them in supporting people accommodated. There is also a quality monitoring system in place to monitor and ensure good practise with regard to medicines at the home. Sutton Court Lodge DS0000020101.V354594.R01.S.doc Version 5.2 Page 14 Our Expert by Experience gave the following feedback in relation to people’s rights and how they are promoted: Dignity People were talked with in a pleasant, friendly and respectful way by staff. Residents were asked if we could see their rooms and were genuinely pleased to show us [and seemed proud of their rooms]. Staff checked with residents if they were happy to have care tasks done at that moment [one resident needed some eye drops and wanted to stay sat at the table with us] People were nicely and individually dressed and took pride in their appearance. The handrails throughout the house meant that residents could get around safely on their own. Privacy Peoples’ own rooms felt very much ‘their’ own place. If people wanted to be on alone. That was respected and they were not forced to join in. [One resident was happy to talk to us, but wanted to stay where she was sitting, another stayed in the living room]. Respect People plan their personal care [with the help they need] and they all have person centred plans. Staff and residents seemed to get on very well. Staff is friendly, respectful and helpful. Comments received from residents included: ‘I like living here, staff are kind to me.’ ‘I chose to share a bedroom with my friend.’ ‘Staff help us when we want help.’ Sutton Court Lodge DS0000020101.V354594.R01.S.doc Version 5.2 Page 15 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): NMS 12, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home’s philosophy to enable and empower people to live normal lives. Usually meets with people’s expectations, preferences and individual diversities. People receive a wholesome and balanced diet, in accordance with their wishes and any assessed dietary needs they may have. EVIDENCE: At our last key inspection of this service we judged that varied activities and recreational pursuits are provided that meet with peoples’ expectations and preferences. That the meals are good, nutritious and appealing and, which residents say they like. In our annual quality assurance questionnaire completed by the home they say that they people are always supported and encouraged to make decisions about their daily lives and to be as independent as possible in their individual Sutton Court Lodge DS0000020101.V354594.R01.S.doc Version 5.2 Page 16 engagement in a variety of social, recreational and daily living activities of their choice. They say that over the last 12 months they have improved by enabling more choice of access for people at day care or evening centres and purchased a larger vehicle, which is adapted and equipped to enable those who may have mobility problems. They feel they could improve by providing more recreational outings for people, which they aim to achieve over the coming 12 months. At this inspection we spoke with people about their daily living arrangements and how they are helped to exercise choice and control over their lives, including activities, social and community contacts, meals and mealtimes. We also made general observations during our visit of activities people were engaged in. Our Expert by Experience’s brief was to spend time talking with people about their lives and experiences at the home, with emphasis as to how they are enabled to maintain their individuality and independence, whilst living together and also as citizens of the local community. Staff were observed to communicate well with people always gave time and were calm and patient in their approaches. All people spoken with said they were happy living at the home and enjoyed the activities they engaged in both in and outside in the local community. One person, case tracked spoke about their holidays and said ‘I really like going out to the day centre, where I meet with other friends.’ Another said she liked to go to the local church on Sunday’s and added, ‘My friend who I share my room with goes to a different church that she likes to go to.’ However, some did say that staffing arrangements sometimes caused difficulties with outings, mainly at weekends. One of the people case tracked said that this means she is only sometimes able go to church. (See Staffing section of this report). Another person case tracked had completed a satisfaction survey questionnaire from the home, choosing the ‘sometimes’ response to questions asked about staff availability to take them out, including going to church. People spoke about regular engagement in a variety of activities, including shopping, day centres, outings to pubs, garden centres. They also spoke about their shared responsibilities for household and domestic tasks and said that they discussed these are their regular meetings, along with planning and agreeing social events and trips out. Sutton Court Lodge DS0000020101.V354594.R01.S.doc Version 5.2 Page 17 All said they liked the food at the home. One person said, ‘its good home cooking and we like it.’ They said they are always involved in menu planning. The residents invited us to eat our lunch with them. Food provided was well presented and wholesome. All knew what was on the menu and were asked about how they would like it present, portion sizes etc. They also chose where they sat and those who needed assistance were given this in a discreet and sensitive manner. Many were looking forward to going to a birthday party that evening outside the home. Our Expert by Experience said: The home had a nice ‘homely’ feel and everyone we met was welcoming and seemed at ease with visitors. It seemed lovely place to live. Residents said it was “friendly” and when asked if there was anything they wanted to change or comment on, they said “No” and “its all fine”. Our Expert also made the following comments taken from what people told him about the home and what he observed: People told us about various activities in the home and in the community; and a wide range was talked about by residents, [who seemed keen on them], and staff. People can go out on their own or with help. They use the bus or the home’s car or walk. They choose where they want to go. If there is more than one room empty, residents can choose their room, as well as how it is decorated and what furniture they have. Residents take it in turns to say what the main meal will be that day, but if someone isn’t happy with that, there is always something else they can have. There is a smoking area outside for residents and staff; the ‘no smoking rule’ [in the house] was mentioned as the only rule. There are no restrictions on bedtimes. Some people need help to stick to their doctor’s advice [or Care Plan] about bedtime. Residents know they can talk problems over with people [staff, manager, advocates, friends] and know how to make a complaint. Staff said that friends and family are free to come to the house; I think this would be so from how welcoming the home was. People have independent advocates or support and know what advocacy is. Residents help cook and do things in the house [like laying the tables, tidying away, gardening…]. They get help from staff if they need it to do their own washing and chores. Residents are free to use the telephone and get support for this if needed. They go to local shops, pubs, clubs [and in Chesterfield] either on their own, with a member of staff or in a small group. Sutton Court Lodge DS0000020101.V354594.R01.S.doc Version 5.2 Page 18 They have house meetings and discuss how the home is run, issues in the house, where to go on trips and holidays. Residents have their own bank accounts and are given any help they need with managing their money. Sutton Court Lodge DS0000020101.V354594.R01.S.doc Version 5.2 Page 19 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): NMS 16 & 18 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People’s rights to complain, raise concerns and to assert their views are sensitively upheld by staff and they are suitably protected from harm and abuse. EVIDENCE: At our last key inspection of this service we judged that people’s welfare was safeguarded and that, residents concerns are taken seriously and are acted upon. In our annual quality assurance questionnaire completed by the home, they say that they provide people with a complaints procedure in a suitable format. Ensure access to advocacy where necessary and act upon any concerns people may raise. Have recognised systems and arrangements in place to safeguard people. They say they have improved by ensuring that all staff has all attended relevant training and updates concerning the safeguarding of vulnerable adults. Sutton Court Lodge DS0000020101.V354594.R01.S.doc Version 5.2 Page 20 They feel they could improve further by adding complaints and concerns to their residents’ meeting agenda on regular basis, which they aim to do so. At this inspection we spoke with people about raising concerns and making complaints, and looked at the home’s complaints record. People are provided with key information in suitable format, about how to make any concerns known when they are unhappy and how to complain and knew what they would do in any event. Staff spoken with is conversant with the home’s procedures in respect of their role and responsibilities in dealing with complaints and responding to and reporting suspected or witnessed abuse of anyone, including external joint agency procedures. They also confirmed suitable training arrangements, including safeguarding principles and procedures and also equal opportunities. During our visit we continually observed staff to listen and respond to people in an empathic and patient manner and also to encourage people to assert their views. Our expert by experience said ‘When one resident got upset, their problem was handled in a calm, quiet way that did not draw attention to it; they soon calmed down and staff took time to explain things to her and the other residents did not get upset by it. The Commission has not received any concerns, complaints or allegations in respect, of the home since the last key inspection. The home’s complaints record detailed one allegation made by a resident in respect of an incident, which had occurred whilst they were out at a day centre. We discussed this with the manager. The home had taken appropriate action in respect of this in order to safeguard that person from harm. Key concerns, views and requests made by people case tracked are recorded, within their own personal care files. Individual outcome for these and any action taken by the home is also recorded in their file in agreement with that person. Sutton Court Lodge DS0000020101.V354594.R01.S.doc Version 5.2 Page 21 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): NMS 19 & 26 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People’s sense of belonging is well promoted within their environment, which is safe, clean and maintained to a high standard. EVIDENCE: At our last key inspection we judged that people live in a home that is well decorated, comfortable and well maintained and meets with individual’s preferences. In our annual quality assurance questionnaire completed by the home, they say that they the home is clean and comfortable, safe, well furnished and equipped. They say they continue to ensure routine maintenance and renewal to the home and to consult with people about their environment. T Sutton Court Lodge DS0000020101.V354594.R01.S.doc Version 5.2 Page 22 At this inspection we looked at the private and communal facilities used by those people case tracked. Our expert by experience was invited by some residents to view their bedrooms. We also looked at the laundry facilities and arrangements at the home. All areas seen were safe, clean, comfortable and homely, odour free and furnished and decorated to a high standard, in consultation with people who live at the home. Our expert by experience commented, ‘The home is pleasant, clean and tidy.’ ‘The corridors had hand rails that fitted in well and meant that people could get around safely on their own.’ ‘People enjoyed showing us their own rooms, which are decorated how they wanted, with their personal things.’ Two of the people case tracked told us about new décor and furnishings they had chosen for their bedroom, due to be undertaken. Sutton Court Lodge DS0000020101.V354594.R01.S.doc Version 5.2 Page 23 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): NMS 27, 28, 29 & 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People are protected by the home’s recruitment practices and supported by staff that is reasonably well inducted and trained. However, some of the arrangements for staff deployment may not be in people’s best interests. EVIDENCE: At our last key inspection of this service we judged that the homes recruitment practices generally assisted to safeguard people and its commitment to training supported staff in the work they do. We recommended that there should be at least 50 of care staff with at least NVQ level 2. In our annual quality assurance questionnaire completed by the home, they say that they have a stable staff group who is reasonably well trained and experienced to meet the needs of people who live at the home. Although, they identify they could improve further on staff training within the management section and summary of AQAA. Dataset information provided there details there has been no change to the number of staff with at least NVQ level 2, being five staff out of a total of thirteen. Sutton Court Lodge DS0000020101.V354594.R01.S.doc Version 5.2 Page 24 At this inspection we asked people if staff are usually available when they need them. We asked staff (some by way of written survey and some at our visit, arrangements for their recruitment, induction, training and deployment. We also examined related records. People said that staff is usually available when they need them in the home, but not always sufficient for them to go out to places of their choice where they need staff support. Examples were given, including at weekends, when, if there are only two staff on duty, people who like to go to church are not always able to go. Staff spoken with also advised the same, although said the service is actively attempting to recruit new staff to vacant posts, which the manager confirmed to be the case. Staff duty rotas also confirmed feedback received from staff and people who live at the home with regard to staff deployment. All staff spoken with or surveyed, together with staff records examined, confirmed that satisfactory recruitment arrangements are in place. The majority felt that for the most part the arrangements for their induction and training are usually satisfactory, although one person did not feel adequately supported in these areas. Staff training records examined detailed a range of training opportunities, many accessed via a rolling programme, including core health and safety matters, equal opportunities and key areas of recognised good practise and clinical guidance, concerned with the care of older persons with learning disabilities. The majority of staff felt that the arrangements for staff deployment could be improved for the benefit of people living at the home and identified staff longterm sickness and staff vacancies to be significant contributing factors. Staff said that they tried, where possible, to provide additional cover, by working additional hours to those contracted for planned events. For example, on the day of our visit a number of residents were going out in the evening to a birthday celebration. Additional staff cover was planned to enable this to take place. We asked staff about the night staffing arrangements with regard to the provision of one staff and in the event of any crisis or emergency. There was a lack of clarity in terms of recognised procedures to follow in such an event and the manager confirmed that there was no written policy in place for staff to refer to in respect of this. (See management section of this report). Sutton Court Lodge DS0000020101.V354594.R01.S.doc Version 5.2 Page 25 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): NMS 31, 33, 35 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Overall the home is well managed and run, in a manner that is usually in peoples’ best interests. EVIDENCE: At our last key inspection of this service we judged that the home was well run in the interests of people living there, with a strong and approachable management team. Assisting to ensure peoples’ health, safety and welfare. Sutton Court Lodge DS0000020101.V354594.R01.S.doc Version 5.2 Page 26 We made two requirements. For the manager to submit her application for registration under the Care Standards Act 2000 to us and to ensure that radiators, which require guards fitted, are provided. In our annual quality assurance questionnaire completed by the home, they say the home is well managed and have identified improvements in aspects of their administration over the last twelve months. They aim to continue to ensure they have a staff team that meets people’s changing needs, to ensure staff safe working practises and to comply with relevant legislation and good practise guidance for their service. At this inspection we spoke with the manager about the need to ensure she submits an application for registration to us, given the period of time she has been acting manager at the home. The manager advised us of her progress with this process and agreed to undertake to submit her application, post haste. We also looked at what the home does to ensure it is run in people’s best interest. This included management arrangements for quality monitoring and assurance, consulting with people, ensuring people’s financial interests are safeguarded, communicating with and supporting staff and promoting safe working practises. We did this by talking with people about these, as may be relevant to them, making general observations in relation to safe practises and examining associated records. With the exception of one person, staff spoken with or surveyed said that communication systems in the home usually work well and that the manager either regularly or often meets with them to give them support and discuss how they are working. Residents spoken with said they have regular meetings and are asked about their lives at the home and listened to. They said they sometimes have written questions asking them what they think. Copies of these were available and looked at for those people case tracked. External management undertake regular visits and auditing in relation to the home’s service aims and objectives and records of these are kept. Comments made under the Staffing section of this report in respect of staffing arrangements at night and the lack of policy guidance for staff in the event of dealing with emergencies and crises, which may arise, apply here. Sutton Court Lodge DS0000020101.V354594.R01.S.doc Version 5.2 Page 27 The arrangements for the management and handling of people’s own monies were examined in relation to those people case tracked, who were in agreement with those arrangements, which are satisfactory. There are suitable arrangements in place to promote safe working practises, including staff training and the provision of equipment. Satisfactory and up to date information is provided regarding the maintenance of equipment at the home. Since our previous inspection of this service, risk assessments are completed for radiators in the home, with covers provided in accordance with those assessments. Sutton Court Lodge DS0000020101.V354594.R01.S.doc Version 5.2 Page 28 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 3 4 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 4 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 2 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 2 X 3 X X 3 Sutton Court Lodge DS0000020101.V354594.R01.S.doc Version 5.2 Page 29 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. Standard OP27 Regulation 18(1)(a) Requirement Staff numbers must be sufficient to ensure more consistent staff support for people to access community facilities in accordance with their known lifestyle preferences, for example church attendance. Timescale for action 30/04/08 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 OP31 Good Practice Recommendations The acting manager should submit an application for registration with the Commission to ensure compliance with the provisions of the Care Standards Act 2000, Section 11. A minimum of 50 of care staff should have achieved or be working towards at least NVQ level 2. Clear policy guidance should be in place for staff to follow in the event of emergencies and crises at the home. This should provide clear and separate reference to night staffing arrangements, which should be risk assessed with regular reviews. DS0000020101.V354594.R01.S.doc Version 5.2 Page 30 2. 3. OP28 OP33 Sutton Court Lodge Sutton Court Lodge DS0000020101.V354594.R01.S.doc Version 5.2 Page 31 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT 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. 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