Inspection on 08/07/08 for Sutton Hall & Sutton Lodge

This inspection was carried out on 8th July 2008.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Sutton Hall & Sutton Lodge 09/07/07

Sutton Hall & Sutton Lodge 25/01/07

Sutton Hall & Sutton Lodge 07/09/06

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Ravensworth Lodge

Abbey The

Snydale Care Home

Larchfield Manor

Hawkhills

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Carentan House

Extracts from inspection reports are licensed from CQC, this page was updated on 28/09/2008.

CARE HOMES FOR OLDER PEOPLE Sutton Hall & Sutton Lodge Cornmill Walk Off Sutton Lane Sutton in Craven BD20 7AJ Lead Inspector Karen Westhead Key Unannounced Inspection 8th July 2008 08:45 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 Hall & Sutton Lodge DS0000065908.V368753.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 Hall & Sutton Lodge DS0000065908.V368753.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Sutton Hall & Sutton Lodge Address Cornmill Walk Off Sutton Lane Sutton in Craven BD20 7AJ 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) 01535 635329 01535 634989 www.orchardcarehomes.com Orchard Care Homes.Com Limited Manager post vacant Care Home 60 Category(ies) of Dementia (60), Old age, not falling within any registration, with number other category (60) of places Sutton Hall & Sutton Lodge DS0000065908.V368753.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home with nursing - Code N, to service users of the following gender: Either, whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP, Dementia - Code DE. The Maximum number of service users who can be accommodated is: 60 9th July 2007 2. Date of last inspection Brief Description of the Service: The home, which was built in 2006, is split into two parts Sutton Lodge and Sutton Hall. The home is owned by Orchard Care Homes and is in Sutton in Craven, on the outskirts of Crosshills. The home is near to the towns of Keighley and Skipton. There is ample car parking for visitors and staff. A change in accommodation has meant the home is now split into an upstairs and downstairs unit. The ground floor – known as Sutton Lodge provides nursing care for people who have a diagnosis of dementia. People living on this floor have access to the conservatory and an enclosed garden. There are digital locks on the doors leading from this area to ensure the safety of those who may leave the area unescorted. Sutton Hall is on the upper floor and is used by people who require nursing care due to their physical needs. They are able to use the garden but this requires them to use the lift. A passenger lift is available between the floors. policy. The home has a no smoking The cost of a week’s stay on 8th July 2008 ranged from £585 to £705, depending on the type of room and length of stay in Sutton Hall. To stay in Sutton Lodge the cost ranged from £620 to £750. There are extra costs for hairdressing, newspapers, chiropody and toiletries. The fee does include the price of travel if the home organises entertainment away from the home. A copy of the most recent inspection report is available at the home on request. Sutton Hall & Sutton Lodge DS0000065908.V368753.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 1 star. This means the people who use this service experience adequate quality outcomes. The inspection process included looking at the information we have received about the home since the last key inspection on 9th July 2007. At the last inspection the manager had recently left. A new manager has now been appointed by the company and has yet to be registered with the Commission for Social Care Inspection (CSCI). The purpose of this inspection was to look at how the needs of people living in the home are being met. This unannounced visit was done in one day; one inspector visited the home between the hours of 8.45am and 4.40pm. During the visit people living in the home, visitors, staff and management were asked about their views and opinions about the home and their experiences. Various records including care records were examined. Parts of the building were seen, including communal areas and some bedrooms. Before the visit, surveys were sent to the home to be given to people living in the home, their relatives, staff and health care professionals involved with the home. In total 24 surveys were returned. Before the visit a self-assessment form (AQAA) was sent to the home, this is an annual requirement. It was returned when due and gave us the information we had asked for. This report incorporates the information we have received from various sources including our visits to the home, the surveys and the home’s self-assessment. What the service does well: These are some of the comments we received from relatives of people living in the home: • • “The regular relatives/carers meetings are a great help. A good chance to discuss issues in a group with the manager.” They “help, care and encourage patients to do things for themselves within their capabilities and understand when they do not feel like doing things suggested.” For example if a resident does not feel like going DS0000065908.V368753.R01.S.doc Version 5.2 Page 6 Sutton Hall & Sutton Lodge • • • • • into the dining room to eat, the meal is brought to them in their room if that is what they are wanting. They are a team of “very caring nursing staff and dedicated care assistants and domestics. They have very patiently worked through my relatives recent difficulties.” “He seems content and satisfied and says he enjoys the meals.” My relative “laughs all the time and today they were having an activity which was for Ascot racing, they were having strawberries and chocolates and had hats on.” “The home is clean, residents are well fed and they respond to emergencies and problems.” “I have nothing but admiration for the patience, dedication and manner in which staff and carers treat their clients.” People living in the home told us the • staff are “doing a very good job” and that they always received the medical support they needed and that staff listened and acted on what they said. Health care professionals said: • There are “caring staff” who are “good with patients”, they are “efficient” and have a “good relationship” with us. • “Good care of patients basic needs” and “staff are available to discuss/review patients” when the GP visits. People are encouraged to visit the home before making a decision about moving in. Someone from the home visits people before they move in to find out about their needs and to give them information about the services provided. There is good access for people with disabilities, there is a ramp at the front of the home, and there is a passenger lift to all floors. In the AQAA the manager said the service was good at providing 24 hour nursing care for people in a clean and friendly environment. He said they aimed to recognise everyone as an individual and tried to encourage them to reach their full potential at all times. The comments received in the surveys support this. Staff surveys showed that staff felt generally well supported by the management team. The areas where they felt improvements could be made are listed in the section below. The standard of care delivered is good overall however, as described in this report, this is sometimes compromised by the lack of up to date documentation, when peoples’ privacy and dignity is overlooked and the lack of attention given to the administration of medication. What has improved since the last inspection? Sutton Hall & Sutton Lodge DS0000065908.V368753.R01.S.doc Version 5.2 Page 7 There were five requirements at the last inspection. Three have been met. Medication with a limited number of days of use is now dated when opened. This makes sure medication, such as eye drops, are not kept after their use by date. Staffing numbers are reviewed regularly to make sure staff are properly deployed in the home and pre-employment checks are now carried. This means only people who are suitable to work with vulnerable people work at the home. Two of the requirements have not been met. Documentation relating to the monitoring of fluid and food intake was again found to be significantly out of date and the recording of medication did not accurately reflect the medication being given to residents. The manager thinks the change in the way they have moved the specialist areas into separate floors rather than two wings, meaning staff had to travel between floors, has been an improvement in how they deliver the care. What they could do better: Some relatives, who completed a survey, highlighted what they thought could be improved on. They said: • “lost property should be better organised”; • “to refit some toilet roll holders”, their point was that if people with dementia cannot see the toilet roll then how can they be expected to use it; • “there is a large turnover of staff which leads to problems with the continuity of care. This might be due to the conditions and terms of service”, thought the relative. Some of the staff team said in their survey that their pay should be reviewed, particularly in Sutton Lodge where the demands are higher; that the training should be more accessible and communication did not always work well between the laundry process and the rest of the home. These views were shared with the manager. As noted above two of the requirements from the last inspection remain unmet. Documentation relating to the monitoring of fluid and food intake was again found to be significantly out of date and the recording of medication did not accurately reflect the medication being given to residents. In the AQAA the manager feels they could make improvements in the activity programme by assessing the needs of individuals and making sure they are encouraged to make choices for themselves. Two new requirements were highlighted. Steps need to be taken to make sure the privacy and dignity of people receiving personal care is upheld. Communal areas must not be used as other people may wander in or be present. Also, Sutton Hall & Sutton Lodge DS0000065908.V368753.R01.S.doc Version 5.2 Page 8 the records showing what care people are receiving and the name of the person giving that care need to be kept up to date. 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 Hall & Sutton Lodge DS0000065908.V368753.R01.S.doc Version 5.2 Page 9 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 Hall & Sutton Lodge DS0000065908.V368753.R01.S.doc Version 5.2 Page 10 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): 2 & 3 Standard 6 does not apply. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. People are given information about the range of services provided and people’s needs are assessed before they move in. EVIDENCE: People living in the home said they or their families were given information about the home before they moved in. Some people said they had visited before deciding to move in and others said the home had been recommended to them. One person said the kindness and understanding of the staff had helped their relative during the settling in period. People’s needs are assessed before they move in to make sure the home will be able to meet their needs. Sutton Hall & Sutton Lodge DS0000065908.V368753.R01.S.doc Version 5.2 Page 11 People gave different responses when asked if they had a received a contract. The inspector was told by the manager that in many cases relatives or advocates had been involved in this and people living in the home had been happy for this to happen. The home does not provide intermediate care. The manager is looking at ways to improve the admissions process further. Where possible pre admission assessments are going to be carried out by the named nurse or named carer who will be on duty on the day the person visits or is admitted. Sutton Hall & Sutton Lodge DS0000065908.V368753.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): 7, 8, 9 & 10 People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. Overall people’s needs are met but documentation does not reflect the care being given or the medication being given. People’s privacy and dignity is not maintained all the times. EVIDENCE: During the visit 9 care plans were looked at and these were cross-referenced with other documents being kept in the home. A number of concerns relating to the administration of medication and the way staff were monitoring the fluid and food intake of people being looked after in bed were highlighted. It was also clear that although people in bed were having their positions changed to help prevent the development of pressure sores, this was not being recorded satisfactorily. The home uses a method of recording which shows when each person was given a drink, ate or was repositioned. The details show the amount of fluid taken, what the person had to eat, what position they were left in (if they are Sutton Hall & Sutton Lodge DS0000065908.V368753.R01.S.doc Version 5.2 Page 13 turned to relieve pressure on any part of the body) and the care they have received. It was of concern to find that each of the four record charts looked at were significantly out of date and there were gaps in the timings of each entry ranging from over five hours and as long as twenty four hours. For example, one record had stopped being completed on 2nd July, another on 3rd July, and two others on 6th July. The inspector could see that the residents had been made comfortable, they were in freshly made beds, had been helped to wash and attend to their oral hygiene. There was evidence in their bedrooms, which showed they had been receiving drinks and meals, however this was not being recorded. Therefore the care being delivered was not being reflected in the records. Staff confirmed the care they had given that morning but said they often forgot to complete the records. Specialist mattresses and cushions were in place for people who are at risk of developing pressure sores and staff consult with the district nursing teams to make sure people have access to the correct equipment. There were risk assessments in place for example to identify the risk of falls and these were up to date. The daily notes are fairly detailed. It was evident reading them that some jargon is used, which does not give the reader an accurate picture of how the person is feeling or wishes to be treated. The use of plain English in records was discussed with the manager. People told the inspector that they got up and went to bed when they choose. The manager said he was trying to involve relatives and residents more in the care planning process and was planning to discuss this at the next relatives meeting. The majority of relatives who completed our surveys said they are happy with the care provided. One person said, “The standard of care is excellent”. Another said the home “always contacted the doctor when necessary” and that they had access to a chiropodist, hairdresser and optician. The health care professionals who completed surveys commented favourably about the home. Medicines are stored safely in the home. Staff are monitoring the temperature of the medication room, which has exceeded the recommended levels. Work has been done to improve ventilation, but the manager still thinks the temperature is still too high. The records relating to the medication given to people was checked against the medication being stored. In one case the record of medication had been signed for, indicating it had been given to the person, but the tablet was still in the packaging. In another instance, medication had not been signed for but Sutton Hall & Sutton Lodge DS0000065908.V368753.R01.S.doc Version 5.2 Page 14 the resident had received it. There were also other examples of where the medication record was not an accurate reflection of the medication people had either been given or not. During the visit a chiropodist was carrying out treatments. This was being done in a communal area, the conservatory, in full view of others and compromised the dignity and privacy of the individual being treated. The inspector talked to the manager and immediately asked for an alternative area to be used, ideally the resident’s own bedroom. Sutton Hall & Sutton Lodge DS0000065908.V368753.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): 12, 13, 14 & 15 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. The home provides a variety of social activities and supports people in keeping in touch with their family and friends. EVIDENCE: People, who were able to share their experiences, said they generally made their own choices about their daily lives. Some people prefer to stay in their bedrooms rather than use the communal areas and this is respected. People seemed to have a choice about where they sat and staff said they encouraged movement around the home so that people could mix and join in different activities. On the day of the visit, the televisions were only on when people wanted to watch something, other times there was either music in the background, music on for entertainment or on some occasions the lounges were quiet. People said they appreciated the quiet sometimes rather than there being a constant noise. Staff were overheard asking people living in the home if they wanted music on and what they preferred. Sutton Hall & Sutton Lodge DS0000065908.V368753.R01.S.doc Version 5.2 Page 16 Planned activities are arranged every afternoon. People living in the home said there are usually activities for them to take part in if they want to. Activities include card games, bingo, visiting entertainers, painting and occasional outings. Two relatives said the home provides activities, trips out and entertainment. They said staff take their relative out in the garden when the weather is fine. All of the people who commented said the meals were “very good” and that there was plenty of choice. The inspector watched the main meal being served on Sutton Lodge. It was well cooked, warm and well presented. Cold drinks were served with the meal and tea was offered at the end. There was a choice of main meal and dessert. Staff made a lot of effort to make the meal time a pleasant social event for people. People were given time to eat at their own pace, specialist cutlery and crockery was being used and staff helped those needing assistance in a discreet and respectful manner. People living in the home are able to have their hair done weekly by the hairdresser. At the moment they are having their hair washed in one bathroom and then being taken to a spare bedroom to have it dried, cut or set. It is recommended that the organisation look at ways of dedicating one area to this. At the time of the visit the hairdresser was using an empty room, which was also being used as a storage area for unused beds. The AQAA shows that there are plans for the garden area to be developed to include a sensory garden. Plans are also being made to put additional memory boards and displays up around the corridors in Sutton Lodge. Sutton Hall & Sutton Lodge DS0000065908.V368753.R01.S.doc Version 5.2 Page 17 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. People are safeguarded from harm and complaints are taken seriously. EVIDENCE: There are safeguarding procedures in place so that staff know what to do if they suspect abuse may have occurred. Talking with staff it was clear that they understood the procedure and felt confident they could report this to a senior member of staff. As part of the quality assurance scheme in the home, complaints are reviewed on a monthly basis. At the time of the visit there were no complaints being dealt with by the home. The manager said they liked to deal with complaints at a local level if possible and felt sure that the regular relatives meetings and ‘open door’ policy meant that things were not being missed or were allowed to get out of hand. There is a clear complaints procedure, which is displayed in the home. It is also handed out with the Service User Guide, which is given to people in the home or their representatives. Sutton Hall & Sutton Lodge DS0000065908.V368753.R01.S.doc Version 5.2 Page 18 All the surveys returned to CSCI by people in the home, their relatives and the staff showed that they knew how to complain or would know who to speak to if they needed to raise an issue. Sutton Hall & Sutton Lodge DS0000065908.V368753.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 22, 25 & 26 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. The home provides a pleasant, safe and suitably equipped place for people to live. EVIDENCE: The home is purpose built and there is a range of equipment which staff have been trained to use for example hoists and bath aids. This means they can move and transfer people safely and in comfort. Staff were seen explaining to people what they were going to do before they used equipment, such as hoists. When people were being hoisted staff paid attention to their dignity by making sure their legs were covered and by using minimal fuss. This meant the person was in the hoist for a shortest length of time. Sutton Hall & Sutton Lodge DS0000065908.V368753.R01.S.doc Version 5.2 Page 20 Everyone who completed a survey said the home was always or usually clean and fresh. On the day of the visit the home was very clean, there were no unpleasant odours and staff clearly take a pride in their work. This is an improvement from the last inspection where there had been an offensive smell of urine in the communal areas. One visitor told the inspector that it was important to their relative that her surroundings were clean and tidy, that is what she liked at home. She said her relative’s room was “spotless” and staff made sure the bins were emptied and her bathroom was kept clean. The records showed that the hoists are serviced at the required intervals to make sure they are safe to use. The bathrooms were warm and clean. Therefore, provide a comfortable environment for people to bath in. Most people have some of their personal belongings in their bedrooms and staff said people are encouraged to make their bedrooms “their own.” One group of visitors said they had been asked to bring as many personal items from their relatives own home when she moved in. They said this had helped her settle. People said clothes sometimes go missing or get mixed up. They said they eventually got them back. A comment by a relative in one of the surveys said they thought the “lost property should be better organised.” The manager said there had been some improvements in this area. The laundry area is well organised. One relative had said the home should “refit some toilet roll holders”; their point was that if people with dementia cannot see the toilet roll then how can they be expected to use it. The operations manager had been able to find a supplier of the type they were wanting and was confident this would be sorted out within the next three weeks. The home employs a handyman who is responsible for routine maintenance and the monitoring of some health and safety aspects of the home. Staff receive fire training and fire equipment is routinely serviced. On the day of the visit a private company was providing fire training to staff. This included practical demonstrations and a lecture. A fire risk assessment of the premises has been completed. A record of hot water temperatures is kept to ensure the delivery of safe hot water and prevent the risk of scalding. Some areas of the home are looking worn and “tired.” The manager said this was an area of work they were looking at improving in the next twelve months. A schedule of redecoration was being planned. Sutton Hall & Sutton Lodge DS0000065908.V368753.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. Only people who are suitable to work with vulnerable adults are employed. Staff are trained and have the skills and abilities to carry out their jobs. EVIDENCE: These are some of the things people living in the home said about staff: • • • • “The staff are very diligent in letting our family know of any illness or problems” with my relative. At present the staff are “a good team.” “The staff understand my relative very well. They have recently been spending time with him, helping with things he likes to do.” “The attitude and manner of staff towards my relative so far has been excellent.” During the visit staff were seen responding quickly and appropriately to requests from people living in the home. Not all their time was taken up with tasks around personal hygiene, such as assisting people to the toilet. Staff were seen sitting with people, talking to them and helping them to join in activities such as reading the paper or painting. Staff explained when the home is full the staffing levels increased. Sutton Hall & Sutton Lodge DS0000065908.V368753.R01.S.doc Version 5.2 Page 22 On the day of this visit there were 52 people living in the home. The staffing arrangements had been adjusted to make sure there were enough staff on each floor and on each shift to meet their needs. There were a minimum of 3 nurses and 8 care assistants on duty all day, until the night staff started work. This is increased by one nurse when the home is full. The manager and deputy work along side the staff team and at times are included in the staff numbers. There is a team of ancillary staff, including a cook, a laundry assistant and domestic staff. The company is trying to attract new staff to take up vacancies. At present agency staff are used to cover the shortfalls. The inspector picked up some problems with the use of agency staff at the time of the visit and this was discussed with the manager. For example an agency worker was in the home but was not wearing a uniform and did not appear to know what their role or function was. The manager was able to give examples of where the use of agency staff had been good, for example when the same staff had been used and become familiar with the home, other staff and the people living in the home. He agreed to look into the points discussed. Staff spoken to and training records examined showed that everyone receives induction training. Some staff said they were waiting to start or complete their induction training but that they had had other training in the meantime. The manager said there is a rolling programme of training. Staff said the training they received was relevant and helped them to understand the needs of people living in the home. Three members of staff said they felt supported by the nurses on duty who had “taught them a lot” about their jobs and they said they were always available to advise. The training programme seen covers all mandatory training e.g. fire training, moving and handling, food hygiene and health and safety. Specialist training includes dementia care, nutrition, medication and care planning. Nearly half of the staff have achieved their national vocational training at level 2 in care or above. Others are waiting to start it. The manager explained the recruitment process. Application forms are completed and an interview takes place. References are sought and this includes a Criminal Records Bureau check, prior to staff starting work. Head office administrative staff process job applications. All of the staff who completed a survey confirmed they had provided this information before starting work. Since the last inspection there has been an improvement in the quality of pre employment checks. People living in the home said that they could choose when to go to bed and when to get up. This was difficult to assess when talking to some of the residents, who found it difficult to give their views. However from what staff said and the notes in their daily records it would appear that there is a choice and that the routines are resident led rather than for the convenience of staff. On the day of the visit some people were still in bed at 10am. Staff said that Sutton Hall & Sutton Lodge DS0000065908.V368753.R01.S.doc Version 5.2 Page 23 this was because the person was still very sleepy and it was their normal routine not to get up too early. Two of these people were being nursed in bed and had already been given their breakfast. Sutton Hall & Sutton Lodge DS0000065908.V368753.R01.S.doc Version 5.2 Page 24 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. The home is satisfactorily managed. It is run in the best interests of the people who live there. EVIDENCE: Since the last inspection the company has appointed a new manager. He has applied to be registered with CSCI. This involves an interview and checks to make sure they are suitable. There are clear lines of accountability within the organisation and the home’s manager is supported by a senior area manager. People told us they are kept informed of anything that affects their relative and that the home helped them to keep in touch with them. The home has Sutton Hall & Sutton Lodge DS0000065908.V368753.R01.S.doc Version 5.2 Page 25 monthly meetings for relatives and carers. The timings of these are varied so that different groups of relatives have an opportunity to attend and share their views. On the whole, staff said they felt supported by the management team. One member of staff said in their survey, about the manager, he is “easily approachable and easy to talk to.” Some said they felt communication within the home could be improved particularly with regard to new admissions and some changes in people’s conditions. They said they were given opportunities to discuss their strengths and areas for development. The home does not collect pensions for people or hold personal money to be spent on people’s behalf, for example to pay for hairdressing. This is organised with relatives where appropriate and bills are sent out regularly. There is a quality assurance scheme where monthly audits of key aspects of the business are monitored. The area manager visits at least monthly to check audits and agree an action plan where any shortfalls are identified. There are policies and procedures covering all aspects of the home. Staff said they could refer to these when necessary and had been given policies to read in the past. The home works to a clear health and safety policy and regular safety checks are carried out. Records of checks and staff training are well kept and up to date. Staff training programmes include Health and Safety training. Sutton Hall & Sutton Lodge DS0000065908.V368753.R01.S.doc Version 5.2 Page 26 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 2 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X 3 X X 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Sutton Hall & Sutton Lodge DS0000065908.V368753.R01.S.doc Version 5.2 Page 27 Are there any outstanding requirements from the last inspection? Yes 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 OP8 Regulation 12 (1) (a) Requirement The registered person must make sure where a persons health needs dictate, that either the amount of fluids or food taken needs to be recorded and monitored. This requirement is outstanding from the previous inspection on 9th July 2007. 2. OP9 13 (2) The registered person must make sure the administration of all medicines is accurately recorded. This means that there is a record of medication being given as prescribed. This requirement is outstanding from the previous inspection on 9th July 2007. 3. OP8 12(1)(a) The registered person must make sure that the records are kept up to date to show what care people are receiving and the name of the person giving DS0000065908.V368753.R01.S.doc Timescale for action 24/08/08 24/08/08 24/08/08 Sutton Hall & Sutton Lodge Version 5.2 Page 28 that care. 4. OP10 18 The registered person must make sure the privacy and dignity of people receiving personal care is upheld. Communal areas must not be used as other people may wander in or be present. 24/08/08 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 OP7 Good Practice Recommendations The registered person should provide training and guidance to staff on the use of plain English when completing records. The registered person should look at providing a more suitable area for people living in the home to have their hair done. 2. OP12 Sutton Hall & Sutton Lodge DS0000065908.V368753.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Sutton Hall & Sutton Lodge DS0000065908.V368753.R01.S.doc Version 5.2 Page 30 - 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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