Inspection on 09/11/05 for Sutton House Nursing & Residential Home

This inspection was carried out on 9th November 2005.

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

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

Other inspections for this house

Sutton House Nursing &... 26/11/08

Sutton House Nursing &... 15/01/08

Sutton House Nursing &... 22/06/06

Sutton House Nursing &... 26/04/05

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

CARE HOMES FOR OLDER PEOPLE Sutton House Nursing & Residential Home Kingfisher Rise Ings Road Sutton, Hull East Yorkshire HU7 4FL Lead Inspector Eileen Engelmann Unannounced Inspection 9th November 2005 09:30 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 House Nursing & Residential Home DS0000062875.V263407.R01.S.doc Version 5.0 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 House Nursing & Residential Home DS0000062875.V263407.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Sutton House Nursing & Residential Home Address Kingfisher Rise Ings Road Sutton, Hull East Yorkshire HU7 4FL 01482 784703 01482 377881 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) Mr Barry Potton Position Vacant Care Home 38 Category(ies) of Dementia (38), Dementia - over 65 years of age registration, with number (38), Old age, not falling within any other of places category (38), Physical disability (38), Physical disability over 65 years of age (38), Terminally ill (38), Terminally ill over 65 years of age (38) Sutton House Nursing & Residential Home DS0000062875.V263407.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The Registered Person must ensure a Fire Risk Assessment is carreid out by 1st December 2004 and periodically reviewed as required by the Fire Precautions (Workplace) Regulation 1997 (as amended 1999). The Registered Person must provide management support within the home until a Registered Manager is in place. The Registered Peson must ensure that the Residential Staffing Forum hours are achieved by 1st November 2005, this will reviewed on this date. 26th April 2005 Date of last inspection Brief Description of the Service: Sutton House is a large elegant looking period building set in extensive grounds. It is located in the village of Sutton and is tucked away discreetly from the main road. The home is a registered nursing home providing nursing and personal care to 38 male and female service users within the categories of physical disabilities, dementia, terminal illness and old age.Accommodation is provided in eight single rooms and fifteen double rooms, all with en-suite toilets and wash hand basins. The home has three floors with a passanger lift and stairs to the upper levels. Equipment and aids/adaptations are in place to ensure service users are cared for in a safe manner whilst allowing them to be as independant as possible. Sutton House Nursing & Residential Home DS0000062875.V263407.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out with the acting manager, staff and residents of Sutton House Care Home. The inspection took 5 hours and included a tour of the premises, examination of staff and resident files and records relating to the service. Twelve of the residents were spoken to in an informal manner; their comments have been included in this report. There have been two additional visits made to Sutton House since the last inspection; both were to investigate complaints made to the Commission about care within the home. The investigating officer found some parts of the complaints to be proven and the provider was asked to take specific action around staff training, effective communication within the home and efficient record keeping to ensure the care within the home improved. What the service does well: What has improved since the last inspection? What they could do better: Medication recording needs to be improved to ensure all signatures are in place for medications administered by the staff, so that there is no mishandling of medication and the residents health is looked after Sutton House Nursing & Residential Home DS0000062875.V263407.R01.S.doc Version 5.0 Page 6 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 House Nursing & Residential Home DS0000062875.V263407.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Sutton House Nursing & Residential Home DS0000062875.V263407.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 4 Limited progress has been made towards the support, guidance and supervision of staff and as a result residents do not receive consistent care. EVIDENCE: The statement of purpose and service user guide have both been reviewed and up dated since the last inspection. Copies of both documents were shown to the inspector and contain enough information about the home for them to meet the required standard. These documents are in the final draft stage before being printed and given out to the residents. A more comprehensive staff training programme is being introduced to the home; with new starters undergoing an Induction process which meets the TOPSS criteria. Discussion with six residents showed that they are very satisfied with the care at the home and those who spoke to the inspector all said the staff were caring and attentive to their needs. The investigation process into the two complaints around care practices received in July 2005, showed that there were some inconsistencies in the level of care being given by the staff and these have been partially addressed by the provider in the provision of additional staff training in effective recording and communication. Sutton House Nursing & Residential Home DS0000062875.V263407.R01.S.doc Version 5.0 Page 9 Staff support and guidance through supervision has been started but must be more regular and structured to ensure staff develop the necessary skills and knowledge to enable them to meet the needs of the residents in full, and to a high standard. Sutton House Nursing & Residential Home DS0000062875.V263407.R01.S.doc Version 5.0 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 9 and 10 Improvements to the medication recording system are needed to safeguard the health, safety and welfare of the residents. EVIDENCE: Since the last visit by the inspector the staff have attended training around effective record keeping practices. Examination of a selection of care plans indicates that these have improved and are being completed to a higher standard than at the last inspection. Individual care plans are in place for all residents and the three examined clearly set out the health, personal and social care needs identified for each person. The plans looked at have been evaluated on a monthly basis and any changes to the care being given is documented and implemented by the staff. Risk assessments were seen to cover pressure sores, nutrition, moving/handling and activities of daily living, the majority of these have been signed by the resident or their family. Information about the resident’s social interests, likes and dislikes, spiritual needs and wishes regarding death and dying are all included within the individuals care plan. Sutton House Nursing & Residential Home DS0000062875.V263407.R01.S.doc Version 5.0 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 14 The home promotes the residents right to exercise choice and control over their lives and offers information and contact details so they or their families can contact external agents, who will act in their interests. EVIDENCE: Four residents spoken to were well aware of their rights and said that they had family members who acted on their behalf and took care of their finances. The manager said she is aware of the advocacy groups in the community that residents can access, and the contact information is on display within the home. All the residents said that the home encouraged them to bring in small items of furniture and personal possessions to decorate their bedrooms. Discussion with the residents showed that they were aware of their care plans and were able to input to them and access them through their key workers. Sutton House Nursing & Residential Home DS0000062875.V263407.R01.S.doc Version 5.0 Page 12 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 The home has a satisfactory complaints system with some evidence that residents feel their views are listened to and acted on. EVIDENCE: The home has produced a simplified complaints process that is easy for residents to read and understand, in response to the comments made in the last inspection report. This policy is on display within the home. Three residents said that they were aware of the procedure and confident that if they had any concerns these would be listened to and acted on by the manager. There has been one internal complaint made since the last inspection and the complaints record shows this was investigated by the manager and quickly resolved. Two complaints made to the Commission in July 2005 were investigated by the inspector and partially upheld. Requirements and recommendations made as a result of the investigations included the need for additional staff training and the development of their skills in record keeping and communication. The provider has complied with this and improved the staff training programme in response to the complaint reports. Sutton House Nursing & Residential Home DS0000062875.V263407.R01.S.doc Version 5.0 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 21 The standard of decoration within the home is improving, with evidence of maintenance and future planning taking place. Residents are provided with a safe, warm and comfortable environment that is homely and welcoming. EVIDENCE: The manager has a record of the ongoing maintenance and renewal programme within the home and this indicated that the provider is committed to improving the facilities and environment within the home. Since the last inspection purchases include new office equipment, a dishwasher for the kitchen, new beds, chairs, curtains and bedding, plus new medical equipment. Replacement of the corridor carpets was requested in previous inspection reports and this work still needs to be carried out, but the manager said that this is because she has asked for the corridors to be decorated first before the carpets are replaced. Bedroom 12 has had a new carpet fitted and other carpets in the residents’ rooms have been either replaced or deep cleaned. New flooring is being fitted to the shower room and residents are using the two assisted bathrooms until Sutton House Nursing & Residential Home DS0000062875.V263407.R01.S.doc Version 5.0 Page 14 this is completed. A number of bedrooms have been redecorated since the last inspection, and additional profiling beds and pressure relief mattresses have been bought. Problems with the lift to the first and second floors, means that a limited service is available until the appropriate part is fitted. The manager said that this expected to take three weeks and lift engineers are going to be on site twice a day to enable residents to come downstairs to the lounge in a morning and go upstairs to bed at night. The Commission and Social Services have been informed and the manager said that residents and families have also been given the relevant information. At the last inspection the residents were not happy with the time taken to toilet them before and after meals, as there is only one disabled toilet near to the dining area (three normal toilets are also available). In an effort to alleviate this problem the manager said that staff were now using one of the bathrooms on the first floor as an additional toileting facility. Sutton House Nursing & Residential Home DS0000062875.V263407.R01.S.doc Version 5.0 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28 and 30 Improvements to staffing levels and the introduction of staff induction training has resulted in staff having a clear understanding of their roles and more time to meet the needs of the residents. EVIDENCE: Discussion with the manager and inspection of the duty rotas indicates that the home has increased the number of staff on duty each morning from six to seven in response to the residents’ comments in the last inspection report. The manager said that whilst the lift is out of order she is using extra staff in a morning and evening to ensure the needs of the residents are being met. Staff vacancies include three registered nurse posts and the manager told the inspector that she is considering using oversees nurses to fill the positions. At the moment the manager and the existing nurses are covering the shifts between themselves. Checks of the staff files showed that the home has introduced an induction and foundation programme that meets TOPSS specification and 19 of the care staff have achieved a NVQ 2 or 3 qualification. Four staff are currently enrolled on the NVQ 2 course and two of these have nearly finished the training. Discussion with the manager indicated there is a need to complete an overall training plan for the home and complete an individual training profile for each staff member so they know what training they have to attend in the coming year. Sutton House Nursing & Residential Home DS0000062875.V263407.R01.S.doc Version 5.0 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31. 33. 35. 36 Since the last inspection staff supervision and the support of new staff members has deteriorated and could present a risk to the health, safety and welfare of the residents. EVIDENCE: The acting manager has submitted an application to the Commission to become the Registered Manager for Sutton House. The application is currently being processed. Discussion with the manager indicated that there has been no progress forward with the audit paperwork for the Quality Assurance System since the last inspection. Regulation 26 reports are being received from the Registered Provider although no report has been completed for October 2005 at the time of this report, and no copy of the visits/reports was available within the home. Sutton House Nursing & Residential Home DS0000062875.V263407.R01.S.doc Version 5.0 Page 17 Checks of the finance systems within the home found that records are all kept on the computer and are up dated by the administrator on a daily basis. For those residents whose finances are managed by their family, a copy of their personal allowance record is sent out each month with the fee invoice. Resident’s who have asked the home to look after their personal allowances are able to access their money on request. All monies are kept safe and secure within the home and only the administrator has access to the funds. Each resident has their own wallet and all receipts are documented on their account sheet and kept with their money. Two accounts were checked and found to be up to date and accurate. Discussion with the manager and checks of the staff files showed that supervision has started within the home, but it lacks structure and is not being carried out on a regular basis. There is a need for this to improve to ensure that staff is offered support and guidance to build their knowledge and skills in care giving, and ensure that residents receive consistent care to a high standard. Sutton House Nursing & Residential Home DS0000062875.V263407.R01.S.doc Version 5.0 Page 18 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 X X 2 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 3 X 3 X X X X X STAFFING Standard No Score 27 3 28 2 29 X 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 1 X 2 X 3 2 X X Sutton House Nursing & Residential Home DS0000062875.V263407.R01.S.doc Version 5.0 Page 19 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 OP4 Regulation 18 Requirement Staff, individually and collectively, must have the skills and experience to deliver the services and care which the home offers to provide (given timescale of 1/2/05 was not met). Accurate records must be kept of all medications , recieved, administered, leaving the home or disposed of to ensure there is no mishandling. A manager must be appointed and register with the Commission. Effective quality assurance and quality monitoring systems must be in place to measure success in meeting the aims, objectives and statement of purpose of the home. Action must be progressed within agreed timescales to implement requirements identified in CSCI inspection reports. The employment policies and procedures and procedures adopted by the home and its DS0000062875.V263407.R01.S.doc Timescale for action 06/02/06 2 OP9 17 06/02/06 3 OP31 8 06/02/06 4 OP33 24 06/02/06 5 OP33 12 06/02/06 6 OP36 18 06/02/06 Sutton House Nursing & Residential Home Version 5.0 Page 20 7 OP36 18 induction, training and supervision arrangements must be put into practice. Supervision must cover all 06/02/06 aspects of practice, philosophy of care in the home and any career development needs. 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. 2. 3. Refer to Standard OP19 OP21 OP28 Good Practice Recommendations The first and second level corridor and bedroom carpets that are stained and worn should be replaced. Consideration must be given to how the two unassisted bathrooms could be adapted to become useable bathing facilities. 50 of care staff should have achieved an NVQ 2 by 2005. Sutton House Nursing & Residential Home DS0000062875.V263407.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Hessle Area Office First Floor, Unit 3 Hesslewood Country Office Park Ferriby Road Hessle HU13 0QF 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 House Nursing & Residential Home DS0000062875.V263407.R01.S.doc Version 5.0 Page 22 - 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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