Inspection on 22/04/08 for Sutton in the Elms Nursing & Residential Home

This inspection was carried out on 22nd April 2008.

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

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 in the Elms Nursing &... 08/08/06

Sutton in the Elms Nursing &... 13/11/05

Sutton in the Elms Nursing &... 09/08/05

Sutton in the Elms Nursing &... 10/12/04

Sutton in the Elms Nursing &... 20/07/04

Sutton in the Elms Nursing &... 22/03/04

Sutton in the Elms Nursing &... 10/08/03

Sutton in the Elms Nursing &... 19/11/02

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

CARE HOMES FOR OLDER PEOPLE Sutton in the Elms Nursing & Residential Home Leicester Road Sutton In The Elms Leicestershire LE9 6QF Lead Inspector Lesley Allison-White Unannounced Inspection 22nd April 2008 10:00 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 in the Elms Nursing & Residential Home DS0000001927.V362959.R02.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 in the Elms Nursing & Residential Home DS0000001927.V362959.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Sutton in the Elms Nursing & Residential Home Address Leicester Road Sutton In The Elms Leicestershire LE9 6QF 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) 01455 286577 01455 286578 admin@drehealthcare.co.uk DRE Healthcare Ltd Mrs Angela Margaret Lonsdale Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40), Physical disability (10), Physical disability of places over 65 years of age (10) Sutton in the Elms Nursing & Residential Home DS0000001927.V362959.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. No person under 55 years of age who falls within category PD may be admitted to the home. No person to be admitted to the home in categories PD or PD/E when 10 persons in total of these categories/combined categories are already accommodated in the home. No person to be admitted to Sutton in the Elms Care Home in categories OP, PD or PD (E) when 40 persons in total of these categories/combined categories are already accommodated in this home. To be able to admit the named person of category PD named in variation number V39718 dated 14th March 2007. 8th August 2006 3. 4. Date of last inspection Brief Description of the Service: Sutton In the Elms Nursing Home is a purpose built modern property designed to accommodate up to 39 people over the age of 65years. The home is registered to admit up to 10 people with physical disabilities who are over 55 years of age. The property is situated in a rural village of Sutton Elms, which is near to Broughton Astley village. This area can be easily reached via the M1 motorway and main routes. The rear of the property offers ample parking spaces and views of the countryside. All areas of the premises are accessible for people with mobility impairments. The Statement Of Purpose and Service User Guide (this is information about how the home is managed and the facilities provided) and the current Commission for Social Care Inspection (CSCI) report are available in the entrance hallway to new people and their relatives. The current Employers Liability of insurance is also clearly displayed. Fees range from £457.00 to £688.00 per week. Sutton in the Elms Nursing & Residential Home DS0000001927.V362959.R02.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. On the day of inspection there were thirty-six people living in the care home two people were in hospital. The inspection process consisted of pre-planning the inspection, reviewing the last inspection report and reviewing significant events that we have been notified of. The unannounced site visit commenced on the 24th April and was completed on that day. The focus of the inspection is based upon the outcomes for the people who live there. The method of inspection was ‘case tracking’. This involved identifying two people who lived at the home with varying levels of care needs and looking at how these are being met by the staff at Sutton In The Elms. The method of case tracking included the review of individual care records, discussions with staff of various delegated responsibilities within the home and reviewing the records, training records and the minutes of a team meeting. We also spoke with three other people who live in the home; they were not part of the case tracking process. What the service does well: An advocacy service can be provided to anyone who may need it so that there is someone who can represent them if they wish; there was no one using this service at the time of inspection. The Registered Manager assesses people before admission. The Registered Manager is prepared to and does travel large distances to make an assessment to ensure that the individual will be able to have their needs met. People living at the home who spoke with the inspector felt they were treated with respect by the staff and were happy to live at Sutton In the Elms. Sutton in the Elms Nursing & Residential Home DS0000001927.V362959.R02.S.doc Version 5.2 Page 6 A comment from someone living at Sutton in the Elms “I can not grumble at anything, all the care staff are good.” The staff that spoke with the inspector said they understood how to alert someone to safeguarding issues and some of them had recently had training in the area of adult safeguarding and whistle blowing. Whistle blowing is where staff can alert external authorities such as the Police, Social Services or the Commission for Social Care Inspection (CSCI) about poor care practices that may concern them. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Sutton in the Elms Nursing & Residential Home DS0000001927.V362959.R02.S.doc Version 5.2 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 in the Elms Nursing & Residential Home DS0000001927.V362959.R02.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. No one moves into the home without having his or her needs assessed, which ensures that their needs can be met. EVIDENCE: A brochure containing the Service User Guide and Statement Of Purpose is also available to new people who come to live at the home. These documents contain information about the services provided in the care home. An advocacy service can be provided to anyone who may need it; there was no one using this service at the time of inspection. The Registered Manager assesses people before admission; this process involves the person their relatives and may involve other professionals so that potential residents are assured that their needs can be met in the home. The Registered Manager is prepared and does travel large distances to carry out assessments. Sutton in the Elms Nursing & Residential Home DS0000001927.V362959.R02.S.doc Version 5.2 Page 9 Standard 6 intermediate care was not assessed, as the home does not provide for this. Sutton in the Elms Nursing & Residential Home DS0000001927.V362959.R02.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. People’s health and personal care needs are met through their plans of care. EVIDENCE: Care plan assessments were included in plans of care. In each care plan, access to services such as the General Practitioner (GP), Opticians, and Chiropodist or for hospital appointments was recorded. This will ensure that appropriate care and treatment is provided to people living in the home. Care staff act as support to residential status people with the Registered Nurses at the home in overall charge, including giving medications. The senior care staff are trained in the area of medications. There are many people living at Sutton In the Elms on medications. Two Registered Nurses are employed on each morning shift then one in the evening and one at night supported by care staff. Sutton in the Elms Nursing & Residential Home DS0000001927.V362959.R02.S.doc Version 5.2 Page 11 Medications were observed over lunchtime/ afternoon. Medication practice was safe and people get the medicines that they have been prescribed; however there are some improvements that need to be made to further safeguard people in the home. There was plenty of hand gels and liquid soap in the home to prevent cross infection; none of these were seen to be used by the Registered Nurse during the medication round. The Registered Nurse was observed to administer topical medication to one person, which involved touching the person and then they returned to continue giving out the remaining medications. Although no further medications were handled, it is good practice to wash hands or wear gloves when administering medicines, which involved physical contact in order to prevent cross infection. People living at the home who spoke with the inspector said that they felt and were treated with respect by the staff and were happy to live at Sutton In the Elms. Sutton in the Elms Nursing & Residential Home DS0000001927.V362959.R02.S.doc Version 5.2 Page 12 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 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at the home find the lifestyle matches their expectations and preferences. EVIDENCE: A newsletter is produced each month. It contains information for the people living at the home and their relatives to read. The newsletter has information about activities that have taken place different to the regular weekday activities (of bingo, manicures, quiz mornings etc.) It has information about the forthcoming events. The activity coordinator organises the activities. She works mornings usually and helps with meal times. There is some opportunity for one to one activity as shown in a care records. The activities provided at the home match the expectations of the people living there. Friends, family and visitors are made welcome and can visit at any time. In this way contacts can be continued in the normal way. Sutton in the Elms Nursing & Residential Home DS0000001927.V362959.R02.S.doc Version 5.2 Page 13 One of the people who spoke with the inspector said that they felt that they had plenty of choices. There was the opportunity for enjoying intimacy within a relationship if desired, their door being lockable from inside. A comment from someone living at Sutton in the Elms Care Home “I can not grumble at anything, all the care staff are good.” A key worker system is operated in the home which means that there is one member of staff allocated to a person living in the home; this member of staff ensures that the person they key work has everything that they need. A mealtime was seen and the people who had lunch looked happy eating the meal. Kitchen staff cooks the meals and the care staff serves the majority of meals. There were people who needed assistance and the care staff provided this for them in a respectful way. Sutton in the Elms Nursing & Residential Home DS0000001927.V362959.R02.S.doc Version 5.2 Page 14 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 and 18 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. Staff are able to protect residents from harm and feel able to seek appropriate advice or help to do so. EVIDENCE: Since the last inspection there have been some complaints to the Commission for Social Care Inspection (CSCI). All have now been dealt with. A record of all complaints is kept. In the April 2008 Newsletter there is no mention of contact details for Social Services or for The Commission for Social Care Inspection (CSCI) as agreed at a meeting held in February 2008 with Social Services and should be a regular feature. People living at the home and their relatives should be able to have easy access to services that regulate and protect the rights of the people living at Sutton In the Elms. People who spoke with the inspector said that they would raise a concern if they needed to either through their relatives or themselves. An advocacy service is also available at the home through an independent older persons charity organisation. The staff that spoke with the inspector said they understood how to alert someone to adult safeguarding issues and some of them had recently had training in the area of adult safeguarding and whistle blowing. Whistle blowing Sutton in the Elms Nursing & Residential Home DS0000001927.V362959.R02.S.doc Version 5.2 Page 15 is where staff can alert external authorities such as the Police, Social Services or the Commission for Social Care Inspection (CSCI) about poor care practices that may concern them. This was successfully used by a member of staff in a recent complaint to CSCI and Social Services. Sutton in the Elms Nursing & Residential Home DS0000001927.V362959.R02.S.doc Version 5.2 Page 16 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 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is clean and pleasant. EVIDENCE: Two rooms were seen. The rooms were spacious, clean and welcoming some have en-suite facilities. A number of people who spoke with the inspector also confirmed that they liked their bedrooms some having pleasant views over the fields at the back of the building. A bathroom was seen and had good facilities for washing and drying hands. The home is well decorated and comfortably meets the needs of the people who work and live there. Sutton in the Elms Nursing & Residential Home DS0000001927.V362959.R02.S.doc Version 5.2 Page 17 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 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Improvements in the area of recruitment still need to be made. In this way people living at the home will be fully protected. EVIDENCE: The inspector spoke to domestic staff from the laundry and cleaning services. They had received training either informally or formally for the area in which they worked. They appeared well informed. The Registered Manager confirmed that all staff had received training in the area of safeguarding and this would be ongoing as new staff or refreshers were required. There is an ongoing training programme for all staff to ensure that the needs of the residents can be met. A number of staff has a National Vocational Qualification (NVQ) in care level 2 or above. Registered Nurses are available 24 hours a day at this home. Two staff records were case tracked. In both cases the Registered Manager had placed the staff on the rota before the homes Criminal Records Bureau (CRB) or POVA first was returned. References had been obtained and a previous CRB from an old employer were on their records. It is important to follow good recruitment practices at all times. A requirement was issued. Sutton in the Elms Nursing & Residential Home DS0000001927.V362959.R02.S.doc Version 5.2 Page 18 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 and 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is run in the best interests and welfare of service users. Improvements to the recruitment practice will further ensure that people living in the home are safeguarded from harm EVIDENCE: Regulation 37’s (this is information about changes to the well being of the people who live a care home) are sent through to CSCI as required. No money is kept on behalf of the people living at the home and the individual and their family members make their own arrangements with regard to financial matters. Sutton in the Elms Nursing & Residential Home DS0000001927.V362959.R02.S.doc Version 5.2 Page 19 The Registered Manager confirmed that all health and safety requirements are up to date and that the people living and working at the home are protected by such measures. Recruitment practice must be reviewed and be compliant with relevant legislation to ensure that only people who are fit to do so are working in the home. This will ensure that residents are safeguarded. Sutton in the Elms Nursing & Residential Home DS0000001927.V362959.R02.S.doc Version 5.2 Page 20 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 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 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 X X X X 3 STAFFING Standard No Score 27 3 28 2 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 2 Sutton in the Elms Nursing & Residential Home DS0000001927.V362959.R02.S.doc Version 5.2 Page 21 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 OP29 Regulation 19 Schedule 2 Requirement The Registered Provider (s) should ensure that all staff records have been through the correct procedure and comply with the Care Standards Act 2000. Timescale for action 31/07/08 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. 2 Refer to Standard OP18 OP26 Good Practice Recommendations Contact details for Social Services or for The Commission for Social Care Inspection (CSCI) should be available to residents and their relatives. Staff must be mindful of the risk of cross infection by any action that they may do or fail to do which could cause other people to be placed at risk of infection. Sutton in the Elms Nursing & Residential Home DS0000001927.V362959.R02.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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 in the Elms Nursing & Residential Home DS0000001927.V362959.R02.S.doc Version 5.2 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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