Inspection on 10/02/06 for Sutton Lodge Nursing & Residential Home

This inspection was carried out on 10th February 2006.

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 Lodge Nursing &... 07/11/06

Sutton Lodge Nursing &... 11/11/04

Sutton Lodge Nursing &... 05/05/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Sutton Lodge Nursing & Residential Home Station Road Sutton On Sea Lincs LN12 2HR Lead Inspector Kima Sutherland-Dee Unannounced Inspection 10th February 2006 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 Lodge Nursing & Residential Home DS0000002642.V283846.R01.S.doc Version 5.1 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 Lodge Nursing & Residential Home DS0000002642.V283846.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Sutton Lodge Nursing & Residential Home Address Station Road Sutton On Sea Lincs LN12 2HR 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) 01507 441905 01507 443322 Mr Stephen John Croudace Mrs Wendy Draper Care Home 34 Category(ies) of Old age, not falling within any other category registration, with number (32), Physical disability (2) of places Sutton Lodge Nursing & Residential Home DS0000002642.V283846.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Restriction The category of Physical Disability is for one named person only (As per letter dated 28.6.02). The registration for Physical Disability will be revoked when the named person no longer lives in the home. Restriction The additional bed in the category of Physical Disability is for persons aged 45 years and over. 20th September 2005 2. Date of last inspection Brief Description of the Service: Sutton lodge is situated in a residential area of Sutton on Sea. The home comprises a large old building with accommodation for 9 residents who require personal care, 3 converted stables that provide semi independent accommodation with a linked call bell system and a large purpose built single storey building that can accommodate up to 22 older people who require personal and nursing care. Garden and parking areas surround the homes. The providers also run a domiciliary care agency from the top floor of the older building. Sutton Lodge Nursing & Residential Home DS0000002642.V283846.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place between 9.25 and 2.30 and consisted of talking with the residents, the manager and the staff. A sample of the records and policies were seen as well as visiting all the areas of the home. What the service does well: What has improved since the last inspection? What they could do better: Sutton Lodge Nursing & Residential Home DS0000002642.V283846.R01.S.doc Version 5.1 Page 6 The manager and senior staff stated that they are able to meet all of the physical needs of the residents but they currently have 17 people who require a high degree of care. This means that they are under pressure on every shift and they do not have time to meet all of the emotional or social needs of the residents. The manager did introduce a programme of activities however none of residents wished to participate, and the homes bus driver left. The manager said that ideally they should spend more time talking to individual residents and they would benefit form a member of staff who could dedicate their time to organising activities and social events, which suit the resident’s expectations. Previous requirements have been made to fit guards to the radiators and this has not been done. The provider informed the inspector that the highest priority radiators that pose the most risk would be fitted straight away. They also agreed to implement all of the requirements from the environmental health report that had not been met, this includes replacing a kitchen unit. The manager had started to supervise the staff regularly, but they stated that due to staffing pressures and the priority of caring for the residents this had not been done since December. 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 Lodge Nursing & Residential Home DS0000002642.V283846.R01.S.doc Version 5.1 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 Lodge Nursing & Residential Home DS0000002642.V283846.R01.S.doc Version 5.1 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): These standards were not assessed at this inspection. EVIDENCE: Sutton Lodge Nursing & Residential Home DS0000002642.V283846.R01.S.doc Version 5.1 Page 9 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): 7,8,10 The home does meet the health needs of the residents and the staff carry out personal care in a way that respects them and protects their privacy, although the staff are unable to offer care at times that suit the residents preferred routine. EVIDENCE: The care plans show that the staff are aware of each residents needs and how these are to be met. The staff maintain detailed daily records to demonstrate the care they are giving. The residents were very positive about the staff and their comments included: ‘The staff are good, they look after you and they let me do what I can for myself.’ ‘ They are lovely, I came out of hospital in a terrible state and I was very glad to be back, they look after me very well.’ ‘ I wouldn’t swap them, they are lovely girls.’ The staff and the manager stated that they are unable to offer care at times that would suit the residents due to the pressure of time and staffing levels. Therefore on occasions help with getting up, going to bed and bathing is delayed Sutton Lodge Nursing & Residential Home DS0000002642.V283846.R01.S.doc Version 5.1 Page 10 The records showed that health advice is sought as soon as necessary; there are trained nurses on each shift. The manager and a carer said that it is difficult in the area to get District nurses to go to the home. They said that the district nurses had set up a wound clinic but the residents now had to go to Mablehtorpe and this proved difficult. The district nurses have stopped the twilight service, which means that some residents who only require personal care have treatment from the nursing staff, which then takes time away from the resident who require nursing. Sutton Lodge Nursing & Residential Home DS0000002642.V283846.R01.S.doc Version 5.1 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): 12,13,15 The staff are unable to meet the expectations of the residents or to provide them with adequate stimulation. The home is welcoming to family and friends. The food has improved but there is not enough evidence to determine whether the residents agree. EVIDENCE: The residents said that they would like more activities of their choosing. The manager said they have tried to provide activities and trips out but the residents have not taken these up. The resident would benefit more from the staff being able to spend time talking to them, but the staff said that unfortunately their priority is to offer a high standard of care and they do not have the time. They said that they attempt to spend time with the residents whenever possible. One resident said they would like more activity ’It happens once in a blue moon, and once a week would be nice.’ One visiting relative said that ‘the staff are wonderful, I take my relative out whenever possible, it couldn’t be better.’ The manager said that their had been problems with the food. The lunches are delivered from the commercial kitchens at the other home in the group and Sutton Lodge Nursing & Residential Home DS0000002642.V283846.R01.S.doc Version 5.1 Page 12 then heated at the home and the previous cook had not been effective. There are new cooks who are able to get the food served hot and to a better standard. Three service users said the food was good. A previous requirement was made for the home to carry out a survey about food quality but this had not been achieved. The residents are offered home made cakes and a tea that is prepared in the home and these are of a high standard. The kitchen staff are aware of the likes and dislikes of each resident, and they cater for special diets. The manager does monitor the food quality and does seek the views of the residents but this had not been recorded. Sutton Lodge Nursing & Residential Home DS0000002642.V283846.R01.S.doc Version 5.1 Page 13 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): 16,17 The home has the procedures to deal with complaints and the staff are open to the views of the resident or their relatives. The staff are able to protect the residents from abuse and they have received training. EVIDENCE: The home has procedures for dealing with complaints and the resident said they would be happy to approach the staff or the manager with any concerns. The staff have received training in adult abuse awareness and more training is planned for 2006. The staff are confident to bring concerns to the manager. Sutton Lodge Nursing & Residential Home DS0000002642.V283846.R01.S.doc Version 5.1 Page 14 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): 19,20,23,24,25,26 All areas of the home are clean and comfortable. The communal and private areas suit the needs of the current residents. The radiators are not guarded and this is a risk to the residents. EVIDENCE: The old vicarage, the stables and the new area are all comfortable and clean. The residents have comfortable chairs in pleasant communal areas, overlooking the well maintained gardens. The lower windows at the old vicarage are very worn and rotten although this mainly affects the appearance of the home, as they do open to provide ventilation. All the residents said they liked their rooms, particularly one of the residents in the old stable who lives in a self contained home and is surrounded by their own furniture and possessions. The bedrooms throughout the homes are well furnished and personalised. Sutton Lodge Nursing & Residential Home DS0000002642.V283846.R01.S.doc Version 5.1 Page 15 The care plans contain full risk assessments for each resident and the environment. These indicated which resident are most at risk of burns and scolds from unguarded radiators. Previous requirements have been made to cover the radiators and following discussions the provider stated that the highest priority ones would be covered straight away. Sutton Lodge Nursing & Residential Home DS0000002642.V283846.R01.S.doc Version 5.1 Page 16 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): 27,30 The care needs of the residents are being met, however not all of their needs can be met with the current staffing levels. The staff are receiving training and they are competent. EVIDENCE: There are currently 31 residents, 12 require help with their personal needs and 19 require nursing care. The manager informed the inspector that 17 residents require a high degree of care which includes two staff to help them turn or get up and staff to assist them with their meals. There are 4 staff on duty in the mornings and 3 in the afternoon with 3 staff on duty at night. These staff are deployed in the old vicarage, the new building and they also offer support to the 3 residents in the stables. The manager has to cover some care shifts and the trained nurse on duty stated that they do sometimes have to delay care for some residents. The training plan showed that both statutory and specialist training was available, this included moving and handling, infection control, basic care practice, health and safety and dementia care. Sutton Lodge Nursing & Residential Home DS0000002642.V283846.R01.S.doc Version 5.1 Page 17 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): 31,33,36 The home is competently managed, however staff are not being regularly supervised. EVIDENCE: The registered manager is competent to lead the staff team. They stated that they have asked the providers for additional resources in order to improve the care, but this had not been made available. The manager works a number of care shifts and is able to monitor the practice of the staff, however they stated that due to time pressures they have been unable to maintain regular formal supervision meetings. The previous inspection in September made a requirement for the registered person to carry out a quality audit of the resident’s views regarding the food. This had not been done. The manager stated that one of the providers had taken responsibility for this. Sutton Lodge Nursing & Residential Home DS0000002642.V283846.R01.S.doc Version 5.1 Page 18 Sutton Lodge Nursing & Residential Home DS0000002642.V283846.R01.S.doc Version 5.1 Page 19 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 X X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 X 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X X 3 3 2 3 STAFFING Standard No Score 27 2 28 X 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X X 2 X X Sutton Lodge Nursing & Residential Home DS0000002642.V283846.R01.S.doc Version 5.1 Page 20 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 OP12OP8 Regulation 12(1a 12(3 18(1a Requirement Timescale for action 30/04/06 2 OP33OP15 3 OP25 4 OP27 The registered person must ensure that each resident receives the care they require and that there are enough staff to provide this care at times that are agreed with the resident or suitable to meet their needs. 24(1ab2(3 The registered person must carry 30/04/06 16(2i out quality reviews to determine the views of the residents regarding the provision of food at the home. The results must be recorded and forwarded to the commission within the timescale. 13(4)(a)c The registered person must 30/04/06 ensure that the residents are protected form burns by fitting radiator guards. This requirement carries over from the previous two inspections. 18 The registered person must 30/05/06 ensure that there are enough staff to meet all of the needs of the residents, this includes care, social needs and emotional support. Sutton Lodge Nursing & Residential Home DS0000002642.V283846.R01.S.doc Version 5.1 Page 21 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Sutton Lodge Nursing & Residential Home DS0000002642.V283846.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN 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. 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