Inspection on 19/12/05 for Sutton Valence Nursing & Care Centre

This inspection was carried out on 19th December 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 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 Valence Nursing & Care... 07/04/08

Sutton Valence Nursing & Care... 04/06/07

Sutton Valence Nursing & Care... 26/06/06

Sutton Valence Nursing & Care... 06/06/05

Sutton Valence Nursing & Care... 22/03/05

Sutton Valence Nursing & Care... 16/08/04

Sutton Valence Nursing & Care... 14/04/04

Sutton Valence Nursing & Care... 27/01/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Sutton Valence Nursing & Care Centre North Street Sutton Valence Maidstone Kent ME17 3LW Lead Inspector Lynnette Gajjar Unannounced Inspection 19th December 2005 09:40 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 Valence Nursing & Care Centre DS0000026208.V270186.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 Valence Nursing & Care Centre DS0000026208.V270186.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Sutton Valence Nursing & Care Centre Address North Street Sutton Valence Maidstone Kent ME17 3LW 01622 843999 01622 844364 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) Tamhealth Ltd, a wholly owned subsidiary of Four Seasons Health Care Mrs Carla Jayne Wilson Care Home 73 Category(ies) of Old age, not falling within any other category registration, with number (73) of places Sutton Valence Nursing & Care Centre DS0000026208.V270186.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The home can provide care for up to 8 persons with a physical disability 40 years and over. The home can care for up to 8 persons who are terminally ill. Date of last inspection 6th June 2005 Brief Description of the Service: Sutton Valence Nursing and Care centre provides nursing care and accommodation for seventy-three older people, including eight places for people who are physically disabled and eight for individuals who are terminally ill. Sutton Valence Nursing and Care centre is owned by Tamhealth Ltd, a wholly owned subsidiary of Four Seasons Health Care. The home is located close to the outskirts of Sutton Valence village and local public transport is available nearby. The home is purpose built, set in its own grounds and provides car parking to the front of the main building. Accommodation is over two-storeys, with access to the first floor via two shaft lifts. Some of the rooms on the first floor have balconies that overlook the garden and car park areas and some of the ground floor rooms look onto an inner landscaped courtyard. Sutton Valence has sixty-one single rooms, eleven of which have en-suite facilities and six double rooms ( for married couples or siblings) , two of which have en-suite facilities. All the residents’ rooms are equipped with a nurse call system, television and telephone points. The home’s staffing team is comprised of the manager; one clinical specialist, one deputy manager; staff nurses and carers who work a roster to give 24hour cover. The home also employs other staff for administration, maintenance, catering, housekeeping and laundry duties. Sutton Valence Nursing & Care Centre DS0000026208.V270186.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, the second in the year running from April 1st 2005 to March 31st 2006. The visit lasted from 09.40am until 16.25pm. The home currently has 65 residents and is running with vacancies and three step down beds for the local authority. The visit was spent talking directly with residents and visitors privately and collectively; care, qualified and auxiliary staff, clinical manager and the registered manager. Due to the nature of the service, it is difficult to reliably incorporate accurate reflections of the residents in the report. Some judgements about quality of life and choices were taken from direct conversation with residents and observation followed by discussion with support staff and evidencing records held at the home. A tour of the premises was undertaken, with time spent assessing various records held in the home. Documentation was on the whole in good order and the recommendations from the previous inspection continue to be addressed by the manager and staff. From assessment of the kitchen area an immediate requirement was issued to repair and make safe the kitchen floor to offer safe working environment for staff but also maintain basic food hygiene and infection control standards. What the service does well: The home was purpose built in 1993 offering facilities for nursing care. Residents continue to be happy that family and friends can visit the home at any time. Residents feel the structured social activities programme offered by the activity co-ordinator are good. Individual key - working is welcomed by residents as it offers regular support and trust with their carers. Personal health care needs are well supported. Residents are encouraged to maintain regular contact with external agencies and professionals to managed their health care and personal preferences. Sutton Valence Nursing & Care Centre DS0000026208.V270186.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? What they could do better: Residents would benefit from the repair or replace current assisted electrical baths and toilets that are out of order. Residents would benefit from the refurbishment of bathrooms and WC’s to offer facilities that meet the needs and personal preferences of the residents. Complete requirements identified by the Environmental Health Officer in relation to food hygiene management of the home. Whilst some residents stated there has been some improvement with the quality of food provided by the home, there was similar response from others that the food remained of poor quality. An informal food quality questionnaire may assist the manager and kitchen staff to address the ongoing shortfalls felt by some residents. Additional information to including social interaction to care plan will ensure staff offer a whole service not just nursing care. Better use of daily records will offer better records of care and specific support or improvement for/by individuals. Continued focusing on how residents are feeling about what it is like living in the home through residents meetings but also individual discussion/complaints, will encourage effective change and enhance the service and facilities provided and that residents will feel their views are listened to. Sutton Valence Nursing & Care Centre DS0000026208.V270186.R01.S.doc Version 5.0 Page 7 Further development of pictorial and object referencing around the home would assist residents to familiarise themselves with their environment and surroundings. Alternative incentives and opportunities should be explored to offer confidence and willingness by staff to complete NVQ in care awards. Further training for care staff in foundation level training other than basic health and safety workshops will benefit residents by having more skilled and competent staff supporting them with varied health and social care needs. Further training and support in written records will enable care and nursing staff to complete comprehensive information about the individual. 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 Valence Nursing & Care Centre DS0000026208.V270186.R01.S.doc Version 5.0 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Sutton Valence Nursing & Care Centre DS0000026208.V270186.R01.S.doc Version 5.0 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3,4,5 Residents and families are given the information they need to be able to make an informed decision to live at Sutton Valence Nursing Home. EVIDENCE: The homes statement of purpose has been reviewed to include clear information about the service and facilities provided by the home. This is only presented in a written format. Residents and families continued to share their experiences of visiting the home and other homes prior to making a decision to move into Sutton Valence. The majority of residents explained that they had left this to their relatives to visit as many were in hospital and unable to do so. Files continue to evidence pre admission assessments taking place including in some local authority assessments. The same forma is being used and adapted for step down beds. Sutton Valence Nursing & Care Centre DS0000026208.V270186.R01.S.doc Version 5.0 Page 10 A new admission was taking place today and the staff had allocated those who would be responsible for meeting them on arrival and supporting them to settle into their room and the home. Sutton Valence Nursing & Care Centre DS0000026208.V270186.R01.S.doc Version 5.0 Page 11 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): 7,8,9,10 Some resident’s feel they are being listened to more by the home through the use of the residents meetings, others continue to feel this process is not effective. Care plans continue to develop offering information to staff of nursing care but still require more information of social care needs. Staff could develop and improve on daily records content. EVIDENCE: Four care plan and records were assessed. Those seen continue to be developed offering detailed and better information to instruct support staff how to meet the nursing needs of individuals. However there is still more work required to reflect the support needed for the personal and social aspects of living at the home. Residents spoken with had varying understanding of their care plans, some with no interest at all. Care plan records evidenced regular contact with GP, Chiropody, continence and tissue viability PCT nurses. Residents talked of how staff tried hard to maintain their dignity and being respectful, often referring to specific carers as they walked by. Many continued to state they preferred the same carers, as they know how to work with them making the task must easier and pleasant. Sutton Valence Nursing & Care Centre DS0000026208.V270186.R01.S.doc Version 5.0 Page 12 There were more residents from this visit who felt they were being listened to more by the home and spoke of the residents meetings and personal issues they had taken up with the manager or staff. Through conversation many knew the manager and clinical supervisor but through different names (the matron, senior nurse) or visual direct contact. However others also expressed that they did not feel attending the residents meeting of value as “ same old same old” “nothing ever gets done” “like water of ducks back, it’s just lip service”, were a few comments shared. Many female residents spoken with expressed that they did not want to cause trouble or put on staff, as they were so busy. Medication was overall managed well and PRN guidelines have been introduced to care plans. The manager discussed the transfer of medication dispensing to one supplier Boots using the Nomad System. This is to reduce the three different suppliers currently used and linked to the different GP surgeries, to improve on medication management and tracking by the home. Disposal of medication will be managed through this new contract. Sutton Valence Nursing & Care Centre DS0000026208.V270186.R01.S.doc Version 5.0 Page 13 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): 12,13,14,15 Residents continue to feel the structured social activities programme offered by the activity co-ordinator are good. Resident’s lifestyle would be improved with increased staff awareness to the environment and residents’ specific needs. Residents choice and control to move around the home would be greatly improved by having assessed, safe mobility aides / equipment and accessible staff to assist them at such times. EVIDENCE: Being such a large home meeting everyone’s personal expectations and preferences is a challenging task. The majority of residents expressed how continue to find the planned activities to be good and the commitment by the activity co-ordinator. Residents expressed that they are able to make clear choices of what they wish to join in with. Local entertainers are booked, some liked more than others. Residents today were occupying themselves in their rooms, communal lounges and some with visitors. With planned bingo this afternoon. In both lounges a number of residents were seated a long way, or out of vision from TV. Small groups of residents were seen to be supportive of each other and spoke of Sutton Valence Nursing & Care Centre DS0000026208.V270186.R01.S.doc Version 5.0 Page 14 liking to sit together in the conservatory and dining room. Others preferred to keep themselves to themselves. A large proportion of residents talked about their dependency on staff to take them around the home and on two occasions were directly observed to be kept waiting for a long period of time when called for assistance to use the toilet. “ You just have to wait there’s nothing else you can do”. Two were seen to self-propel themselves in wheelchairs not suitable for this to look for staff. There was a number of occasions directly observed where residents were calling for staff support and unable to access call points in communal lounges. A weekly menu is set with an alternative option. Many stated they can ask for alternatives but don’t like to. Through conversation with different residents there is a common theme that there is still a lot room for improvement in the quality of food as well as presentation. It was suggested that an informal questionnaire (that could be anonymous) would get a lot more people speaking truthfully as many didn’t like to speak up at residents meeting or want to offend staff, they are very grateful for all they do for them. Residents choosing to eat in their rooms expressed that at times food was cold on arrival. Others also felt tea was often cold but usually as “they put too much milk in”. Other spoken with today felt food was “good and plenty of it” “ no complaint there it’s very nice”. Sutton Valence Nursing & Care Centre DS0000026208.V270186.R01.S.doc Version 5.0 Page 15 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): 16,18 Residents are becoming more aware of how to raise concerns or complain, but there remains some reticence that these would be listened to, with action taken to resolve them. Protection from abuse is promoted through staff training and understanding of the support and actions they may need to take. EVIDENCE: Some residents spoken with were a little confused or unsure of the compliant process, where as others, knew who to talk to if they had a concern or wished to make a compliant. This included the manager, the clinical supervisor and relatives. However there is still some lack of confidence in the organisation to listen to these and take appropriate action. Copies of the complaint procedure are available in the home. Staff evidenced an understanding of how to protect and prevent abuse and how to report under local procedures. The home has had adult protections raised, but these have now been closed. Sutton Valence Nursing & Care Centre DS0000026208.V270186.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,23,25,26 Residents live in a warm and purpose built home, which would be enhanced further by better bad odour control, adequate assessed equipment and storage. Resident’s lifestyle and personal care will be enhanced further with the repair or installation of appropriate assisted baths/showers rooms and WC’s in good working order. Resident’s would feel much safer with the appropriate accessible call systems in the communal areas. EVIDENCE: Sutton Valence Nursing & Care Centre DS0000026208.V270186.R01.S.doc Version 5.0 Page 17 The home was purpose built in 1993. The location of the home is on main road and bus routes. Ongoing decoration is underway to all areas of the home. Two bedrooms were being decorated before new admissions (storage of furniture was cluttering hallways and restricting mobility through these areas). Carpets have just been approved for some communal areas. The smoking area of the home carpet is badly burned by cigarettes. Due to the layout of the home there are periods of time where staff are not in direct contact with residents. Non-ambulant residents do not have a method to call for assistance in communal areas other than shouting very loudly or waiting for staff to walk through, leaving residents feeling very vulnerable. A corner of one lounge was being used for storage of wheelchairs and activity equipment blocking access to stock of puzzles and games. There are restricted bathing facilities in the home. All electrical baths are currently out of order. Reducing personal choice and needs to access hoist assisted baths only. There are no walkin shower room facilities in the home. Four WC’S were also out of order today. The manager has been informed that refurbishment is being considered for next budget year and such repairs are being put on hold for this. Following the EHO visit requirements to storage of food, cleaning of filters and repairs to the kitchen floor were identified. Action has been taken to address this except for completion of repairing the kitchen floor. This was assessed today to be unsafe, serious tripping hazard and infection control issues that requires addressing immediately but the organization. The manager evidence quotes being made for replacing the flooring but was still awaiting maintenance to assess and agree structure repair to the hole in the floor before this can be replaced. The homes laundry covers all of the homes laundry no aspects are contracted out. A number of families have chosen to do their own washing due to problems with shrinkages and discoloring. A proportion of clothes seen today were unlabelled and awaiting carers to come and identify for their key residents. Temporary staff has managed the laundry over the past four months due to sick leave. The laundry is of good size with one staff member that has just returned to work but it is understaffed to manage effectively the level of laundry generated for a home this size. Sutton Valence Nursing & Care Centre DS0000026208.V270186.R01.S.doc Version 5.0 Page 18 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): 27,28,29,30 Residents are cared for by a committed staff team. Residents would benefit from care staff undertaking further core and foundation level training at NVQ or equivalent. Staffing numbers seen today at times were not directly meeting the social and care needs of current residents. Clear recruitment processes and checks have been implemented to promote the safety and well- being of residents. EVIDENCE: The home is currently running with 3 qualified nurses and 5 carers per shift for today. The home also had ancillary staff in specific areas of the home and the clinical manager on duty. There has been a reduction in the use of agency since the last inspection, but where these are used the same staff are requested to offer consistency. Despite the current staffing levels on duty to 65 residents there were periods during the day where staff were not visibly working in communal areas or rooms. Residents were waiting for help to move around the home or for personal care, leaving residents feeling very vulnerable and frustrated. Social interaction was limited to care interaction; no carer or nurse was seen to sit even for short periods of time in communal areas and talk to residents. Sutton Valence Nursing & Care Centre DS0000026208.V270186.R01.S.doc Version 5.0 Page 19 Residents spoke with high regard for specific carers and nurses, but with little respect for the organisation. Other comments received “they are so kind but never have time to take a breath”. “ She’s great she is, nothing is too much for her”. Staff development to core training requirements continue to be addressed and more courses are planned for the New Year. Further training in other areas related to health and specialist care needs would enhance and motivate carers to understand and support residents effectively. Off the thirty-three care staff, three care staff have NVQ2 in care and two have NVQ 3. There is evidence of the manager’s and organisations commitment to support staff in this training with letters sent to all offering this opportunity but with no response. Alternative incentives and packages must be explored to address this deficit. The home will not meet the 50 completed or even committed to undertake this training by 31st December 2005. Staff files are being reviewed and collated to hold information required under regulation and nearing completion. Minor gaps were identified that could be addressed immediately. New staff employed have undergone recruitment and checks to promote the safety and well- being of residents. Sutton Valence Nursing & Care Centre DS0000026208.V270186.R01.S.doc Version 5.0 Page 20 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): 31,32,35,38 The home has clear leadership from a motivated manager and clinical manager to put into place training and monitoring system. Thus continuing to work towards promoting new and current good care practice and working towards protecting residents from risk. EVIDENCE: The registered manager holds Dip HE Adult Nursing – Part 12. She also holds NVQ and nursing assessor awards and nearing completion of the RMA award. The manager is supported supernumerary by the clinical manager. Residents and staff both feel more supported having a stable management team in place. There was a clear line of accountability with in the home today. Whilst there has been some improvement in confidence of residents meetings there remains some lethargy from others. These are held on last Wednesday if each month. Sutton Valence Nursing & Care Centre DS0000026208.V270186.R01.S.doc Version 5.0 Page 21 Resident’s, family or solicitors are appointees for their personal monies. Individuals hold small amounts at the home for ease of access. This is recorded individually and kept in resident’s monies bank account. The organisation is monitoring progress through monthly visits and reports, what influence these have on outcomes for individuals is difficult to assess. There is evidence of equipment being regularly maintained, with exception of the all-electrical baths that are out of order, as identified earlier in this report. Staff awareness of moving and handling has improved through recent training. A number of staff are now working through or have completed the core health and safety training required within agreed timescales for renewal. Residents are taking un-necessary risks to promote their independence due to the lack of correct equipment/ mobility aides and staff availability to support them around the home is limited. Consultation has taken place with the fire officer with a proposal to remove safety chains off bedroom door so that they can be left open during the day with out being propped open with door stops/ bricks. This has not yet been implemented. Concerns over safety of staff working in kitchen have been highlighted earlier in this report and requires immediate action by the organisation. Sutton Valence Nursing & Care Centre DS0000026208.V270186.R01.S.doc Version 5.0 Page 22 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 3 3 3 X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 3 2 3 1 2 3 X 2 2 STAFFING Standard No Score 27 2 28 1 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 2 X X 3 X X 2 Sutton Valence Nursing & Care Centre DS0000026208.V270186.R01.S.doc Version 5.0 Page 23 NO Are there any outstanding requirements from the last inspection? 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 OP1OP37 Regulation 5(1)(b) Requirement The registered person shall produce a written guide to the care home (in these Regulations referred to as ‘the resident’s guide’) which shall include – the terms and conditions in respect of accommodation to be provided for residents, including as to the amount and method of payment of feesIn that:· Three previous inspections identified that terms and conditions/contracts for residents were with the owning company’s solicitors for further clarification from the Office of Fair Trading.· The manager explained that this continued to be the case. Documentation was not available for inspection within the home, although stated as such, within the statement of purpose. Written response to be submitted to the commission by the timescale date Sutton Valence Nursing & Care Centre DS0000026208.V270186.R01.S.doc Version 5.0 Page 24 Timescale for action 31/01/06 2 OP7 15(1) The registered person shall, after 31/01/06 consultation with the resident or their representative, prepare a written plan as to how their needs in respect of their health and welfare are to be met.In that:Previous inspection identified many shortfalls and gaps in care planning. An audit of all residents’ care plans clearly identified strengths and weaknesses within current records. (This requirement is repeated from previous inspection dated 14th April 2004 and 16th August 2004 and 22&24th March 2005,6th June 2005) It was evident that care plans had been reviewed and amended, a process for monitoring potential improvements is in place to develop these further and discussed with staff today. Written response to be submitted to the commission by the timescale date The registered person shall ensure that, as far as possible, all parts of the home to which residents have access and any activities in which they participate are free from hazards to their safety and avoidable risks and that unnecessary risks to their health and safety are identified and eliminated. In that:Previous inspection identified many shortfalls and gaps in risk assessment. An audit of all residents’ care 3 OP7 13(4) 31/01/06 Sutton Valence Nursing & Care Centre DS0000026208.V270186.R01.S.doc Version 5.0 Page 25 plans clearly identified strengths and weaknesses within current records. (This requirement is repeated from previous inspection dated 14th April 2004 and 16th August 2004 and 22&24th March 2005,6th June 2005) It was evident that amendment/addition and a process for monitoring potential improvements have been put into place but this remains an ongoing requirement to ensure consistency. Written response to be submitted to the commission by the timescale date The registered person shall having regard to the size of the care home and the number and needs of residents – provide, in adequate quantities, suitable, wholesome and nutritious food which is varied and properly prepared and available at such time as may be reasonably required by residents. In this regulation ‘food’ includes drink. In that: The process of reviewing the food offered by the home must be ongoing in order to maintain and increase improvement with regard to the quality, quantity, temperature, presentation, choice and timing of meals provided. (This requirement is repeated from previous inspection dated 16th August 2004 and 22&24th March 2005, 6th June 2005.) 4 OP15 16(2)(i)(4 ) 31/12/05 Sutton Valence Nursing & Care Centre DS0000026208.V270186.R01.S.doc Version 5.0 Page 26 Maintaining the working kichen in good state or repair and fit for purpose. Whilst improvement have taken place there is still strong feedback this has not been met satisfactorily by a number of residents spoken with today and EHO report. Immediate requirement a written response to be submitted to the commission by return post before timescale date. The registered person shall 31/12/05 having regard to the number and needs of residents ensure that the premises to be used are kept in a good state of repair. In that; The kitchen floor is repaired and rplace immediately. Immediate requirement a written response to be submitted to the commission by return post before timescale date. The registered person shall having regard to the number an needs of residents ensure that the equipment used by the home is maintained to good working order with sufficient numbers of lavatories, bathrooms and showers fitted with hot and cold running water. In that all electrical baths and out of order toilets are repaired or replaced and refurbishment of bathrooms is reviewed and assessed to met the needs of current residents. Sutton Valence Nursing & Care Centre DS0000026208.V270186.R01.S.doc Version 5.0 Page 27 5 OP19 23(2)(b) 5 OP21 23(2)(c)(j ) 31/01/06 7 OP26 16(2)(j)(k ) Written response to be submitted to the commission by the timescale date The registered person shall having regard to the size of the care home and the number and needs of residents – after consultation with the environmental health authority, make suitable arrangements for maintaining satisfactory standards of hygiene in the care home, keep the care home free from offensive odours and make suitable arrangements for the disposal of general and clinical waste. In that:· Offensive odours were noted in sluice rooms, lounges and some bedrooms . Cleanliness of toilets. (This requirement is repeated from the previous inspection reports dated 27th January 2004, 14th April 2004, 16th August 2004 and 22 7 24th March 2005) 31/01/06 8 OP28OP30 Whilst improvements have been acknowledged there are still areas requiring further monitoring to ensure consistency of hygiene Written response to be submitted to the commission by the timescale date 18(1)(a)(c The registered person shall, 31/01/06 ) having regard to the number and needs of residents, ensure that at all times suitably qualified, competent and experienced DS0000026208.V270186.R01.S.doc Version 5.0 Page 28 Sutton Valence Nursing & Care Centre persons are working at the care home in such numbers as are appropriate for the health and welfare of residents and ensure that they receive training appropriate to the work they are to perform. Some training has taken place since the last inspection but remains ongoing to ensure all staff receives the training required including NVQ qualified care staff. Written response to be submitted to the commission by the timescale date 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 OP1 OP7 Good Practice Recommendations It is recommended alternative simpler photographic / object referencing and personalised resident guide is developed. It is recommended that care plans have:· Ongoing review and updating of care plans to ensure current information is in place and updated where necessary to avoid any potential confusion.· Additional information should be recorded in respect of residents’ social needs and activities. It was recommended that, as far as possible, residents were able to choose the day/s and number of their baths per week.(This recommendation is repeated from previous inspection dated 16th August 2004.) Residents continue to evidence this is not happening. It is strongly recommended that the home reviews their current consultation and involvement processes personally and as a group, to ensure residents are able to maximise their capacity to personal autonomy and choices. Their DS0000026208.V270186.R01.S.doc Version 5.0 Page 29 3 OP14 4 OP14OP33 Sutton Valence Nursing & Care Centre views are listened to and appropriate action taken as necessary. Quality assurance surveys are proposed to be circulated in January 2006. It is strongly recommended that call systems are reviewed for communal areas to enable residents to call for assistance with personal care or emergencies. It is recommended that additional staff are on duty at peak times of activity during the day· In sufficient numbers to escort less ambulant residents around the home as required.· In sufficient numbers to run and supply the homes laundry service. It was strongly recommended that staff training needs and documentation should be reviewed, in that:· The use of booklets for training in infection control, health and safety and the protection of vulnerable adults should be reviewed to ensure that sufficient detail and content was included.· The review of staff training needs should include resident specific training. Alternative incentives and policies are introduced to encourage care staff to undertake NVQ Awards. There is evidence this is being addressed through the training audit currently being undertaken by the manager. It is strongly recommended that the registered manager develop strategies and effective processes to enable residents, staff and other stakeholders to appropriately affect the way in which services are delivered. Evidence of working towards this but to ealry to assess success. It is strongly recommended that the home develop effective quality assurance and monitoring systems using resident’s views and feedback, with clear records of action that has been taken. Quality assurance surveys are proposed to be circulated in January 2006. 5 6 OP22 OP27 7 OP30 8 OP32 9 OP33 Sutton Valence Nursing & Care Centre DS0000026208.V270186.R01.S.doc Version 5.0 Page 30 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Valence Nursing & Care Centre DS0000026208.V270186.R01.S.doc Version 5.0 Page 31 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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