Inspection on 07/04/08 for Sutton Valence Nursing & Care Centre

This inspection was carried out on 7th April 2008.

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

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

Other inspections for this house

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

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

Sutton Valence Nursing & Care... 19/12/05

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 Justine Williams Unannounced Inspection 7th April 2008 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 Valence Nursing & Care Centre DS0000026208.V361152.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Sutton Valence Nursing & Care Centre DS0000026208.V361152.R01.S.doc Version 5.2 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 sutton.valence@fshc.co.uk 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 Limited (wholly owned subsidiary of Four Seasons Health Care Limited) 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.V361152.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 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. Of the 8 persons with a physical disability, one person under 40 whose date of birth is 28.07.1972. 12th December 2007 Date of last inspection 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. 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, two of which have ensuite 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. The current fees range from £437.02 to £770.00 per week. Chiropody, hairdressing and other sundries are not included. The manager gave this information following the site visit. Sutton Valence Nursing & Care Centre DS0000026208.V361152.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. An unannounced inspection was carried out on 7th April 2008 between 09.20 am and 3.30pm by regulatory inspector Justine Williams. During that time residents, staff and the registered manager agreed to speak with the inspector both in public and privately. This report contains assessments made from observations, conversations and records, case tracking and a tour of the premises. Feedback was given during and at the end of the inspection. As part of this inspection process surveys were sent to service users, GP’s, health care professionals, care managers and relatives of residents. Whilst many of the requirements made at the last inspection have been met it is the case that several more requirements have been made. A random inspection was carried out on 12th December 2007, and the purpose of this inspection was to assess what actions had been undertaken to meet the statutory requirements from the previous inspection and to ensure the immediate requirements regarding health and safety had been met. It was found that most requirements given at the previous key inspection had been met or partly resolved. However, it has been established that the providers and management did not receive a copy of this report, and were therefore unaware that some requirements had been repeated, and some new ones were given. As a result of this, CSCI have recognised that there were some mitigating circumstances in that the home could not be expected to meet requirements that they had not been fully informed about. What the service does well: New residents have their needs assessed by a senior member of staff prior to moving to the home. Residents may have visitors at any reasonable time. The majority of residents enjoy the quality of food and varied menu. The recruitment policy and procedures are robust and ensure staff have CRB checks and references prior to beginning work at the home. Sutton Valence Nursing & Care Centre DS0000026208.V361152.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Further efforts should be made to include residents’ social interests in their care plans. Equipment to enable staff to tether the medication trolley at convenient points around the home is needed, so that if they are called away it may be secured safely and conveniently. Providing residents with means of summoning staff when they are in communal areas is needed to protect their privacy and dignity and also to better assure their health and safety. The current activities must be reviewed to include all the residents at Sutton Valence, and to encompass a wide range of interests the residents have. Currently the majority of residents are socially isolated due to activities being aimed at a select few. Sutton Valence Nursing & Care Centre DS0000026208.V361152.R01.S.doc Version 5.2 Page 7 Minor complaints or those that are considered not formal complaints are not recorded centrally and therefore are hard to track and more difficult to include in the quality assurance programme to ensure they do not recur. The home has had several adult protection alerts since the last inspection, and this coupled with the fact that not all staff have had training in adult protection or have worked through adult protection workbooks perhaps in 2005 or 2006, should indicate the home needs to take some action to better assure residents’ safety. The practice of wedging residents’ bedroom doors open with bricks must cease, a risk assessment must be completed urgently and fire safe equipment be fitted. The refurbishment to the home, which did not take place in November 2006, is now very much overdue with the communal areas looking in a very poor state. Residents and their relatives were upset by the state of many areas of the home but were unaware that the refurbishment is imminent. (NB: since this inspection, and prior to this report being published, CSCI have been notified of the home’s schedule of works to carry out a redecorating programme, and to replace many items of furniture, flooring and soft furnishings). Some infection control issues were identified presenting further risks to residents well being, with net underwear being shared, and not for individual named residents and hoist slings, wheelchairs and an item of clothing being stored in bathrooms. Broken equipment must not be stored in bathrooms. Residents should be given keys to their lockable storage space and their bedrooms, unless they are unable or do not wish to have the keys. Some areas of staff training continue to be an issue with two members of the catering staff, one an assistant one a cook not having had food hygiene training, several care staff not having had adult protection training, and many more not having had health and safety training. The home has a quality assurance system in place, which includes surveys and audits, and reports by staff senior to the manager and not based at the home, however the quality assurance system is failing to identify significant areas where the home must improve including those relating to health and safety. Residents do not have access to their money outside of office hours if they have handed it to the home for safekeeping. The resident written agreement to this and better advertising of this fact in the service users guide is advisable. Sutton Valence Nursing & Care Centre DS0000026208.V361152.R01.S.doc Version 5.2 Page 8 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 Valence Nursing & Care Centre DS0000026208.V361152.R01.S.doc Version 5.2 Page 9 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Sutton Valence Nursing & Care Centre DS0000026208.V361152.R01.S.doc Version 5.2 Page 10 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3,6 Quality in this outcome area is good, This judgement has been made using available evidence including a visit to this service. Residents can feel confident that they will have their needs assessed prior to moving to the home. EVIDENCE: A senior trained nurse assesses prospective residents prior to their moving in, and residents said this gave them an opportunity to find out more information about the home, as most had not visited the home prior to moving in. An updated brochure and the service user guide are given to the prospective resident when they are visited. Trial visits are offered and can be arranged on Sutton Valence Nursing & Care Centre DS0000026208.V361152.R01.S.doc Version 5.2 Page 11 behalf of new residents but often residents are too unwell to visit, the home welcomes the family to visit on their behalf. The manager stated that following a recent adult protection alert the homes practices have changed in relation to residents who come to the home for repeated episodes of respite care, these residents are now assessed prior to or on admission, prior to the alert, these residents could be readmitted several times without being properly reassessed. Intermediate care is not offered at Sutton Valence. Sutton Valence Nursing & Care Centre DS0000026208.V361152.R01.S.doc Version 5.2 Page 12 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents care plans now better reflect their needs in relation to personal and health care. Some minor improvements are needed in the home’s medication practices. Residents’ privacy and dignity could be better promoted. EVIDENCE: Following the last inspection care plans have been improved and contain more detailed information about how staff are to meet the individual residents’ needs. Care plans are regularly reviewed and updated and residents have had some involvement in the drawing up of their care plans. A discussion took place as to more able residents writing their own daily record of events. The Sutton Valence Nursing & Care Centre DS0000026208.V361152.R01.S.doc Version 5.2 Page 13 care plans seen indicated residents’ preferred daily routines such as the time they like to get up in the morning etc. Residents social needs are now included in the care plans, but there has been little effort to match residents’ interests and hobbies into the activity programme. The care plans include information as to how the resident health needs are to be met, and assessments are undertaken using recognised tools for the risk of pressure sore development, incontinence, nutritional risk, falls and other specific risk assessments. The actions taken to minimise risk of residents developing pressure sores is recorded in the care plans however of the 6 residents with pressure sores, 3 were acquired at the home. All these residents are having their positions changed regularly and this is documented and they are being nursed on special mattresses and cushions. The residents’ files contained detailed information completed by GP’s and other healthcare professionals visits. The home has a medication policy the staff work to and residents may self medicate if they wish to and subject to risk assessment. All residents have lockable storage space for medicines. The home has a medication room with hand-washing facilities, and storage for medicines and drug trolleys. The medication fridge was locked as were all the other cupboards containing medicines in line with legislation and good practice guidelines. Staff still do not have areas around the home they can safely tether the medication trolleys to should they need to during the medication round. As the home has 3 wings, 2 on the first floor and the only place to lock away the trolleys safely at present is in the medication room on the ground floor this should be addressed as soon as possible. The privacy and dignity of some residents is being compromised by inappropriate information being displayed in their bedrooms rather than in the care plans or other more appropriate place, one gentleman had signs on his wardrobe regarding the use of strident for cleaning his dentures and a note to relatives about marking clothing with residents names. Residents spoken with said they felt staff dealt sensitively with their personal care needs and they were not made to feel embarrassed, however the lack of an appropriate call bell system in communal areas meant that a resident requiring help to use the toilet are was left having been incontinent, whilst trying to attract attention of the staff. Sutton Valence Nursing & Care Centre DS0000026208.V361152.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15, Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The lifestyle and activities at the home do not match resident expectations, preferences or capacities. Residents receive an appealing diet let down by having to eat their meals in dirty looking, worn and unpleasant surroundings. EVIDENCE: The home employs an activity coordinator for 40 hours per week, who has recently been joined by another member of staff who in addition to her usual role now spends 10 hours per week running activities. Residents are asked when they move into the home about their interests, and hobbies but there is no effort to incorporate these into the programme of activities. The activity programme is displayed on a calendar in the lobby, which is accessible to the very few residents who are mobile. The calendar for the Sutton Valence Nursing & Care Centre DS0000026208.V361152.R01.S.doc Version 5.2 Page 15 month did not indicate that any religious services or visits were taking place, and the activities planned are limited to bingo, coffee mornings and some external entertainers such as PAT dogs, and a singer. The residents said that a small number of residents (approximately 8) who are more able, regularly participate in the organised activities and trips, and indeed there were 8 residents participating in bingo on the afternoon of the site visit. Social contact for the majority of residents most of whom are confined to their rooms due to their frailty, is restricted to when the activity coordinator goes round the home with the shop trolley. This only happens on a Friday afternoon and due to the numbers concerned can only be for a brief period of time. This is documented as “shop and social contact” and for some this could be all the social contact that they have. These factors will contribute to residents’ feelings of social isolation. Some residents spoken with did not know who the activity coordinator was. The home have been saving money for a minibus but have recently been given a minibus by the company. The manager said they intend to spend the money they have saved on activities for residents. Residents are able to have visitors at any reasonable time. Resident spoke highly of the chef and the standard of cooking, and the variety of the menu. The menu displayed on a wipe board in the dining room. However, the menu displayed was out of date so all the residents spoken with did not know what they were having for lunch that day. The menu is in each resident’s bedroom in a folder and in the lobby on display but again these can only be accessed by more able and mobile residents. Many of the residents chose to eat their lunch in the dining room, which has deteriorated into a very unpleasant room, with peeling and stained wallpaper, a stained ceiling, damaged walls probably from wheelchairs, and a sticky carpet. Residents still do not have access to fresh fruit unless it is on the menu and part of pudding choices. The chef caters for residents requiring special diets such as diabetic diets, soft diets etc. The residents are not asked to formerly feedback to the chef their opinions or suggestions about the menu and meals, other than through an annual survey, or the resident meetings. These unfortunately are not well attended due to the frailty of the residents. Sutton Valence Nursing & Care Centre DS0000026208.V361152.R01.S.doc Version 5.2 Page 16 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): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents are confident their formal complaints will be acted on, though minor complaints may not recur, as they are not included in the complaints records or in the quality assurance systems. Residents have not been protected from abuse, though changes in the home’s policy for respite clients should better protect all residents. EVIDENCE: The home has a complaints policy which includes timescales for actions, the policy is contained within the service users guide which is given to each resident when they move in and is displayed in the lobby. The home has received one complaint since the random inspection conducted in December from a relative unhappy with the state of the residents room, the room has been re-carpeted and the relative was assured the home refurbishment was imminent. Another complaint was sent via the Commission. Both complaints are now considered to be resolved. Again the actions taken to address complaints made must be clearly documented once completed not just at the investigation stage. This was identified at the last key inspection. The home still does not record minor complaints or Sutton Valence Nursing & Care Centre DS0000026208.V361152.R01.S.doc Version 5.2 Page 17 dissatisfaction centrally. These are dealt with informally and may be recorded in the daily events in the care plan, recording them centrally would enable the manager to discover any trends, and could feed in to the quality assurance process. This was identified at the last inspection but no action has been taken. The home has had four adult protection alerts since the last inspection, one of which is still ongoing. Whilst the policy and procedure for reporting and responding to adult protection alerts once raised is appropriately managed the home has not ensured the safety of at least one of the residents, through poor communication and failure to reassess an individual who was being admitted for a phased respite care, and delays in sourcing appropriate pressure relieving equipment. The home has changed its policy as a result and now reassesses all residents on admission or before their admission to the home, and has a designated mattress and cushion for respite clients. According to the home’s own training matrix 9 of the care staff and a further 6 ancillary staff have received no adult protection training around half the remaining staff have completed a workbook, in some cases up to 3 years ago, and the other half have had recent adult protection training. The manager is aware of her responsibilities in the safe recruitment of staff, and in referring staff for inclusion onto the POVA list. Sutton Valence Nursing & Care Centre DS0000026208.V361152.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19,22,26 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Residents do not have a well maintained environment in which to live, and due to the poor state of the home adequate cleaning is made much more difficult. Residents are at risk from poor infection control practices. EVIDENCE: The home is overdue its major refurbishment which was promised to the residents, relatives and staff over 1½ years ago. The most serious health and safety issues identified at the last key inspection were addressed. However, residents’ bedroom doors are being wedged open with bricks, as fire safety equipment has not been purchased to allow resident to have their doors open. The manager agreed to risk assess this immediately and has ordered fire Sutton Valence Nursing & Care Centre DS0000026208.V361152.R01.S.doc Version 5.2 Page 19 safety compliant equipment to be fitted immediately it arrives. The communal areas, toilets, bathrooms, corridors and many bedrooms are now clearly in need of redecoration, new flooring or carpets, new furniture etc. The pink lounge has sticking tape holding a pane of glass in place on one door to the exterior, presenting a health and safety and security risk, the yellow lounge remains very uninviting with sparse furniture, scruffy, peeling wallpaper, and stained ceiling. The dining room remains very poor. It is poorly lit, with a stained carpet, which is sticky underfoot, and the wallpaper is peeling off the walls. Several corridors remain poorly lit with damaged walls. The bathrooms and toilets are institutional and uninviting. Some residents have damaged and scruffy bedroom furniture. The home has an inadequate call bell system in the communal areas, the manager stated that mobile call bells had been purchased, however two residents were calling out and in need of assistance in one of the lounges for some time before a member of staff walked through. A broken hoist was being stored in the bathroom, arrangements to repair or remove this should be made. Whilst residents have lockable storage space, few have been given the key, and residents who are able to lock their rooms have not been given this option. Since the last key inspection the laundry room has been repainted and cleaned, and the washing machine and dryers are now working. The sluice rooms were cleaner, than at the last key inspection, and there were no linen shortages. Distinct offensive odours were noted in two areas of the home. The practices regarding net underwear remain unchanged. The home does not label residents’ own net underwear, and it is shared among the residents. In order to protect residents’ health and dignity, residents must have their own items of clothing labelled and for their use only. This includes net underwear. The storage of items in bathrooms such as wheelchairs, hoist slings, and items of clothing, must cease as they present an infection control hazard. Sutton Valence Nursing & Care Centre DS0000026208.V361152.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents are cared for by a safely recruited staff group, but some staff have not received recent training updates in core areas. EVIDENCE: The staffing numbers and skill mix appeared adequate for the number and needs of the current residents. Staff and residents said there were not long delays in answering call bells, and with residents getting up and being assisted with washing and dressing at reasonable times. The home has a recorded rota showing what staff are on duty and in what capacity. The staffing numbers have been increased on two units since the last inspection. The home still has not achieved 50 of staff having achieved NVQ, although some staff are studying at present. The home operates a robust and thorough recruitment procedure, with all staff providing two written references and having POVA checks and CRB checks, prior to starting work. Sutton Valence Nursing & Care Centre DS0000026208.V361152.R01.S.doc Version 5.2 Page 21 There is now a qualified first aider on duty 24 hours per day, but there are some lapses in other areas which must be addressed, not all staff have received adult protection training, health and safety training, and not all catering staff have received food hygiene training. Sutton Valence Nursing & Care Centre DS0000026208.V361152.R01.S.doc Version 5.2 Page 22 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents live in a home where their health and safety is not consistently protected. Residents would benefit from a more proactively run service. EVIDENCE: Requirements made at the key inspection in 2007 have mostly been met, or partially met. However, requirements given at the random inspection in December 2007 to check compliance have not all been met, and the home would benefit from a more proactive management approach. Sutton Valence Nursing & Care Centre DS0000026208.V361152.R01.S.doc Version 5.2 Page 23 The home appears to have thorough quality assurance systems in place however they have failed to pick up, or act on issues found at the site visit, including some relating to health and safety, infection control and privacy and dignity. Therefore effective quality monitoring is not as effective as it could be. The home’s practices around keeping residents monies is unchanged, in that the home keeps small amounts of money for the majority of residents, and there is a system in place with clear records of expenditure and money deposited. Receipts are kept for individuals, it is recommended that the money is not pooled, but held separately, and that the bank account be set up so that it is for individuals and that they may receive interest on their money. The residents do not have access to their money outside of office hours Monday to Friday. Residents must be asked to agree this and this should be advertised in the service users guide. The self-assessment tool completed by the home indicates that they are up to date with servicing and maintenance of equipment and systems. The manager took the immediate action required following the last key unannounced inspection to resolve the health and safety issues identified. The health and safety of residents is compromised by the home’s lack of appropriate fire safety compliant equipment to hold residents bedroom doors open, and some risk assessments have not been completed. The health and safety in respect of infection control is also compromised, due to equipment being stored in bathrooms, which can present an infection control hazard, and the practices of sharing net underwear. Staff would clearly benefit from health and safety training, which has not been provided for all staff. Qualified first aiders are now on duty 24 hours a day, and all staff have received moving and handling training. Sutton Valence Nursing & Care Centre DS0000026208.V361152.R01.S.doc Version 5.2 Page 24 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 2 8 3 9 2 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 3 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 1 1 X X X X 2 X 1 STAFFING Standard No Score 27 3 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 1 X 2 X X 2 Sutton Valence Nursing & Care Centre DS0000026208.V361152.R01.S.doc Version 5.2 Page 25 YES 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 OP9 Regulation 13 (2) Timescale for action The registered person shall make 30/06/08 arrangements for the safe handling, safe administration and safe keeping of medication in that, Equipment be fitted to enable medication trolleys to be tethered in areas other than in the medication room. Repeated from the last inspection If this remains unmet the Commission may take enforcement action. The registered person shall make 30/05/08 suitable arrangements to ensure that the home is conducted in a manner which respects the privacy and dignity of service users, in thatResidents have access to appropriate equipment to summon staff so they are not left having been incontinent. The registered person shall 30/05/08 consult service users about their social interests, and make arrangements to enable them to engage in local, social and community activities. DS0000026208.V361152.R01.S.doc Version 5.2 Page 26 Requirement 2 OP10 12 (4)(a) 3 OP12 16 (2)(m) Sutton Valence Nursing & Care Centre Repeated from the last inspection If this remains unmet the Commission may take enforcement action The registered person shall ensure so far as practicable service users have the opportunity to attend religious services of their choice. The registered person shall by make arrangements by training staff or by other measures, to prevent service users from being harmed or suffering abuse or being placed at risk of harm or abuse. The registered person shall ensure the home is kept in a good state of repair, internally and externally, and all parts of the home are reasonably decorated. Repeated from the last inspection If this remains unmet the Commission may take enforcement action The registered person shall ensure suitable adaptations are made and such support and equipment and facilities as may be required are provided for service users, in that- 4 OP12 16 (3) 30/05/08 5 OP18 13 (6) 30/06/08 6 OP19 23 (2)(b)(d) 15/07/08 7 OP24 23 (2)(n) 15/07/08 8 OP26 13 (3) 1) Residents are provided with keys to their bedrooms doors and lockable storage space, unless they are unable or do not wish to have them. The registered person shall make 30/05/08 suitable arrangements to prevent infection, toxic conditions and the spread of infection at the care home in that; net underwear be used for named individuals and not DS0000026208.V361152.R01.S.doc Version 5.2 Page 27 Sutton Valence Nursing & Care Centre 9 OP26 13 (3) 10 OP30 18 (1) 11 OP33 24 12 OP38 13(4)(c) shared. Repeated from the last inspection If this remains unmet the Commission may take enforcement action The registered person shall make suitable arrangements to prevent infection, toxic conditions and the spread of infection at the care home, in that; Hoist slings, wheelchairs, and items of clothing are not stored in toilets and bathrooms. The registered person shall ensure that staff receive training appropriate to the work they are to perform, in that; Staff receive health and safety training, catering staff receive food hygiene training. The registered person shall establish and maintain a system for reviewing and improving the quality of care provided at the home. The registered person shall ensure that unnecessary risk to the health and safety of service users are identified and so far as possible eliminated. In thatFire doors are not propped open with bricks or other items but fire safety compliant equipment is purchased for those residents who wish to have their doors open, and risk assessments be completed whilst these are being fitted. 30/05/08 30/06/08 30/07/08 08/04/08 Sutton Valence Nursing & Care Centre DS0000026208.V361152.R01.S.doc Version 5.2 Page 28 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 OP15 OP28 Good Practice Recommendations It is recommended that residents have access to fresh fruit, on a daily basis. It is strongly recommended that staff be supported to enrol on NVQ training courses and that the home aims to attain the minimum recommendation of 50 , as soon as possible. It is strongly recommended that arrangements be made for resident to be able to access their money any time or to attain the written agreement of residents, that the current arrangements are suitable, the information should also be included in the service users guide. 3 OP35 Sutton Valence Nursing & Care Centre DS0000026208.V361152.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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. 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