CARE HOMES FOR OLDER PEOPLE
Sycamore Lodge Residential Home Nookside Grindon Sunderland SR4 8PQ Lead Inspector
Mr Clifford Renwick Unannounced Inspection 13th February 2006 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Sycamore Lodge Residential Home DS0000015741.V276692.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. Sycamore Lodge Residential Home DS0000015741.V276692.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Sycamore Lodge Residential Home Address Nookside Grindon Sunderland SR4 8PQ 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) 0191 525 0181 0191 528 8908 SLW Limited Judith Dolan Care Home 40 Category(ies) of Dementia - over 65 years of age (10), Mental registration, with number disorder, excluding learning disability or of places dementia (1), Old age, not falling within any other category (40), Physical disability (4) Sycamore Lodge Residential Home DS0000015741.V276692.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 16th September 2005 Brief Description of the Service: The home provides care to older people over the age of 65 years, eleven of who may have dementia or mental health needs and four places for people who may have a physical disability. It provides personal care only and any health needs are dealt with by the Community Nursing Services. The main part of the house is Victorian in construction and was previously owned by the social services department. The current owner acquired the home several years ago and after extensive refurbishment reopened the home to provide care for twenty persons. Since then the owner has built an extension to the home with the provision of a two-storey building, in order to enable forty people to be accommodated. All areas of the extension offer disabled access but there are some restrictions on the upper floor of the main house. The home is detached and stands in its own grounds with well-established trees and is approached by a private drive. Though it is located in the heart of the Grindon community it has a feel of being in the country due to its location and large expanse of external space. There is a large garden to the front of the home that can be used by service users and their visitors. There is easy access to a bus service, which offers services into the City Centre, where there is a range of services and shops. Sycamore Lodge Residential Home DS0000015741.V276692.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This announced inspection took place over 6 hours and was carried out as part of the statutory twice-yearly inspection process. Selected areas of the premises, which included communal areas and a number of bedrooms on the ground and first floor, were viewed. Care records were examined as well as records that related to health and safety, administration of medicines and staff recruitment. Discussion took place with the staff on duty throughout the visit. Discussion also took place with several service users and one relative and time was spent observing staff practices and how staff spoke to residents. It was established that the people who live in this home preferred to be known as residents therefore this term of reference is used throughout the report. The judgements made are based on the evidence available at the time of the inspection. What the service does well:
There continues to be a positive commitment by the owners towards staff training. Stability has been maintained within the staff team and this has ensured that they are consistent with their work. The atmosphere in the home is nice and this is consistent with previous inspections. Discussions held with residents and a relative stated was one of the nicest things about the home. In discussion with a relative they shared a recent bad experience of another home and stated that this home was 100 better in all respects. They said that staff were friendly and always welcoming when they visit and they liked the idea of being able to use the small kitchenette for making drinks when visiting. Observations made confirmed that staff are professional in their approach with residents whilst at the same time able to share a laugh and a joke and this contributed to the positive atmosphere. Residents stated that this is a “nice home” and “they like living here”. One resident has made plans to go on an overseas holiday with their family and they said that it was good that they could pursue their interests outside of the home. The building is well-maintained, clean, in good decorative order and residents are encouraged to arrange the furniture in their rooms to suit them. Sycamore Lodge Residential Home DS0000015741.V276692.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Sycamore Lodge Residential Home DS0000015741.V276692.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 Sycamore Lodge Residential Home DS0000015741.V276692.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): None of these standards were looked at during this inspection. EVIDENCE: Sycamore Lodge Residential Home DS0000015741.V276692.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, 9, 10 Care plans are in place for each resident but they require more detail to be added in order to demonstrate how residents individual needs are met especially when restrictions and limitations have been put in place. Staff at the home successfully supports residents with their social, health and personal care needs in a way, which treats them with respect and promotes their rights and privacy. Medication administration procedures ensure that the resident’s health care needs are addressed. EVIDENCE: Case tracking that involved examining four resident’s files and care plans was carried out. Care plans for individual residents have continued to be developed by the manager and these set out how staff will meet individual needs. For two residents risk assessments have been implemented in respect of their alcohol consumption. This has resulted in restrictions and limitations being put in place by staff in order to ensure their health needs are met. One resident has behaviours that challenge and though staff are responding appropriately to this it is not recorded in sufficient detail in the care plan.
Sycamore Lodge Residential Home DS0000015741.V276692.R01.S.doc Version 5.1 Page 10 Records of administration and storage for medication are satisfactory though the manager was advised of the need to ensure that fridge temperatures are taken on a daily basis when storing medicines in the fridge. An audit of the medicines referred to as controlled drugs was carried out and was satisfactory. Observations made throughout the inspection confirmed that staff are respectful to residents. And personal and intimate care tasks were carried out in the privacy of resident’s bedrooms. Sycamore Lodge Residential Home DS0000015741.V276692.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, 14, 15 Residents are encouraged and supported to lead active lifestyles based on their preferences and choices. Friendships and relationships with people outside the home are encouraged. The meals provided offer a good balanced diet, which contributes to the promotion of healthy eating, and residents are involved in menu planning. EVIDENCE: Staff encourage residents to maintain their independence wherever possible. For one resident they are supported to have their own kettle and fridge in their bedroom. One resident goes out unaccompanied on a daily basis to purchase his or her own items from the local shops. Another resident has made plans to go on holiday with their family to Ireland. The routines in the home are flexible and residents can choose when they get up and when they wish to retire to bed. Activities in the home vary but one, which is popular, is chatting and to facilitate this staff have supplied new chairs in the lobby area near to the public payphone. This has proved to be a popular meeting point for a group of residents who like to chat among themselves and also observe who is coming in and out of the home.
Sycamore Lodge Residential Home DS0000015741.V276692.R01.S.doc Version 5.1 Page 12 Lunch was taken with residents in the ground floor dining room and this offered a good opportunity to chat with residents while eating. Tables were nicely laid and the meal, which was presented in tureens, was piping hot and plentiful. Residents were able to choose what they wanted on their plates and the menus also showed a range of alternative dishes to the main meal. Some residents exercised their choice and had something, which was not on the menu or even on the list of alternatives. They confirmed in discussion that this was never a problem in the home and that the cook was always able to prepare a meal that they wanted. The residents stated that there was always sufficient to eat and plenty of refreshments through the day and night. One resident who stated that they like to be up at 6am each day confirmed that the staff always made sure there was a hot drink for them when they got up in the morning. Sycamore Lodge Residential Home DS0000015741.V276692.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): None of these standards were assessed on this occasion. EVIDENCE: Sycamore Lodge Residential Home DS0000015741.V276692.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, 22, 23 The home is clean, warm and well maintained offering residents a homely and safe environment in which to live. Though no one requires the use of any specialist equipment the home have purchased a hoist. Resident’s rooms are furnished to reflect their individual choice and taste, which ensures that they have comfortable rooms to live in. EVIDENCE: A number of bedrooms were viewed on ground and first floor levels of the home as well as all communal areas. A good standard of housekeeping is in place and there were no noticeable safety hazards. Many residents have been encouraged to bring in to the home personal possessions and this has ensured that each room is different. In discussion with residents they confirmed that they were satisfied with their rooms and that they enjoyed spending time in the privacy of their room watching television. The home have a specialist hoist for assisting with lifting should this be required. Sycamore Lodge Residential Home DS0000015741.V276692.R01.S.doc Version 5.1 Page 15 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 28, 29 The deployment and number of staff on all shifts is appropriate to ensure that at all times residents are supported by an experienced group of staff. Record keeping in respect of new staff employed in the home is robust and offers sufficient information to ensure that residents are protected. EVIDENCE: There is a positive commitment by the owners to ensure that staff receive training appropriate to their work. The mix of staff on duty ensures that there is a balance with both experienced and qualified staff. The key worker systems ensure that staff have specific tasks and responsibilities to ensure consistency of care for the residents and this is working well. Records were examined for new staff appointed since the last inspection. This confirmed that all documentation required as part of recruitment had been obtained. Sycamore Lodge Residential Home DS0000015741.V276692.R01.S.doc Version 5.1 Page 16 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 35, 38 Appropriate recording systems are in place to ensure that any monies handled on behalf of residents is dealt with satisfactorily. Arrangements to ensure that the health safety and welfare of residents and staff are in place and are successful. EVIDENCE: Records that are used to record personal allowances held on behalf of residents were examined and were satisfactory. Advice was offered to the manager about these could be developed further in order to enhance the system in use and provide a clear audit trail. Risk assessments are in place, which identifies potential hazards in the home, and also the control measures which are in place to deal with them. The manager is awaiting a visit from the fire officer to discuss these with him.
Sycamore Lodge Residential Home DS0000015741.V276692.R01.S.doc Version 5.1 Page 17 Staff receive appropriate training in health and safety matters to ensure that they are up to date with current practice and any changes to the homes health and safety policy. Sycamore Lodge Residential Home DS0000015741.V276692.R01.S.doc Version 5.1 Page 18 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 X 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 3 X X 3 3 X X X STAFFING Standard No Score 27 X 28 3 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X 3 X X 3 Sycamore Lodge Residential Home DS0000015741.V276692.R01.S.doc Version 5.1 Page 19 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 15 Requirement Residents care plans must include in detail any restrictions or limitations that are currently in place. Care plans must continue to be developed as advised during the inspection. Timescale for action 30/08/06 2. OP7 15 30/08/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard OP7 OP35 OP9 Good Practice Recommendations Consideration should be given to updating resident’s personal profiles as discussed during the inspection. Sheets used to record financial transactions should be developed as advised during the inspection. Daily temperature checks of the fridge used to store medicines should be taken on a daily basis with a written record kept. Sycamore Lodge Residential Home DS0000015741.V276692.R01.S.doc Version 5.1 Page 20 Commission for Social Care Inspection South of Tyne Area Office Baltic House Port of Tyne Tyne Dock South Shields NE34 9PT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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