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Inspection on 08/08/06 for Sycamore Court Nursing And Residential Care Home

Also see our care home review for Sycamore Court Nursing And Residential Care Home for more information

This inspection was carried out on 8th August 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Sycamore Court provides a caring and pleasant home for service users, dealing with any problems they may have in an empathetic and practical manner. The standard of care and the quality of care planning is high, and staff interact well with residents with a key worker system, which ensures that one member of staff has responsibility for the overall care of the resident, being in place.The standard of catering is excellent, providing a well balanced diet, choice of menus and with a salad and a sweet trolley provided at lunchtimes. One resident stated that choices are always available on the menu and `we are treated as adults by being able to choose what we eat`. A licensed bar is available some evenings and for events taking place within the home. The turnover of staff is low and many staff have worked at Sycamore Court for a number of years. Privacy and resident`s choice is placed high on the agenda and a relative stated that `the home always asks the resident if the relative can be present at any reviews or if they can read their care plans`. Care plans are kept in the resident`s room so as to be always available to the resident and all care needs and care to be given are identified in conjunction with the resident. Arrangements are made to take residents out into Brighton or on other outings by using community transport or taxis; these always have a member of care staff accompanying the resident. All residents have single rooms, doors of which are lockable with keys being given to those residents who are able to use them safely. The standard of management is good, all health and safety measures to protect both residents and staff are in place, and an immediate requirement made in relation to testing and recording of water temperatures was dealt with well within the time scale given.

What has improved since the last inspection?

The administration of medication has improved, with regular audits now being done to ensure that all medication is recorded correctly. Individual room doors all have door closures, which will close the door automatically in the event of the fire alarm being sounded. All requirements and recommendations made at the last inspection have been complied with.

What the care home could do better:

Staff said that although there are enough staff employed for the number of residents living in the home, the increase in the needs of residents admitted, including the frequent admissions of interim care residents made it difficult to complete their workload within a reasonable time, especially when a member of staff leaves the home to accompany a resident on an outing. The manager and staff must discuss of ways to deploy the staff numbers and balance the work so that this problem is alleviated.Although activities for residents take place, these need to have more variety and would benefit from a specific person being responsible for the provision of these. Likewise residents may benefit from a programme of activities which is made available to them. The number of staff completing the National Vocational Level 2 in Care falls below that which would be expected. The National Minimum Standards stated that 50% of staff must have achieved this by 2005. Although other training has been given to staff which is relevant to the care of the resident, efforts must be made to encourage staff to undertake study for this qualification.

CARE HOMES FOR OLDER PEOPLE Sycamore Court Nursing And Residential Care Home Bear Road Bevendean Brighton East Sussex BN2 4DD Lead Inspector Elizabeth Dudley Key Unannounced Inspection 8th August 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 Court Nursing And Residential Care Home DS0000014065.V302713.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. Sycamore Court Nursing And Residential Care Home DS0000014065.V302713.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Sycamore Court Nursing And Residential Care Home Bear Road Bevendean Brighton East Sussex BN2 4DD 01273-697331 01273-621163 Address 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) sharon.blackwell@anchor.org Anchor Trust Suzan Frances Green Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40) of places Sycamore Court Nursing And Residential Care Home DS0000014065.V302713.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. That service users must be older people aged sixty-five(65) years or over on admission. The maximum number of services users to be accommodated is forty (40). The maximum number of service users forty (40) in receipt of nursing care can include five (5) in receipt of personal care. One named service user aged sixty one 61 years on admission. Date of last inspection 6th December 2005 Brief Description of the Service: Sycamore Court is a purpose built home owned and run by Anchor Trust, it is registered to offer both nursing and residential care to people over 65 years of age. The home is situated in a residential area on the outskirts of Brighton within approximately five minutes walk of local transport services. The home can also offer parking for around 14 cars. Spanning three floors, all of which are served by a shaft lift, the home has a large lounge/ dining area on the first floor and small lounge areas on each of the other floors. The small lounges have tea and coffee making facilities for relatives and friends of residents. There is also a small well-maintained garden, which is accessible to all from the ground floor. There are five assisted bathrooms and all residents rooms have an en-suite facility consisting of shower, washbasin and w.c. The home is staffed by registered nurses twenty four hours a day. The home is now contracted to provide five beds for transitional and interim care for Brighton and Hove social services. Sycamore Court Nursing And Residential Care Home DS0000014065.V302713.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key unannounced inspection took place on the 8th August 2006 over a period of eight and a half hours. During this time a tour of the home took place and fifteen residents, ten members of staff and four visitors were spoken with. Six residents had their care plans and care given examined in depth, and four relatives were spoken with by telephone. Questionnaires were sent out to residents, their relatives and GP’s prior to the inspection and a percentage of these were returned. Thanks are extended to those who returned the questionnaires and these have been very helpful in informing the inspection process. Documentation, which included care, plans; personnel files, health and safety documents and catering records were examined. Comments received about the home were positive with relatives saying that ‘We are always made welcome into the home, and staff inform us if there are any concerns about our relative’ and ‘The home is head and shoulders above others I have known’. Residents in the home said ‘the food is good’, ‘staff are very kind’ and ‘most of the time our bells are answered quickly’. Recently the home has undertaken a contract with the Brighton and Hove contracts unit to provide five beds for transitional and interim care, which enables people that would otherwise have to remain in hospital to be admitted to the home on a short-term basis whilst a nursing home bed is found for them. Thanks are extended to all residents, staff visitors and the manager for their help and hospitality during the time spent in the home. What the service does well: Sycamore Court provides a caring and pleasant home for service users, dealing with any problems they may have in an empathetic and practical manner. The standard of care and the quality of care planning is high, and staff interact well with residents with a key worker system, which ensures that one member of staff has responsibility for the overall care of the resident, being in place. Sycamore Court Nursing And Residential Care Home DS0000014065.V302713.R01.S.doc Version 5.2 Page 6 The standard of catering is excellent, providing a well balanced diet, choice of menus and with a salad and a sweet trolley provided at lunchtimes. One resident stated that choices are always available on the menu and ‘we are treated as adults by being able to choose what we eat’. A licensed bar is available some evenings and for events taking place within the home. The turnover of staff is low and many staff have worked at Sycamore Court for a number of years. Privacy and resident’s choice is placed high on the agenda and a relative stated that ‘the home always asks the resident if the relative can be present at any reviews or if they can read their care plans’. Care plans are kept in the resident’s room so as to be always available to the resident and all care needs and care to be given are identified in conjunction with the resident. Arrangements are made to take residents out into Brighton or on other outings by using community transport or taxis; these always have a member of care staff accompanying the resident. All residents have single rooms, doors of which are lockable with keys being given to those residents who are able to use them safely. The standard of management is good, all health and safety measures to protect both residents and staff are in place, and an immediate requirement made in relation to testing and recording of water temperatures was dealt with well within the time scale given. What has improved since the last inspection? What they could do better: Staff said that although there are enough staff employed for the number of residents living in the home, the increase in the needs of residents admitted, including the frequent admissions of interim care residents made it difficult to complete their workload within a reasonable time, especially when a member of staff leaves the home to accompany a resident on an outing. The manager and staff must discuss of ways to deploy the staff numbers and balance the work so that this problem is alleviated. Sycamore Court Nursing And Residential Care Home DS0000014065.V302713.R01.S.doc Version 5.2 Page 7 Although activities for residents take place, these need to have more variety and would benefit from a specific person being responsible for the provision of these. Likewise residents may benefit from a programme of activities which is made available to them. The number of staff completing the National Vocational Level 2 in Care falls below that which would be expected. The National Minimum Standards stated that 50 of staff must have achieved this by 2005. Although other training has been given to staff which is relevant to the care of the resident, efforts must be made to encourage staff to undertake study for this qualification. 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 Court Nursing And Residential Care Home DS0000014065.V302713.R01.S.doc Version 5.2 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 Sycamore Court Nursing And Residential Care Home DS0000014065.V302713.R01.S.doc Version 5.2 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): 1,2,3,4 and Quality in this outcome area is good, this is based on the available evidence including a visit to this service. Prospective residents have sufficient information about the home to enable them to make an informed decision over whether to make Sycamore Court their home. EVIDENCE: The statement of purpose and service user guide meet the National Minimum Standard and the regulations. All residents have a copy of the service user guide and most residents spoken with stated that they had received sufficient information about the home prior to their admission. The service user guide and statement of purpose include details of the recently contracted beds for Transitional and Interim Care. The manager assesses all residents prior to their admission to the home, including those admitted for transitional and interim care. There is evidence of thorough pre-admission assessment which forms the basis of the care plan. Sycamore Court Nursing And Residential Care Home DS0000014065.V302713.R01.S.doc Version 5.2 Page 10 Prospective residents and their representatives are encouraged to visit the home prior to making the decision over whether to move into the home. All residents receive a statement of terms and conditions and contract following their admission to the home. Under the amended Regulation 3 fees, payable will require to be notified to the prospective resident prior to their admission to the home. Sycamore Court Nursing And Residential Care Home DS0000014065.V302713.R01.S.doc Version 5.2 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 and 11 Quality in this outcome area is good, this is based on the available evidence including a visit to this service. Observation of residents and examination of care plans show that the home delivers a good standard of care to residents whilst maintaining their dignity and confidentiality. The standard of medication administration and audit maintains the safety of the residents. EVIDENCE: A total of ten care plans were examined and these included the care plans of the residents that were being case tracked (their care across all areas being examined in depth). Care plans seen addressed the social, psychological and health care of the residents and showed evidence of monthly review and consultation with the resident or their representative, all residents or representatives spoken with were aware of the contents of the care plans, with representatives stating that they were invited for periodic reviews following the residents consent for this being gained. One relative commented that ‘They ask mother’s permission for me to attend reviews and be involved in the care plan’. Sycamore Court Nursing And Residential Care Home DS0000014065.V302713.R01.S.doc Version 5.2 Page 12 There was evidence that residents’ current needs were documented with instructions for meeting these needs being very clear in the majority of the care plans examined. However the structure of the care plans does make it difficult for a person unfamiliar with the layout of the plans to ascertain where to find details of the care to be given, but the manager states that the format of the care plans are under review. It was apparent that care needs were addressed on an ongoing basis with review of the resident care plans taking place monthly and any additions to the care required being detailed. All care plans contained risk assessments and consent forms for any form of restraint required, which included bedrails or specialist chairs. All care plans are kept in the resident’s rooms therefore being accessible to the resident or their representative. Residents are consulted about their on-going care and different care requirements and the reason for these being carried out discussed. All residents spoken with stated that they were aware of why various interventions were being undertaken. Health care professionals including GPs. Speech and Language therapist, wound care nurse and the services of the older persons specialist nurses are accessed for residents as required. A physiotherapist visits once a week for all residents, this is in addition to the physiotherapist that attends those residents admitted for transitional and interim care. One relative of a resident stated that ‘they do consult me on a regular basis if they have any concerns’. However one relative did raise a concern that she had not been contacted immediately following an accident involving her mother but ‘the night staff contacted me to say they were concerned and getting the advice of a doctor’. Most relatives and representatives of residents spoken with said that they were contacted within a reasonable time of a concern or incident occurring. The home has equipment for moving and handling and specialist equipment for the prevention of pressure damage. All residents looked clean and cared for, with those nursed in bed or in specialist chairs appearing comfortable. Relatives said that the residents looked comfortable when they visited and that they were satisfied with the care given. Sycamore Court Nursing And Residential Care Home DS0000014065.V302713.R01.S.doc Version 5.2 Page 13 All medical and nursing interventions take place in the resident’s own room and residents have access to a portable phone. It was noted that staff record the residents preferred form of address and use this when talking with residents, and all staff were seen to be interacting with residents in a sensitive and kind manner. The home has three clinic rooms for the administration and storage of drugs and dressings, with the application of dressings taking place in the resident’s room. All clinic rooms were clean and there was evidence of the recording of drug fridge temperatures and maintenance of equipment with all medications being stored at the optimum temperatures and liquid medication and eye drops having their dates of opening recorded. All medication charts were signed following administration and all controlled drugs were stored and recorded correctly. The home undertakes a medication audit on a weekly basis. Two registered nurses have undertaken a short course in Palliative care and the manager and her deputy are planning to attend an in-depth course in this at the end of the year. All registered nurses are aware of the use of syringe drivers and other analgesia used in the care of the terminally ill resident. Testimonials thanking staff for their care from relatives of those residents who have died in the home were seen and stated that the residents had been well looked after and kept comfortable. Sycamore Court Nursing And Residential Care Home DS0000014065.V302713.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 Quality in this outcome area is good, this is based on the available evidence including a visit to this service. Residents benefit from the quality of life offered by the home, although the standard of activities offered is variable. Catering is of a high standard providing a selection of meals, which are attractively presented and served in a manner reflecting the awareness of the individuality of the residents and avoiding institutionalisation. EVIDENCE: The home does not employ an activities organiser but has a member of staff employed on a part-time basis who is responsible for helping residents with a few activities and helping with drinks and meals. There is an activities programme but the manager stated that this was experimental at present to get a feel for what residents like. The manager intends to review the provision of activities and activities coordinator. Residents go out into Brighton shopping accompanied by a carer in taxis or community transport and some activities take place in the home. Sycamore Court Nursing And Residential Care Home DS0000014065.V302713.R01.S.doc Version 5.2 Page 15 The physiotherapist has an exercise session weekly and other activities which include outside entertainers take place. Residents were taking part in a painting session on the afternoon of the visit. The home recently held a fete and birthdays are celebrated. Some residents said that ‘There is not much going on’, ‘I get bored but the staff are so busy’, ‘Sometimes staff have time to come in and talk but most of the other people in the lounge are not able to talk to me, so it can be very lonely’. Residents said that they could rise or retire as they wished and could make choices around the activities of daily living. There is an open visiting policy with relatives saying that they were welcome at any time. The manager can access an advocacy service if required and has brought in an advocate for some residents. The standard of catering is high, with a good range of menus, the ability to cater for most special diets and liquidised or soft meals having their constituents served separately on the plate to ensure they appear attractive. The chef stated that for one resident it was difficult to do this as her meals require extra liquid adding to them, a discussion emphasising the importance of this took place. All meals were seen to be attractively presented with a sweet trolley is taken around containing several different types of dessert. The majority of cakes and puddings are home made, there is fresh fruit available and a cooked breakfast is offered twice a week. Residents can have a snack or drink at any time of day or night. The kitchen was very clean with evidence of all records including a cleaning schedule, fridge and freezer and food temperatures being in place and in date. All catering staff is in possession of the ‘food hygiene certificate’, with the home having gained the ‘Clean Food Award’ which is awarded by the Environmental Health Authority. Records must be kept of those residents who have meals that are different from the daily menu. Residents stated that ‘the food is excellent’, ‘Its more like a restaurant than a nursing home’, ‘thank goodness they treat us like adults and allow us to make choices – and the dessert trolley is wonderful’. Sycamore Court Nursing And Residential Care Home DS0000014065.V302713.R01.S.doc Version 5.2 Page 16 Visitors to the home described the food as ‘Unfailingly good, mother eats very well’, ‘I am visiting at breakfast time and although mother never ate porridge before she likes it there as it s creamy. There is a choice at breakfast and the meal is well served from what I can see’ and ‘There is a wonderful selection of food offered and it always looks nice’. Residents can take their meals either in the dining room or in their rooms. Orders for the meals are taken from residents at the tables or in rooms immediately prior to the meals being served. This method ensures that residents do not forget what they have ordered. The daily menu is on view in the dining room. The home has a licensed bar with drinks being available to residents either in the evenings or at events held within the home. Sycamore Court Nursing And Residential Care Home DS0000014065.V302713.R01.S.doc Version 5.2 Page 17 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 and 18 Quality in this outcome area is good, this is based on the available evidence including a visit to this service. Residents and representatives can be confident that their complaints will be taken seriously and acted upon in an appropriate and transparent manner. Staff are aware of their responsibilities in protecting the residents under their care. EVIDENCE: Complaints were seen to be well recorded and addressed in a transparent manner within 28 days and complainants informed of the result of investigation. There are copies of the complaints procedure throughout the home and all residents and relatives spoken with were aware of how to make a complaint. Complaints received during the past year related to a resident being noisy, laundry missing and the inappropriateness of carers clothing. These had been addressed in a full and empathetic manner with the complainant fully informed of the result. There have been two adult protection issues in the past twelve months; these were addressed in line with multi agency guidelines. All staff have received training in the protection of the vulnerable adult. Sycamore Court Nursing And Residential Care Home DS0000014065.V302713.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,23,24,25 and 26 Quality in this outcome area is good, this is based on the available evidence including a visit to this service. Although some minor maintenance is required the home is reasonably decorated and clean and provides a pleasant home for residents. EVIDENCE: The home is fairly well maintained, but attention to minor maintenance issues is required. These include renewal of curtain poles and curtain hooks, filling of small holes where grab rails have been repositioned and redecoration in some areas of the home. Some areas of the home, including resident’s accommodation, is in need of redecoration and the manager said that this is being addressed. There is a large dining room and lounge area available on the ground floor and small lounges on each floor with tea and coffee making facilities. The ground floor lounge accesses the garden area. Sycamore Court Nursing And Residential Care Home DS0000014065.V302713.R01.S.doc Version 5.2 Page 19 The home has five assisted bathrooms and resident’s rooms have ensuite facilities with assisted showers. There is a range of equipment, which includes variable height beds, full body hoists, and the home has been assessed by a qualified occupational therapist to ensure that it has sufficient equipment, grab rails and other aids for those who are disabled. Residents rooms have radiator guards and window restrictors in place, there have been some problems with the regulation of the hot water temperatures and although the bath and shower temperatures have been regularly tested and recorded there has been no testing of the water from the wash basins. A serious concerns letter has been sent to the home relating to this and an immediate requirement made. This was complied with and temperatures in all resident’s outlets were tested, recorded and were within recommended parameters. The manager responded to the CSCI with these measurements within 72 hours of the inspection. All residents’ rooms are fully furnished but residents can bring in furniture following discussion with the manager, and are encouraged to bring in their own possessions to personalise their rooms. It was seen that one room is in need of a bedside locker, the television is now on this and therefore this will need to be replaced in order to ensure that the resident has this facility. All residents have a lockable facility and a lockable door, the manager is asked to ensure that risk assessments are in place for those who wish to take advantage of this and to keep a list of those residents who have refused a key for their doors, this will also provide evidence that all residents are given the choice of this. Infection control measures are in place; this includes staff wearing aprons and gloves for care and protective clothing when entering the kitchen. All bathrooms and toilets were in a clean condition, as were the sluices, and all soiled washing is put in red alginate bags. Two rooms were malodorous and this was discussed with the manager. All communal bathrooms and toilets have soap and disposable towel dispensers. Sycamore Court Nursing And Residential Care Home DS0000014065.V302713.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 Quality in this outcome area is adequate, this is based on the available evidence including a visit to this service. Residents would benefit from staffing levels that reflect the currently high level of needs in the home. A greater proportion of staff with a care qualification would enhance the care of the residents. EVIDENCE: The rota indicated that sufficient staff were on duty over a twenty four hour period to meet the needs of the residents, however staff said that at times they found that they were overly busy, and that the registered nurses had little time to get care plans updated, especially with the continual influx of new residents coming in with the transitional and interim care programme. They said that the high anxiety levels of those admitted for interim care and the process of getting to know the new residents increased the workload disproportionately in relation to the number of residents in the home. There is an increase in the care needs of residents living in the home and also of those being admitted for long term care and staff stated that they found it difficult, especially at weekends, if a member of staff is absent and a replacement cannot be obtained. Previous inspections identified that staff stated that staffing levels were sufficient at that time. Sycamore Court Nursing And Residential Care Home DS0000014065.V302713.R01.S.doc Version 5.2 Page 21 Some agency staff are used, but the manager prefers to use the staff from the home’s nurse bank to cover vacancies, and staff turnover is low The home has staff meetings and staffing levels have been discussed at these, minutes are kept and were seen. Four care staff have their NVQ level 2 in care, this is below the numbers that would be expected, the percentage of staff with NVQ 2 in Care must be increased as residents and staff will benefit from care staff having the extra knowledge gained through this qualification. The manager said that at the present time it had been difficult to find time to commence staff on the NVQ and to assess staff. All staff receive mandatory training and have an induction course at the commencement of their duties at the home. Personnel files were examined and documentation as required by the standard and regulations were in place. Discussions were held with the manager regarding specific persons supervising new staff awaiting their CRB check. Sycamore Court Nursing And Residential Care Home DS0000014065.V302713.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,35,36,37 and 38 Quality in this outcome area is good, this is based on the available evidence including a visit to this service. The management of the service ensures that residents safety and wellbeing is protected. EVIDENCE: The manager Mrs Suzan Green has been in post for twenty-one months. She is a registered nurse and has many years experience in the care of older people, previously having been the manager at Sycamore Court. She has attained her registered managers award and is registered with the CSCI. Visitors to the home stated that the home is very welcoming and staff were ‘very kind’, residents also made positive comments about the home stating that ‘staff are very good and I am listened to’. The home appeared busy with call bells ringing most of the time, but these appeared to be answered within a Sycamore Court Nursing And Residential Care Home DS0000014065.V302713.R01.S.doc Version 5.2 Page 23 short amount of time. Residents stated that the home is ‘quite a busy place’. There was good interaction seen between staff and residents. The home has an on-going quality assurance programme, and this is now being undertaken by a commercial firm separate from Anchor Homes. This involves the sending out of questionnaires and talking to residents and visitors to get their views on the home, the results are then collated. The quality assurance rating given stated that ‘the home is consistently strong across most areas’. Questionnaires were sent by the CSCI to residents, visitors and health care professionals. Feedback from the GPs was good and positive comments were received from the small sample of visitors and resident questionnaires returned. Formal supervision of staff is being undertaken and this takes generally takes place within the time scales dictated by the National Minimum Standards. However efforts must be made to ensure that this is not left overlong between sessions. Monthly visits by the operations manager take place and reports relating to these were seen within the home. Staff meetings take place at regular intervals and some residents meetings have taken place. The accounts and business plan for Anchor Trust relating to Sycamore Court has been seen in the past eighteen months, and the manager has stated that she participates in the annual business plan for the home. The accounting for resident’s monies is satisfactory, with the home holding some personal monies for residents in a general bank account, which identifies the residents individually. The money held is only sufficient for resident’s dayto-day needs. All records are kept securely in a locked office. Residents care plans are kept in their rooms. All certificates relating to the servicing of utilities and equipment were seen to be in date and all staff have received mandatory training. Sycamore Court Nursing And Residential Care Home DS0000014065.V302713.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 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 2 3 3 3 3 3 2 3 STAFFING Standard No Score 27 2 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 3 3 3 3 3 Sycamore Court Nursing And Residential Care Home DS0000014065.V302713.R01.S.doc Version 5.2 Page 25 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. 2 Standard OP27 OP28 Regulation Reg 18(1)(a) Reg 18(1)(c) Requirement That the deployment of staff relates to the varying needs of the service users. That care staff receive training appropriate to the work they are to perform. Timescale for action 20/09/06 01/12/06 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 OP19 OP28 OP12 Good Practice Recommendations That minor maintenance issues and redecoration are addressed. That staff are encouraged to undertake their NVQ 2. That systems are put into place to ensure a regular, varied programme of activities is offered to residents. Sycamore Court Nursing And Residential Care Home DS0000014065.V302713.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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 Sycamore Court Nursing And Residential Care Home DS0000014065.V302713.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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