Inspection on 29/11/07 for Syne Hills

This inspection was carried out on 29th November 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Syne Hills 12/01/09

Syne Hills 01/08/06

Syne Hills 01/02/06

Syne Hills 18/07/05

Syne Hills 15/12/04

Syne Hills 17/05/04

Similar services:

Hillside

Applegarth

122 Scorer Street

Byars Care Home

St Marys Nursing Home

Jubilee Villa Care Home

Bramble Lodge

Parkmanor Residential Home

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

CARE HOMES FOR OLDER PEOPLE Syne Hills Syne Avenue Skegness Lincolnshire PE25 3DJ Lead Inspector Ken Hague Unannounced Inspection 29th November 2007 06:30 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 Syne Hills DS0000002431.V355554.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. Syne Hills DS0000002431.V355554.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Syne Hills Address Syne Avenue Skegness Lincolnshire PE25 3DJ 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) 01754 764329 info@synehills.co.uk Mrs Jean Sweeney Mr Christopher Matthew Sweeney Care Home 35 Category(ies) of Learning disability (2), Old age, not falling registration, with number within any other category (33) of places Syne Hills DS0000002431.V355554.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 1st August 2006 Brief Description of the Service: Syne Hills care home is set in a quiet residential area of Skegness. It provides accommodation for 35 service users - 2 with a learning disability and 33 old age not falling within any other category. A dedicated intermediate care service is not provided by the home. The home is a large Victorian building set in extensive landscaped gardens, which leads to the sand dunes and the seafront. The home is a two-storey building with access to the second floor being provided by stairs and a passenger lift. Recently a ground floor extension has been added to be used for short term care. The home offers accommodation in 21 single rooms and seven double bedrooms. Public transport passes the care home. The home is close to shops, pubs and other local amenities. A car park is provided at the front of the care home. At the time of the inspection the home confirmed that the weekly fees ranged from £348 - £500 depending on the residents assessed needs. Additional charges are made for services such as chiropody, hairdressing and toiletries. Information about these costs as well as the day-to-day operation of the home, including a copy of the last inspection report, can be found in the home’s statement of purpose and service user guide. These documents are available in the reception area. An additional copy is kept in the home’s office. These documents are made available to all new potential residents. The homes Website Address is www.synehills.co.uk Syne Hills DS0000002431.V355554.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over 7 hours. The registered manager was provided with feedback at the end of the inspection. The main method of inspection used was called ‘case tracking’ which involved selecting three residents and tracking the care they receive through the checking of their records, discussion with them and the staff, and where more appropriate observation of interaction between staff and residents and related care practices. A sample of care records was inspected. Three members of staff were interviewed and the opinions of four residents were sought. The inspectors spoke to night staff prior to them going off duty at 7:30 a.m. Detailed discussions were held to establish the level of care needed during the night period. An (AQAA) Annual quality assurance assessment was completed by the care home and sent to the Commission for Social Care Inspection prior to the site visit. This is a self- assessment document completed by the providers of the care home. It sets out evidence from the provider to demonstrate that they are meeting the Care Home Regulations. It is normal procedure to obtain written feedback from residents prior to the site visit using a document called “have your say”. This document sets out a number of questions for residents to answer which invites them to give their views of the services offered by the home. In the case of this key inspection it was not possible to obtain these documents prior to the key inspection as the inspection was carried out at short notice. However residents were spoken to during the site visit and the questions raised in the have your say document were discussed face-to-face with residents. Their opinions are reflected within this inspection report What the service does well: The home provides a comfortable, safe and homely environment for people to live in. There are assessment and care planning processes in place. Residents have detailed care plans, which enables staff to know how residents needs are to be met by the resources of the home. Regular residents meetings and care reviews are held where residents comment on the services provided at the home. The home offers, a wide range of social and leisure activities. A balanced and varied diet is provided. Residents are encouraged to make their own choices; and they, their relatives and other visitors to the home are encouraged to give their views and opinions of the service, which means that they can influence the way the service is run. Syne Hills DS0000002431.V355554.R01.S.doc Version 5.2 Page 6 Resident stated that they felt their needs were being addressed by the care home. They said staff are kind. The home is always clean. We are very satisfied with the service being provided to us. There is a training plan in place for staff who are well supported by the management of the home, which helps them to provide a good quality of care. 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. The summary of this inspection report can be made available in other formats on request. Syne Hills DS0000002431.V355554.R01.S.doc Version 5.2 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 Syne Hills DS0000002431.V355554.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 3 & 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are robust and updated procedures in place which are used for the assessment of new residents to the service. This ensures that all of their personal care, health care and social needs are met. A dedicated intermediate care service is not provided by the home. EVIDENCE: The files of three new residents were examined as part of the case tracking process. They all contained a full assessment including a risk assessment for each individual resident caried out prior to their addminsion to the home. Where a risk had been identified a management strategy for that risk was set out in the assessment and care plan. The assessments set out the care needs, social needs and health needs of each individual resident. Residents confirmed that they have been involved in the writing of their initial assessment. Members of staff interviewed confirmed that assessments are always carried out prior to residents being admitted. Syne Hills DS0000002431.V355554.R01.S.doc Version 5.2 Page 9 The three residents being case tracked all confirmed that they received an assessment prior to being admitted to the home. The registered manager stated that an individual copy of the service users guide is given to all new residents when they are addmitted to the home. Residents confirmed that they have been sent an individual letter stating that their assessed needs could be met by the resources of the care home. Syne Hills DS0000002431.V355554.R01.S.doc Version 5.2 Page 10 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): Standards 7,8,9 &10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Individual needs are reflected in clear, comprehensive and up to date care plans; and the privacy and dignity of residents is maintained. EVIDENCE: The individual care plans for the residents being case tracked all contained a comprehensive care assessment including an individual care plan. The needs identified at the initial assessment have been transferred onto care plans which identify the resources of the care home and meet the individual residents needs. Care plans were personalised for each resident. Care plans are reviewed on a monthly basis. There is a schedule of dates available that shows when reviews are due for each resident. During the site visit call bells were answered promptly and a resident said ‘they come as soon as I ring the bell’. Call bells were in reach of people, and staff were observed to place them appropriately when they helped residents move to different areas of the home. Syne Hills DS0000002431.V355554.R01.S.doc Version 5.2 Page 11 There was evidence of the skin condition of the residents being monitored and recorded. Pressure area relief routines were being followed in line with care plans. Specialised equipment and mattresses will be provided when identified within care plans. Residents confirmed that they could request a bath or shower at any time. The bathing of residents was recorded within care records including their choice of bath or shower. In addition the manner in which care was provided and their choice of toiletries were found in each care plan. Residents and relatives made comments such as ‘staff are very helpful and kind. ‘They come to help you very quickly if I ring my call bell.’ ‘Staff make sure that I have my privacy when I want it’. Pre inspection information (AQAA) shows that there is a policy available regarding privacy, dignity, choice and independence. The care home has a policy for the Administration and storage of medication. The registered manager provided evidence that all staff have being trained to administer prescribed medication in a safe manner. A recent pharmacy report confirmed that medication is being stored appropriately. Staff were observed to be following the home’s procedure when giving out medication during the site visit. A sample of residents records for the administration of medication were found to have been completed correctly. The records for the administration of controlled drugs were studied and discussed with the staff on duty. The evidence from these discussions and the inspection of records for controlled drugs were that medication is being managed in accordance with the procedures of the care home. Records show that residents have access to support services provided such as chiropody and an optician. Physiotherapy, Occupational Therapy and Dietician services are available by referral to the appropriate service. There were a number of residents already awake when the inspector visited the home at 6:30 a.m. These residents confirmed that they had chosen to get up early. All the residents spoken to at the site visit confirmed that they could go to bed and get up in the morning at a time of their choice. Syne Hills DS0000002431.V355554.R01.S.doc Version 5.2 Page 12 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): Standards 12.13.14 & 15 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. There are enough suitable activities provided for residents that are in accordance with their needs and wishes. They receive a healthy and balanced diet that is based on their likes and dislikes. They are able to control their lives as much as they are able. EVIDENCE: There is evidence in records and through feedback from residents that activities such as bingo, various outings, relaxation and board games are available. Residents said that there is always plenty to do and staff are very kind to their visitors. The registered manager states in the pre- inspection information that regular activities, including outings are arranged for all residents. The home has its own newsletter called Syne Post, which tells residents of the activities being carried out within the home. Entertainers come into the home on a regular basis. There are links to local churches and a Minister visits the home to provide services for residents. Local schoolchildren visit and there are links into the local community. Residents are enabled to visit local community events. Syne Hills DS0000002431.V355554.R01.S.doc Version 5.2 Page 13 The registered manager supplied a copy of the menu, which demonstrated choices. Comments from residents regarding the menu were all positive. A resident stated “ the food is excellent here, you could not ask for better’. The food is well presented and is of good quality and sufficient in quantity. A second residents stated “I like the food here, we do have choices and it is always nice.” No negative comments were received from any residents regarding the food and the menu. The likes and dislikes of each resident were recorded on their individual care records. Staff described the choices of each residents being case tracked in respect of their dietary needs. Syne Hills DS0000002431.V355554.R01.S.doc Version 5.2 Page 14 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): Standards 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ benefit from updated and comprehensive complaints and adult protection procedures. Care workers have been trained to ensure residents are protected from any possible abuse. EVIDENCE: The care home has a detailed, up-to-date complaints procedure given to all residents and displayed in the care home. Discussion with residents provided evidence that they do know how to make a complaint. A resident stated “we can approached the manager or any member of staff at any time if we are unhappy”. A second resident said “staff ask us if we have any problems almost on a daily basis it is a good home”. The home also holds residents meetings on a regular basis, where any concerns can be raised. Staff confirmed that they were aware of the home’s whistle blowing policy and stated that they would use it if they have any concerns about care practice. The registered manager stated that all staff have been trained in the prevention and recognition of abuse. Staff confirmed that this statement was correct. Syne Hills DS0000002431.V355554.R01.S.doc Version 5.2 Page 15 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): Standards 19 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a clean well maintained care home, which provides them with safe comfortable accommodation. The up-to-date infection control policy is followed and a safe environment is maintained. EVIDENCE: The home is very well maintained, decorated to a high standard and clean throughout. The registered manager stated in the AQAA that improvements have been made to the general appearance of the home particularly the main entrance. Updating has been carried out to the laundry floor since the last inspection. Landscaping has been carried out in the rear gardens and a new wet room facility has been installed. 10 stage air purifiers have been fitted in the care home. Syne Hills DS0000002431.V355554.R01.S.doc Version 5.2 Page 16 The area outside the home is well maintained and safe. Residents are encouraged to bring possessions into their rooms and to make them homely. Each room is individually furnished, and residents stated that they were fully supported to use their rooms safely and in the way they wished. There are enough bathrooms and toilets to meet the needs of the residents and appropriately serviced equipment is in place to support resident’s physical needs as appropriate. Staff confirmed they regard the needs and safety of residents as central to their role. The staff interviewed confirmed that fire alarms are tested weekly, and were able to describe the appropriate action they would take in order to maintain residents and staff safety in the event of a fire. They confirmed a fire drill had been carried out recently. All areas of the home were clean and smelled fresh. Residents stated their satisfaction with the environment of the care home. One stated “the home always smells fresh, my room is lovely”. A second resident said “ you couldnt find a nicer home to live in”. Syne Hills DS0000002431.V355554.R01.S.doc Version 5.2 Page 17 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): Standards 27,28,29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s needs are met by appropriately trained staff; and they are safeguarded by robust recruitment procedures. EVIDENCE: During the site visit a relaxed atmosphere was evident, call bells were answered promptly, and staff demonstrated efficient management of residents needs Staff said that there are enough people on duty to meet needs, and if shortages occur through sickness, there are staff to call upon to fill any gaps. The staff stated that if resident’s needs increased additional staffing was provided Rotas show satisfactory numbers of staff are available on each shift. Records show that staff have received training in areas such as moving and handling, fire safety, health and safety, optical awareness, diabetes, and dementia. There is also evidence that induction training is provided in line with a nationally recognised induction process; and training for a nationally recognised qualification is available. Staff confirmed this and said that access to training is very good and they received a good induction process. The registered manager states in the AQAA that extensive training courses are provided to all staff. A dedicated training coordinator is identified for the home. Syne Hills DS0000002431.V355554.R01.S.doc Version 5.2 Page 18 Recruitment records include application forms, criminal record bureau checks, references, identification and terms and conditions of employment. Policies are available for recruitment and disciplinary processes. All new staff have been recruited in accordance with the home’s recruitment procedure which meets national guidelines. Syne Hills DS0000002431.V355554.R01.S.doc Version 5.2 Page 19 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): Standards 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. Staff are provided with leadership and guidance from the registered manager ensuring that residents needs are met. The home’s up to date health and infection control policy is being followed. However the failure to ensure non perscibed medication and corosive cleaning fluid are stored correctly does place residents at risk. EVIDENCE: The care home has an experienced registered manager. They homes AQAA states that the home has a strong management structure which offers security, advice and leadership to all staff. Staff agreed that this statement is accurate. A resident stated “we have a good manager here, staff do their job well. The home is well run’. Syne Hills DS0000002431.V355554.R01.S.doc Version 5.2 Page 20 Staff said that the managers, including the registered manager, are very supportive and will listen to what they have to say. They said that they receive supervision regularly and find it useful in terms of communication, and discussing training needs. Records show that supervision takes place and that there are regular staff meetings. There are financial procedures in place to ensure that residents financial interests are safeguarded and protected. A health and safety issue was identified at this key inspection. The inspector noticed that non-prescribed painkillers had been left on a trolley in the office with the door open. A resident could have accessed 22 painkillers which if taken would put them at serious risk. There were cleaning materials in one corner of the office, which had not been placed in a locked cupboard. It was also observed that cleaning fluid was left on a cleaner’s trolley unattended. It is essential that any substances or medication, which could pose a potential risk to residents are kept in locked cupboards. The inspection of recruitment records for new members of staff provided evidence that the home’s recruitment procedure was being followed. There were criminal record bureau checks on each staff members file. Two written references and proof of identity were also on the files. Interview notes and application forms were included on personal records. The date employed and a copy of their job description was found on all files. Syne Hills DS0000002431.V355554.R01.S.doc Version 5.2 Page 21 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 3 8 3 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 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 x X 2 Syne Hills DS0000002431.V355554.R01.S.doc Version 5.2 Page 22 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 OP38 Regulation Reg 13 –4 (a) Requirement Non prescribed medication or any substance which poses a risk to residents must be kept in a locked cupboard. This removes any risk of residents taking substance or medication by mistake. Action taken by manager on the day of site visit. Timescale for action 29/11/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Syne Hills DS0000002431.V355554.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT 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. Extracts may not be used or reproduced without the express permission of CSCI Syne Hills DS0000002431.V355554.R01.S.doc Version 5.2 Page 24 - 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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