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Inspection on 06/09/05 for The Sandford Nursing and Residential Home

Also see our care home review for The Sandford Nursing and Residential Home for more information

This inspection was carried out on 6th September 2005.

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

The home has a well established group of staff who have worked in the home for some time, they are keen to maintain the good name the home has in the local community of Church Stretton. The management team in the home is very supportive to both residents and staff, and staff training has a high priority in the home. The residents spoken to felt that the staff have a good relationship with them and they work hard to improve their quality of life. They also stated that there was a good choice and quality in the meals offered to them and they were able to join in the daily activities that were provided for them both inside and outside the home should they so desire. The home was very clean and tidy at the time of the inspection and the homes domestic staff are to be commended, and comments by the residents supported this.

What has improved since the last inspection?

There have been developments in the home since the last inspection. The refurbishment programme has commenced, with new decoration, furnishing and fittings in the dining room. The new proprietor Mr Michael Freelander has set out a programme of refurbishment for the rest of the home and he was attending to undertake an audit of all the residents rooms the day after the inspection. The good standard of care provided by the home has been maintained by the staff since the last inspection.

What the care home could do better:

No requirements or recommendations for improving standards in the home were made at this inspection, as all the standards inspected were met.

CARE HOMES FOR OLDER PEOPLE Sandford House Nursing and Residential Home Watling Street South Church Stretton Shropshire SY6 7BG Lead Inspector Mike Highfield Unannounced 6 September 2005 10:00 th 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 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. Sandford House Nursing and Residential Home E56 S22271 Sandford V208503 UI 060905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Sandford House Nursing and Residential Home Address Watling Street South Church Stretton Shropshire SY6 7BG 01694 723290 01694 723290 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Jubilee Care Limited Mrs Tracey Jane Smith Care Home with Nursing 35 (35) Category(ies) of Old Age registration, with number of places Sandford House Nursing and Residential Home E56 S22271 Sandford V208503 UI 060905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home may accommodate a maximum of 35 Older Persons of which 25 may be Older People requiring nursing care. 2. The home must comply with the following minimum staff requirements for nursing clients:0800 - 1400 1 RGN 4 Care Assistants 1400 - 2130 1 RGN 4 Care Assistants 2130 - 0800 1 RGN 2 Care Assistants These are minimum levels required every day, including weekends and do not take account of extra staff needed when more heavily dependent service users are in residence. These minimum levels are for service users care only. Date of last inspection 26th April 2005 Brief Description of the Service: The Sandford Care Home is situated close to the town centre of Church Stretton, which has all local amenities. The accommodation at The Sandford is provided in one building, which was formally a hotel. The accommodation is on three floors; all of the floors may be accessed via a shaft lift. Communal facilities are all situated on the ground floor. There is easy access to gardens and the home has car-parking facilities. Sandford House Nursing and Residential Home E56 S22271 Sandford V208503 UI 060905 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over a period of four hours, it was unannounced and formed part of the two routine inspections per year undertaken by the Commission for Social Care Inspection. During the inspection an unaccompanied tour of the premises took place, and discussions with residents and staff. Care records of the residents were perused together with medicine administration charts. There was a calm atmosphere in the home, some residents were outside under gazebo,s enjoying the late summer sunshine, others were preparing for an afternoon visit to a local garden centre. What the service does well: What has improved since the last inspection? There have been developments in the home since the last inspection. The refurbishment programme has commenced, with new decoration, furnishing and fittings in the dining room. The new proprietor Mr Michael Freelander has set out a programme of refurbishment for the rest of the home and he was attending to undertake an audit of all the residents rooms the day after the inspection. The good standard of care provided by the home has been maintained by the staff since the last inspection. Sandford House Nursing and Residential Home E56 S22271 Sandford V208503 UI 060905 Stage 4.doc Version 1.40 Page 6 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. Sandford House Nursing and Residential Home E56 S22271 Sandford V208503 UI 060905 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Sandford House Nursing and Residential Home E56 S22271 Sandford V208503 UI 060905 Stage 4.doc Version 1.40 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 standard(s) 1-5 The homes Statement of Purpose and the Residents Guide to the home provide present and prospective users with detailed information which would assist them in making a decision on whether or not they wish to become a resident in the home. Visits are encouraged to confirm the written material. EVIDENCE: The home has produced a very comprehensive Statement of Purpose which is available to the general public in the entrance hall of the home as is a copy of the last inspection report. Each resident has their own personal copy of the residents guide and their contract with the home which states, the number of the room they occupy and what part of the fees they are expected to pay themselves. A copy of the complaints procedure is also included. Contract terms and Conditions have not changed since the last inspection. The residents assessment is completed by a senior nurse and utilises elements from the Social Workers Assessment and Discharge Liaison Nurse of the Local Primary Care Trust. The staff on duty at the time of the inspection had a very detailed knowledge of each residents needs and appeared very confident in meeting them. Sandford House Nursing and Residential Home E56 S22271 Sandford V208503 UI 060905 Stage 4.doc Version 1.40 Page 9 Residents can spend a weekend in the home if a bedroom is available before making up their mind whether or not they wish to become a permanent resident or not. Many of the residents had been in the home for some considerable time, they were well settled and had the support of their family members. Sandford House Nursing and Residential Home E56 S22271 Sandford V208503 UI 060905 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7-11 The health needs of the residents are well met with evidence of good multidisplinary working. The system of medicine administration is well managed and safe. EVIDENCE: The home has a policy on care planning which clearly states that the care plans must be reviewed and updated monthly. Care records seen in each residents room evidenced this. The care plans developed are discussed with the resident and a close member of their family. Each resident has a personal care check list in their care file, their likes and dislikes in diet and social activities are documented in their care plan. Appropriate procedures are in place for the safe administration of medicines, medication sheets are printed by the local pharmacy with whom the home has a close working relationship. It was observed that the residents are treated with the utmost dignity and respect. When staff enter a residents room they always knock first. There was a homely atmosphere in the home and the residents spoken to substantiated this. Sandford House Nursing and Residential Home E56 S22271 Sandford V208503 UI 060905 Stage 4.doc Version 1.40 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 standard(s) 12-15 The systems for consultation with the residents are good, being in verbal and written form. The home has good links with the local community for activities which enriches the residents social opportunities. A good well balanced diet with choice is available to all residents. EVIDENCE: Through discussions held with residents it was evident that individuals have the opportunity to exercise choice, meal times are flexible and the residents can choose how they wish to fill their day. Each resident’s interests are recorded in their care plan and the home encourages them and supports wherever possible to continue with these if the staff skill is present in the home to do so. The residents stated that their visitors are always made welcome when visiting the home, this was observed happening during the inspection. A residents daughter was visiting from Chesterfield, she was having lunch with her mother prior to them going out with other residents to visit a local garden centre. Discussions held with the residents on the day of the inspection confirmed that they are happy with the choice of meals that are provided and that drinks are readily available at all times. Sandford House Nursing and Residential Home E56 S22271 Sandford V208503 UI 060905 Stage 4.doc Version 1.40 Page 12 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 standard(s) 16-18 The home has an effective complaints procedure, which was evidenced by comments made by the residents who knew who to make their comments to and they felt that their views were listened to and acted upon. EVIDENCE: No complaints had been received by the home concerning the service they offer since the last inspection. Residents are aware of the complaints procedure as this is in booklet form and they hold a personal copy. An easily accessible comments book is available to all visitors who enter the home for them to make an entry if they so desire. None of the residents presently in the home access an advocacy service as their families act for them. The home is aware of the service if required. The residents are registered to vote with the local council. Sandford House Nursing and Residential Home E56 S22271 Sandford V208503 UI 060905 Stage 4.doc Version 1.40 Page 13 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 standard(s) 19-26 The standard of the environment in the home is good providing the residents with an attractive, clean and homely place to live in. The refurbishment programme by the new proprietor has started and will further enhance the ambience of the home when completed. EVIDENCE: It was established through inspection of the lounge, dining room, kitchen, bathrooms and bedrooms that the residents live in a homely, very clean, comfortable environment. The programme of refurbishment is in progress. The bedrooms of the residents are personalised with many family photographs and momento’s. The home has an assisted Parker Type bath on the first floor and two walk in showers. Toilets are provided in close proximity of the lounge and dining areas in the home. The home was very clean and fresh, the residents spoken to made very favourable comments about this. The domestic staff are to be commended on their work. Sandford House Nursing and Residential Home E56 S22271 Sandford V208503 UI 060905 Stage 4.doc Version 1.40 Page 14 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27-30 Staff morale in the home is high resulting in an enthusiastic work force that work positively with the residents to improve their quality of life. The home is very committed in training their staff to provide a quality service. EVIDENCE: The home is registered for 35 people, and the present staffing levels met the assessed needs of the present residents living in the home. The home employs several carers from the eastern block of Europe, they have an induction programme to the home and work under close supervision of the senior staff. Since the last inspection basic training in Fire Prevention and Manual Handling has been updated. Sandford House Nursing and Residential Home E56 S22271 Sandford V208503 UI 060905 Stage 4.doc Version 1.40 Page 15 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31-38 The Manager of the home is well supported by the Proprietor and General Manager. She provides clear leadership in the home demonstrating to the staff an understanding and awareness of her responsibilities. The home regularly reviews aspects of its performance through self review and consultation with the residents, relatives and staff. EVIDENCE: The Registered Manager holds the relevant qualifications for running the home. There is a management structure and accountability process in the home. Regulation 26 visits are made by the General Manager as part of the quality review of the care being provided by the home, these are forwarded to the inspectorate. Through discussions held and observations made it was evident that the staff are well motivated and committed to their work. There were very positive letters of appreciation from families of care given to residents for visitors to read. Sandford House Nursing and Residential Home E56 S22271 Sandford V208503 UI 060905 Stage 4.doc Version 1.40 Page 16 The residents or their families have control of their financial affairs. Lockable storage is available to the residents for privacy and their room has a locking facility, risk assessment are undertaken on each resident to assess whether or not they are able to hold their own key. Staff reported that they had received their mandatory training, and Health and Safety Records perused at the inspection were in correct order. Fire Alarm Testing takes place weekly, all the recommendations made at the fire inspection in January 2005 had been attended to. Fire Training had taken place on the 12th June 2005. Lifting Apparatus and Emergency Lighting Servicing had taken place in August 2005. Gas Safety Testing is due to take place in October 2005. Sandford House Nursing and Residential Home E56 S22271 Sandford V208503 UI 060905 Stage 4.doc Version 1.40 Page 17 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 4 STAFFING Standard No Score 27 4 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 4 3 3 3 3 3 3 3 3 Sandford House Nursing and Residential Home E56 S22271 Sandford V208503 UI 060905 Stage 4.doc Version 1.40 Page 18 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard Regulation Requirement No requirements were made at the inspection. Timescale for action 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. Refer to Standard Good Practice Recommendations No recommendations for good practice were made at the inspection. Sandford House Nursing and Residential Home E56 S22271 Sandford V208503 UI 060905 Stage 4.doc Version 1.40 Page 19 Commission for Social Care Inspection 1st Floor, Chapter House South Abbey Lawn SHREWSBURY SY2 5DE 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 Sandford House Nursing and Residential Home E56 S22271 Sandford V208503 UI 060905 Stage 4.doc Version 1.40 Page 20 - 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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