Care Home: Sandbeck House

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What the care home does well The home is well managed and staff are committed to providing good standards of care to people who use the service and are open to listening and responding to ways in which the service may be improved. People who use the service can participate in a wide range of social, leisure and recreational activities within the home and community, which meet their individual needs and wishes. A comment made was "I get taken on a variety of outings and all the staff are helpful and always smiling". Visitors are made to feel welcome and staff have regular training to ensure that their knowledge and skills are kept up to date. People who use the service are able to make their views known in various ways in order for them to lead the life they choose. Examples of comments which were made to us were "I never thought I would call a place like this home but I do" and "the manager is more than dedicated and I think that goes for a lot of the staff". What has improved since the last inspection? Action has been taken to ensure that matters raised at the previous inspection visit have been addressed. This related to care plans and risk assessments giving staff clearer guidance and sufficient information to ensure they know how care must be provided and how risks may be minimised. There has been improvements to ensure that recent legislation in relation to people`s capacity to make decisions is recorded. What the care home could do better: The information which is available to tell people about the service should be reviewed to ensure that it is consistently reflecting our correct name and contact details so that people know how to contact us if they wish. Records kept to show when medication has been administered need to ensure that times are consistently completed to ensure safe procedures are followed. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Sandbeck House 77 - 81 Sandbeck Avenue Skegness Lincolnshire PE25 3JX     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Sue Hayward     Date: 1 7 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 25 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Sandbeck House 77 - 81 Sandbeck Avenue Skegness Lincolnshire PE25 3JX 01754766585 01754898228 care@sandbeckhouse.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Lynn Annette Shipley Type of registration: Number of places registered: Mr Kanagasooriam Ravivaruman care home 38 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Sandbeck House is a former guesthouse and domestic premises, which has been adapted and extended to offer personal care and accommodation for up to 38 older people on two floors. Access to the first floor is provided via an eight-person shaft lift, a stair lift and stairs. The home is situated in a residential area near to the sea front in the resort of Skegness. It is close to the main shopping area of the town and more local shops are available within a few hundred yards. Car parking is available at the side of the home and on the roadside, which can be a problem in the summer months. There is a small attractive enclosed patio area situated in the middle of the home and a space at the front of the home, which is planted with shrubs and overlooks Sandbeck Avenue. There are three lounges, including a quiet area, and an open plan dining area. 0 Over 65 38 Care Homes for Older People Page 4 of 25 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This was an unannounced visit and formed part of an inspection, which focused on key standards, which have the potential to affect the health, safety and welfare of people who use the service. Throughout this report the terms we and us refer to the Commission for Social Care Inspection (CSCI). The visit lasted approximately 5 hours. We took into account previous information held by us including the last inspection report which was completed on 03/03/08, the history of the service and records of any incidents we had been notified of since the last inspection. Care Homes for Older People Page 5 of 25 We used a method of working called case tracking which is following the care of a sample of people, on this occasion four, who use the service through their records and assessing their care. We spoke to all the people whose care was followed and one other person as well as a relative and two staff members. We also viewed the rooms of those people who said we could. The manager was present throughout and the general outcomes of the visit were discussed with her. The current fees range from 351 pounds - 445 pounds per week. Hairdressing and chiropody costs are additional to the fees. Information about the service including a copy of the most recent inspection report are on display in the home. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 7 of 25 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 8 of 25 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People coming into the service have the information available to help them make a decision about moving into the home and there are good procedures in place to ensure people are only admitted after a full needs assessment has been carried out. Evidence: We saw that there is a range of information on display in the home including the most recent inspection report, a statement of purpose and a guide for people who use the service. This gives clear information about what people can expect if they choose to live at the home, however the statement of purpose needs updating to reflect accurately our general title, should anyone need to contact us. People also showed us the information about the home that they had been given to keep. Of the records checked, all contained information which showed that an assessment of peoples individual needs had been undertaken based on the services own assessment Care Homes for Older People Page 9 of 25 Evidence: as well as other professionals, such as information obtained from social workers or hospital staff. The assessment covered a range of needs such as physical, social, dietary and religious needs and how they may best be met. For example, whether people preferred male or female carers carrying out their personal hygiene needs. Comments from service users and a relative, confirmed that they had been able to visit the service prior to making a decision to stay. A relative said we looked at various homes. Mum was invited to come to Sandbeck, look around and stay for the day. They made us feel very welcome and talked about everything including the fees, they could not have been more helpful if they had tried. Service users who were spoken to also felt that they were given enough information to help them decide whether it was the right place for them. We saw that people who use the service had been written to confirming the outcome of the assessment and had been issued with information telling them about the terms and conditions of their stay at the home. The surveys that people had completed prior to our visit also confirmed that people were of the opinion that they had received sufficient information about the home. Care Homes for Older People Page 10 of 25 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans contain sufficient information to identify peoples individual needs and to ensure their health and welfare is promoted. There are satisfactory procedures in place for staff to follow to ensure medication is administered safely and staff are responsive to ways in which they can be improved. Evidence: All four of the personal files we checked on this occasion contained care plans. They showed the individual needs of people and the risk assessments which had been undertaken. People told us that they were aware of the records that are kept about them and said their key worker (a specific named staff member) discussed with them from time to time whether their care plans needed any changes. They have recently introduced a form which demonstrates that peoples capacity to make decisions has been considered and the manager said that training is planned to ensure staff are fully aware of this legislation which came in to force in October 2007. Care Homes for Older People Page 11 of 25 Evidence: Care plans made reference to various individual aspects of people such as their personal hygiene, social, nutritional and spiritual needs. In one instance it was noted whether or not the service user preferred a male or female carer to carry out personal care. A system has recently been introduced where care plans are audited on a monthly basis to ensure that they are up to date and well maintained. People told us that they are able to see other health professionals when they wish, for example if they wanted to see a doctor staff would make them an appointment. Another service user said that she had visits from a community nurse. Peoples personal records contained information to show when visits from other health professionals had taken place and also showed that their general health and well being was being monitored by staff. Peoples comments about the care provided were positive. For example full care and support is always there when needed and a visitor commented that staff were always attentive. People who use the service made comments which indicated they felt their privacy and dignity was respected and staff were noted to knock on the door and wait for an answer before entering bedrooms. We were told prior to the visit that the service have policies and procedures about medication administration. We observed a staff member administering some of the lunchtime medicines and generally a safe process was followed, records were noted to be signed after medication had been given and storage arrangements were satisfactory. It was noted that a staff member had not completed on a couple of occasions the time that a specific medication had been administered but the manager agreed to address this matter with the person concerned. Staff and training records showed that staff have training about how to administer medication and the most recent report of 11/08/08 from the pharmacist who visits the service periodically and offers advice and guidance on the systems in place, had not raised any concerns. Care Homes for Older People Page 12 of 25 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are encouraged and supported to have control of their daily lives. Recreational and leisure activities are arranged both within the home and community to ensure people can participate in a wide range of events if they choose. Meals are well balanced and cater for peoples individual preferences and specific dietary needs. Evidence: People told us about the range of social and leisure activities that are arranged. They also said that they had a choice of whether or not they joined in with them. For example, on the day of the visit some people were playing dominoes in the morning and others in an indoor bowling session in the afternoon. We were told by people who use the service that they had recently been out for lunch and that entertainers also come in to the home. We saw photographs of some of the outings that had occurred this year for example a trip to a butterfly park. We were also shown photographs of people who had attended a talk on China and had been able to sample Chinese foods. Currently there is a wishing well in the home for people to make suggestions for things they would like to do. People also told us that Church services held in the home, others Care Homes for Older People Page 13 of 25 Evidence: said they are able to attend local Churches if they wish. A person is specifically employed for five hours a day as an activities co-coordinator. There is newsletter and notices on display informing people about events. There are regular residents meetings held and people can put forward their ideas at these sessions. People said they are free to come and go around the home and local community as they wish and could have visitors whenever they wanted. A visitor made very complimentary comments about the care and support given to her relative. She said that she was always made to feel very welcome and staff always had time for a chat. She also said mum gets out more now than she ever has. Comments about the meals were also positive and indicated that people have a choice and are made aware of the options available prior to being served the meal so they can request an alternative if needed. One person told us that the chef was happy to prepare seafood for her which she had purchased herself. Records showed that peoples nutritional and specific dietary needs are catered for and menus showed meals to be varied and well balanced. Care Homes for Older People Page 14 of 25 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are protected by satisfactory policies and procedures which are in place relating to complaints and safeguarding adults and staff have training about these. People and families are confident that any complaints will be dealt with properly. Evidence: We saw copies of the complaints procedure on display in the home and that service users had been given this information on their admission. The manager said, and service users confirmed, that she speaks to them personally as does the owner to check out whether or not they are satisfied with the service. We were told by people who use the service that they knew who to complain to and felt sure staff would listen to them and the manager would take action to rectify anything if she could. There are clear records kept of any complaints which detail the action taken to address and resolve matters. There are also leaflets on displays for anyone to use to make comments and suggestions. Staff had a good knowledge of complaints procedures and of what to do if they became aware that people may be at risk of abuse. Records showed that they had had training about safeguarding people. We checked how the service manages any money held in safekeeping on behalf of people who use the service. Storage arrangements are satisfactory and accurate and Care Homes for Older People Page 15 of 25 Evidence: up to date records are kept showing any transactions although occasionally two signatures are not obtained. It is acknowledged that there are auditing systems in place however it is good practice to obtain two signatures whenever any transactions occur as a safety measure. Care Homes for Older People Page 16 of 25 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A comfortable and homely environment is provided for people who use the service which is clean and tidy. Evidence: People were complimentary about the comfort and cleanliness of the home. People told us that they had been able to make their rooms more homely with their own personal belongings and effects. We saw for example, that one person had brought with them their own double bed. We also noticed that people had been provided with equipment to meet their needs such as air flow mattresses and bed guards. Stocks of gloves and aprons were available for staff to use to ensure good hygiene practices. There are various sitting rooms some offering a quieter room than others and people can choose where they wish to be. The environmental health officer and fire officer visit the home periodically. The most recent visit by the environmental health officer on 25/09/08 awarded the home a three star or excellent rating for food hygiene. Care Homes for Older People Page 17 of 25 Evidence: Staff said that a record is kept of any maintenance issues and they are dealt with promptly. Comments from people about their satisfaction with the environment were it is very clean and fresh and anyone who visits us says it looks like a nice hotel. A relative commented Sandbeck is a very nice, clean and fresh smelling environment. Care Homes for Older People Page 18 of 25 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are sufficient numbers of well-trained staff available to meet the needs and wishes of people who use the service and the staff recruitment procedure followed helps to ensure people are protected. Evidence: We were told prior to the visit staff had participated in a range of training and that eighty per cent had achieved a nationally recognised vocational qualification(NVQ) in care whilst the other twenty per cent were working toward achieving it. Staff we spoke to confirmed this as did training records which also showed for example that this year first aid, health and safety, dementia, manual handling, protection of vulnerable adults, fire safety and food hygiene training had occurred. The manager was able to show us that she is in the process of arranging further training which will include the Mental Capacity Act which is likely to take place in December 2008. People who use the service made positive comments about the care and support provided. Comments such as every request I have made has been quickly dealt with in a kind and efficient way, all staff work very hard and are kind to all residents and staff take time to talk to residents, they are always friendly and attentive. We checked a sample of records of the staff recruitment process. They showed that Care Homes for Older People Page 19 of 25 Evidence: this had included staff completing an application form and obtaining references from previous employers as well as criminal records bureau (CRB) and protection of vulnerable adults (POVA) register checks. The manager said she had not yet received confirmation of the CRB checks for the two most recent employees, however she provided records to show that a POVA check was in place one prior to their employment in the home and confirmed that they were currently being supervised until such time as satisfactory CRBs were received. Staff and records confirmed that there are five care staff in the mornings, four in the afternoons and two wakeful staff members at night. Catering and domestic staff are also employed daily. In addition there is an activities co-ordinator who works five hours a day. The manager works additionally to the staff rota and there is always a manager or deputy on call. People who use the service and staff made comments which indicated there was sufficient staff on duty to meet their needs. Care Homes for Older People Page 20 of 25 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed. There are good systems in place to monitor the quality of the service, which includes obtaining the views of the people who live in the home to help ensure their health and welfare. Evidence: The management arrangements have not changed since the previous key inspection visit. The manager has relevant qualifications and experience and people who use the service told us that they thought she worked very hard to try and make any resident as happy as possible, working many hours in her own time too. Staff said that they felt valued and sufficiently supported to enable them to meet the differing needs of people who use the service. One person said the office is always open if you need to talk. A staff member commented that there was good communication through daily handover sessions. One staff member said If there is anything wrong with the way you are working or the way it should be done, the manager will discuss things with you and I have regular supervision and appraisal with my manager . These benefit Care Homes for Older People Page 21 of 25 Evidence: both me and my manager. She can tell me how my work is progressing and I can tell her anything that I might think can improve my work and I know she will support me. Records and staff comments confirmed that all new employees follow a training programme to induct them into the work. We were told and records confirmed that there are various ways in which the quality of the service is monitored. For example residents meetings and staff meetings are regularly held and both staff and people who use the service said they would feel comfortable to make their views known and felt they would be listened to. Surveys have recently been used (June 2008) to obtain the views of staff, relatives and people who live in the home to determine how satisfied they are with the service. The owner also engaged an independent company to conduct an audit of the service and makes regular visits to the home. A comment from a person who lives at the home was that he always asked them if there was anything which could improve the service. We were told prior to the visit that there are a range of policies and procedures in place for staff to refer to ensure that peoples health, safety and welfare is promoted. They have also confirmed with us that regular maintenance checks of the environment and equipment are made to ensure peoples safety. The sample of records checked during this visit which included tests of the fire alarm and emergency lighting system, lift servicing, and the gas safety records were in place to confirm this. Care Homes for Older People Page 22 of 25 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 23 of 25 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 9 13 Records must be completed consistently to show the specific time when medication has been administered. This will help to ensure the health, welfare and safety of people who use the service. 15/12/2008 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 1 It is recommended that the statement of purpose be reviewed to reflect changes to the title and address of where the Commission for Social Care can be contacted to ensure that people who use the service have consistent and up to date information. Care Homes for Older People Page 24 of 25 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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