Care Home: Sandhurst Rest Home

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What the care home does well Comment received from residents about living in the home were all positive. The 9 surveys returned directly to the CQC confirmed that eight people felt they always received the care and support they needed. One reply stated that they felt they usually received the care and support they required. Responses to the question, are staff available when you need them, out of the nine replies three stated usually and six always, and for the question is there someone to speak to informally if you are not happy, all replies received stated yes there was. Other comments received included. `They care for me in a happy family way. They are always trying to improve and maintain standards. They are very kind to me and nothing is too much trouble for them.` Responses to the question what the home does well, included `looking after us, we would not manage at home by ourselves`, `the staff are so kind I know their names, they like it that I know their names`. The manager is always on hand to speak to me any time and the staff are very helpful and caring to me and x, and go that extra mile to care for x`. `I don`t think the home could do any better as I think what they are doing now is first class`. `Friendly home environment`, `my Friends are always welcome they appreciate the cup of tea or coffee`, `the arrival at the front door my friends like the greeting`. `At present the home seems to be functioning very well I cant think of any improvements`. `The food is a very good selection and always served hot`. `Food and customer care`. What has improved since the last inspection? The home has ensured care plans and risk assessments have been improved, and they now contain more detail. However there is still room to provide more guidance in these documents. Medication procedures in the home have improved since the last inspection and are now in good order. What the care home could do better: Further detailed information would be beneficial for guidance in care plans and risk assessments for example, a care plan may state that a person requires help with washing, but doesn`t detail what help, such as help running the water, undoing buttons etc. On the day of the inspection one staff member was working prior to having a CRB check returned, however they have since left. The Provider has assured the CQC that the correct procedures for recruitment of staff will be followed in the future. The service must ensure they have received the appropriate checks prior to offering staff a place in the service. The Registered Provider must ensure any appointed Manager is registered with the CQC. Key inspection report Care homes for older people Name: Address: Sandhurst Rest Home 142 Barnhorn Road Bexhill-on-Sea East Sussex TN39 4QL     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Alexis Reilly     Date: 1 9 1 0 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. that people have said are important to them: They reflect the things 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. Care Homes for Older People Page 2 of 25 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Sandhurst Rest Home 142 Barnhorn Road Bexhill-on-Sea East Sussex TN39 4QL 01424844405 01424845144 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Sanctuary Care Homes Ltd care home 24 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users to be accommodated is 24. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (OP). Date of last inspection Brief description of the care home Sandhurst Rest Home is registered to provide accommodation for up to 24 older people and admits people with low through to medium dependencies. Sanctuary Care Homes Ltd purchased the home in February 2008. A manager was appointed in June 2008 and has day-to-day control of the home. They are not yet registered with the Commission. The owners are involved in running of the business. The premise is an older detached building with ground floor extensions added. There are 22 bedrooms on the ground and first floor. Two of these are doubles. Twenty-one rooms have ensuite facilities, although some quite small. A passenger lift provides Care Homes for Older People Page 4 of 25 Over 65 24 0 2 2 1 0 2 0 0 8 Brief description of the care home access to the first floor. There are two assisted bathrooms one on each floor and one assisted shower. The home has a large lounge, conservatory and dining room. The home is non-smoking. The slopping gravel driveway leads to the front of the house, which is level and mainly laid to lawn with trees, shrubs and a flowerbed. To the side is a level paved area with tables and chairs. The home is suitable for wheelchair access. There is parking on the front drive for several cars. The home is located on the main road between Pevensey and Little Common. The home is approximately one-mile from local shops, churches, pubs and other community facilities in Little Common. The staff compliment consists of the manager, care assistants and ancillary staff. Care staff work a rota that includes a minimum of three care staff on duty during the day plus the acting manager and a carer on duty at night with another person on call sleeping on the premises. Current fees charged are available from the home. Additional charges are made for hairdressing, dry cleaning, telephone, toiletries, newspapers and chiropody. Previous inspection reports are available from the home or can be downloaded from www.csci.gov.uk. Care Homes for Older People Page 5 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: The inspection began at 10am and finished at 2.30pm. The inspector spent time with three residents in the home individually and one relative. The inspector looked at the care that three particular residents received in the home. As part of that process various documents were viewed, these included the plans of care and associated documents such as risk assessments and list of daily activities engaged in. Other documents examined were copies of notifications, accidents and appointments, evidence of external reviews, the complaints procedure, copies of service users meetings, care plan meetings and staff meetings. Staff recruitment files and staff induction training sheets were also examined, as were a sample of the sheets which record the administration of medication and the duty rota. The plan of staff supervisions and the Service user guide were also viewed. The inspector visited all communal areas, lounge, dining area, and passed briefly through the kitchen. The inspector had the opportunity to speak to three residents Care Homes for Older People Page 6 of 25 individually and did so in their rooms. The inspector spent time with the Acting Manager, one senior carer, a newly appointed staff member and one of the joint providers of the service. The inspector also observed other staff interacting in a positive manner with service users during the inspection. In the report the inspector has included comments from people met on the day of the inspection and comments from the returned CQC surveys. Information was also taken from the AQAA which was comprehensively filled in and returned by the due date. Care Homes for Older People Page 7 of 25 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 on page 4. Care Homes for Older People Page 8 of 25 The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 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 10 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. Service users benefit from receiving relevant and up to date information, which is made available to them prior to admission, they are made to feel welcome in the home. The service demonstrated it can meet the needs of the service users placed. Evidence: As part of this site visit the inspector looked at the care which three service users received in the home, time was spent with two of the people involved in the case tracking, and the relative of a resident. The inspector had the opportunity to spend time with one other resident individually, spending time with three residents and one relative in total. Staff were observed interacting in a positive manner with residents. The inspector also had the opportunity to speak with the senior carer, Acting Manager, new care staff member and one of the providers of the service. As part of the case tracking the inspector examined the person centred care plans and the associated documents such as risk assessments and activity plans for these individuals, also evidenced were the external reviews from the placing team to ascertain if the needs Care Homes for Older People Page 11 of 25 Evidence: identified in the assessment are used as a basis for a comprehensive care plan. The home has had two new admissions since the last inspection, evidence was supporting to confirm that service users are involved in the admissions process and are given choice, the service had comprehensive assessment document in place which were used to assess someone referred to the service. Also available to view was collated information with regard to service users in the home, and their referring documents. This highlighted that the Manager obtains background information prior to offering someone a place in the service. The entrance hall to the home is welcoming and bright. Relevant information is available to view such as the residents guide, and statement of purpose. The inspector had the opportunity to speak with residents during the visit; two of these people had made the decision to visit the home and subsequently move in themselves, and were both very happy with the care they received in the home. I visited the home and decided when the time came that is were I wanted to live. Intermediate care is not offered by this home. Care Homes for Older People Page 12 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 and procedures in place are sufficient to ensure that a good provision of health care and personal support is provided to service users by the home. Care is administered in way that protects residents privacy and dignity. Medication procedures are in order. Evidence: As part of this site visit the inspector looked at the care which three service users received in the home. Time was spent with two of the people involved in the case tracking, and the relative of a resident. The inspector had the opportunity to spend time with one other resident individually, spending time with three residents and one relative in total. Staff were observed interacting in a positive manner with residents. The inspector also had the opportunity to speak with the Acting Manager, senior carer, new care staff member and one of the providers of the service. As part of the case tracking the inspector examined the person centred care plans and the associated documents such as risk assessments and activity plans for these individuals, also evidenced were the external reviews from the placing team to ascertain if the needs identified in the assessment are used as a basis for a comprehensive care plan. Care Homes for Older People Page 13 of 25 Evidence: Care plans and risk assessments have improved since the last inspection and now include more detail. However further information would be beneficial, for example a care plan may state that a person requires help with washing, but doesnt detail what help, such as help running the water, undoing buttons etc. Evidence from care plans and discussions with staff demonstrated a good understanding of the needs of the individual residents placed in the home. It is evident that health care needs are addressed quickly and efficiently and that a good level of personal care is provided in a client centered way which is respectful. Changes have been made to the recording of administration and storage of creams and these are now in good order. Comments received on the day of the inspection included X is well looked after Xs skin is in very good condition even though X is in bed, very happy with the care X has received in the home. Care Homes for Older People Page 14 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Evidence was supporting to confirm that a range of social, cultural and recreational activities are on offer with the wishes of the service users being central to the provision. The menu is varied and specialist diets are provided for service users, with service users choice and wishes being respected. Evidence: As part of this site visit the inspector looked at the care which three service users received in the home. Time was spent with two of the people involved in the case tracking, and the relative of a resident. The inspector had the opportunity to spend time with one other resident individually, spending time with three residents and one relative in total. Staff were observed interacting in a positive manner with residents. The inspector also had the opportunity to speak with the Acting Manager, senior carer, new care staff member and one of the providers of the service. As part of the case tracking the inspector examined the person centred care plans and the associated documents such as risk assessments and activity plans for these individuals. The service provides mid morning drinks and biscuits. Lunch is a hot home cooked meal, two alternatives are offered and the home will suggest a third alternative if the resident does not wish to eat either of the first two choices on the menu. The Care Homes for Older People Page 15 of 25 Evidence: residents are also served afternoon tea/coffee and cake or biscuits. They have a choice of suppers usually a lighter meal with dessert followed by tea/coffee. Residents can have their meals in the dining area or on trays in their rooms. The inspector noted that food preferences were recorded in the care plans. Information from the AQAA supports the fact that residents are able to request food/snacks/ drinks at any time of the day or night and the home can cater for all dietary requirements, assistance with meals or drinks will be given if required. It is clear from the evidence collected that the home provide person centred activities for the people in the home, and these are tailored for individuals so no one is left out. For example some residents may be read to and residents enjoy sherry and wine with music. Residents are encouraged and supported to maintain contact with the community and some residents are involved very much in their life in the community as was prior to moving into the home. Food was described as delicious. Comments received from the surveys which were returned directly to the CQC included friendly home environment. My friends are always welcome they appreciate the cup of tea or coffee. In answer to the question what the home does well, responses included the arrival at the front door my friends like the greeting. The food is very good selection and always served hot. Food and customer care. Care Homes for Older People Page 16 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. Service users benefit from a robust and efficient complaints procedure, whilst the homes procedures and processes protect residents. Evidence: During the inspection the inspector examined copies of notifications, and accidents and appointments, evidence of external reviews, and the complaints procedure. Evidence was supporting to confirm that staff receive training in POVA, The Mental Capacity Act and Deprivation of Liberty training. The service has had no safeguarding alerts or formal complaints since the last inspection. The service has a grumbles log in which they record concerns and the inspector could see these are addressed and dealt with appropriately. Residents are safeguarded by the policies in place with regard to handling residents finances. Care Homes for Older People Page 17 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. The home provides bright clean and comfortable accommodation. Service users rooms were personalised and homely. The home was clean on the day of the inspection. Evidence: As part of the inspection the inspector visited the communcal areas of the home, which included dining room and lounge also passing through the kitchen. The inspector had the opportunity to speak to service users in their bedrooms. The home is well maintained and all areas of the home, including the garden, are accessible to service users. The building has 12 rooms on the ground floor and 10 on the first floor assessable by a passenger lift. The building has a large lounge and dining area where the residents are able to watch T.V, videos or listen to music. There is also a conservatory and downstairs bedrooms which open into the glazed area. Residents are encouraged to bring their own furniture and personal possessions when they move into the home. This was clearly evidenced when the inspector had the opportunit to visit residents in their bedrooms. The dining tables are spread between the lounge and dining room at the request of the residents. The dining room has patio door which open out onto the garden and Care Homes for Older People Page 18 of 25 Evidence: patio area. The service has a downstairs hairdressers room and a hairdresser comes in once a week. The home was clean and odour free throughout. . The home has an infection control policy in place and staff are trained in infection control procedures, staff training records viewed confirmed this. Care Homes for Older People Page 19 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. Staff recruitment procedures must be improved to ensure they are effective and protect service users fully from potential harm or risk associated with poor recruitment practices. Evidence: As part of the inspection the inspector examined the recruitment files of three newly recruited staff to the service these were found to be in order. However one of the staff working in the home did not have a CRB returned. The service must ensure they have received the appropriate checks prior to offering staff a place in the service. Evidence was supporting to confirm that staff receive appropriate induction into the home and the home used the skills for care induction training. Staff are supervised and receive appropriate training. New staff on their induction in the home were additional to the rota and were clearly in a shadowing capacity. Members of staff were seen on the day of the inspection interacting positively with service users in an encouraging manner. Staff were described by residents as thoughtful and kind 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 has ensured that service users live in a safe and well manager service which is run in their best interests Evidence: Evidence through out the inspection was supporting to confirm that service users received a good level of service in the home. Care plans and risk assessments were informative, activities are provided and service users dignity and independence is respected. Staff are well managed, supervised and trained. Service users are protected by the homes policy on handling of finances and valuables. However the Registered Provider must ensure that strict recruitment procedures are followed in relation to recruiting staff in the service. The home has worked hard to address the shortfall of the last inspection and the requirements have been met, however there is room to improve the detail in the care plan documents as discussed earlier on in the report. Care Homes for Older People Page 21 of 25 Evidence: Comments received about the manager on the day of the inspection from residents relatives and staff included, Manager very approachable, the manager does really well. Comments received from the surveys which were returned direct to the CQC confirmed this view and included. The manager is always on hand to speak to at any time and the staff are very helpful and caring to me and x and go that extra mile to care for x. I dont think the home could do any better as I think what they are doing now is first class. Friendly home environment. At present the home seems to be functioning very well I cant think of any improvements. Additional information taken from the nine surveys returned directly to the CQC showed eight people felt they always received the care and support they needed, and one reply stated that they usually received the care and support they required. In response to the question are staff available when you need them out of the nine replies returned three stated usually and six always, and for the question is there someone to speak to informally if you are not happy all replies received stated yes. The Acting Manager is not registered with the CQC and they must ensure they progress their application for registration. Evidence in the AQAA confirmed that policies and procedures are in place with regard to health and safety. 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 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 Care Homes for Older People Page 24 of 25 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.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. Copyright © (2009) Care Quality Commission (CQC). 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. 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