Care Home: Sandilands Lodge

What the care home does well Comments from residents were generally positive, with indication that staff are kind and helpful in meeting their care needs. Residents are actively encouraged to keep in contact with family and friends living in the community. Visitors are welcome at any time and facilities are available for them. The home has a settled staff group and has sufficient staff to meet residents` needs. The home`s recruitment procedures protect the residents through vigorous staff vetting. What has improved since the last inspection? A new call bell system has been installed. There has been improvement made with regards to the general documentation in the home. Staff training has started and is ongoing in order to promote the delivery of person centred services. Staff supervision has also commenced. What the care home could do better: There is no requirement or recommendation from this visit however the registered manager must ensure that the home continues to provide a good standard of service. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Sandilands Lodge 228 Carshalton Road Sutton Surrey SM1 4SA     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: Mohammad Peerbux     Date: 0 7 0 4 2 0 0 9 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. 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. 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 23 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.cqc.org.uk Internet address Care Homes for Older People Page 3 of 23 Information about the care home Name of care home: Address: Sandilands Lodge 228 Carshalton Road Sutton Surrey SM1 4SA 02086436291 02086423788 bmwilliams@btconnect.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Ms Barbara Williams care home 15 Number of places (if applicable): Under 65 Over 65 15 dementia Additional conditions: 0 The maximum number of service users who can be accommodated is: 15 The registered person may provide the following category of service only: Care Home Only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Dementia - Code DE (E) (of the following age range: 65 years and over) Date of last inspection Brief description of the care home Sandilands Lodge is registered to provide residential care for up to fifteen older people with dementia. The home is a large detached house situated on the Carshalton Road close to local shops and bus routes between Wallington and Sutton. It is an old property in need of refurbishment and difficult to adapt to modern standards of comfort and disability access. There are three single and six double bedrooms located over two floors. The home has a separate lounge and dining room on the ground floor. There are bathrooms and toilet facilities located on both floors. The home has a small kitchen and a laundry room. The office is also very small, too small to effectively manage the home. A small patio area and raised garden is to be found at the rear of the property and parking space to the front. Care Homes for Older People Page 4 of 23 Brief description of the care home Care Homes for Older People Page 5 of 23 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 unannounced visit to the home was undertaken as a part of the inspection process for the year 2009/2010. In writing the report consideration has also been given to information received throughout the year such as comments from people who use the service, reports of incidents and complaints. Some time was spent looking at records, talking to staff and the supervisor who was in charge as the registered manager was away. Some of the residents were spoken to however due to their cognitive ability it was difficult to seek their views. A tour of the building was also carried out. They are all thanked for their time and all of those who provided feedback for their support in the inspection process. Care Homes for Older People Page 6 of 23 Care Homes for Older People Page 7 of 23 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.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 8 of 23 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 9 of 23 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A judgement was unable to be made regarding standard 3. Evidence: Standard 3 has been assessed as not fully met, as there has not been any new admission to the home recently. Previously it was noted that people had moved into the home without having their needs fully assessed prior to admission. Intermediate care for rehabilitation and return to the community is not provided by this home. Care Homes for Older People Page 10 of 23 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. Generally, residents care plans include detailed information about their needs and personal goals. This helps staff to know the residents needs and how to meet them. Evidence: Each resident has a care plan that where possible has been agreed with them. This is written in plain language, is easy to understand and considers all areas of the individuals life including health, personal and social care needs. The plan also includes a risk assessment where applicable. Areas have been identified where staff are willing to support residents to take some risks, which may have an impact on their rights.Presently the care plans are being reviewed and updated. Residents have access to healthcare and remedial services. Staff make sure that those who are fit and well enough are encouraged to be independent, have regular appointments and visit local health care services. The health care needs of residents unable to leave the home are managed by visits from local health care services. Staff must ensure that residents who are not eating well,are weighed on a regular basis and Care Homes for Older People Page 11 of 23 Evidence: seek professional advice as necessary. The home has an efficient medication policy supported by procedures and practice guidance, which staff understand and follow. Medication records are fully completed, contain required entries, and are signed by appropriate staff. People receiving services are happy with the way that staff deliver their care and respect their dignity and rights.The home arranges for residents to enjoy the privacy of their own rooms. Observation of the staff team interacting with the residents showed that the carers were mindful how they addressed residents, and they were seen to be polite and friendly. Care Homes for Older People Page 12 of 23 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. The routines of daily living and activities made available are flexible and varied to suit peoples expectations, preferences and capacities.Dietary needs are well catered for and a well balanced diet is provided, to ensure health and enjoyment of food. Evidence: At the time of the inspection there were only eight residents in the home. The majority of residents seem to spend much of the time together in the lounge which is a pleasant and cosy. This promotes a very homely atmosphere, which residents seem to like. Staff are aware of the need to plan the routines and activities of the home in a way, which meets the choice, and wishes of residents. People who use the service have the opportunity to develop and maintain important personal and family relationships.The home has open visiting arrangements and residents know they can entertain their family and friends in their own room. If they prefer they can use communal areas of the home to talk to visitors. The home tries to be flexible and attempts to provide a service that is as individual as possible, using its staff and resources effectively. Care Homes for Older People Page 13 of 23 Evidence: It was clear from the menus that a wide variety of different food options were available in the home with a lot of consideration given to the nutritional value of the meals provided. Staff are ready to offer assistance in eating where necessary, discreetly, sensitively and individually, while independent eating is encouraged for as long as possible. Care Homes for Older People Page 14 of 23 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. Complaints are generally managed well, which should ensure that residents and relatives concerns are listened to. Evidence: The home has a complaints procedure that generally meets the national minimum standards and regulations. It keeps a full record of complaints and this includes details of the investigation and any action taken. The home understands the procedures for safeguarding adults and will always attend meetings or provide information to external agencies when requested. Training of staff in safeguarding is regularly arranged by the Home. Care Homes for Older People Page 15 of 23 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 is generally hygienic and clean, homely and comfortable; this environment therefore facilitates residents health and emotional well-being. Evidence: The home provides a physical environment that generally meets the specific needs of the people who live there. The home is comfortable and has a programme to improve the decoration, fixtures and fittings. A new call bell system has been installed in line with a requirement made at the last inspection.Hand rails have also been installed in the garden to minimise accidents. The home is kept clean, hygienic, and free from offensive odours throughout. Systems are in place to control infection in accordance with relevant legislation and published professional guidance. Care Homes for Older People Page 16 of 23 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. The home has the numbers and skill mix of staff sufficient to meet residents needs and ensure their safety. There is a staff training and development programme in place. This ensures that staff fulfil the aims of the home and meet the changing needs of residents. Evidence: Copies of staff rotas show well thought out and creative ways of making sure that the home is staffed efficiently, with particular attention given to busy times of the day and the changing needs of the residents. The manager needs to include her hours worked on the rota. The supervisor who was facilitating the inspection informed us that more than 50 of staff have an NVQ level qualification at level 2. Recruitment procedures seemed appropriate. One newly recruited staff file was examined and found to contain all the information required by the Care Homes Regulations 2001 including a completed job application, terms and conditions of employment, an enhanced CRB check and proof of their identity. The home ensures that all staff within its organisation receive relevant training that is Care Homes for Older People Page 17 of 23 Evidence: targeted and focussed on improving outcomes for residents. Training is ongoing. Care Homes for Older People Page 18 of 23 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 generally provides guidance and direction to staff to ensure residents receive consistent quality care. There is a quality monitoring system and this ensures the home is run in a way that is in the best interests of the residents. Evidence: Since the last inspection there has been significant improvement made with regards to the general management, environment and some of the paperwork. The Commission acknowledges this. The manager and supervisor are still working towards improving the service being provided.At the time of the inspection the manager was away. Effective quality assurance and quality monitoring systems, based on seeking the views of residents, are in place to measure success in meeting the aims, objectives and statement of purpose of the home. Copies of completed surveys were seen during the inspection. Care Homes for Older People Page 19 of 23 Evidence: The supervisor stated that the home does not handle residents monies. Records with regards to health and safety are of a good standard and are routinely completed. Certificates relating to health and safety were up to date. All the issues that were identified during the last inspection had been attended to. Care Homes for Older People Page 20 of 23 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 21 of 23 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 22 of 23 Helpline: Telephone: 03000 616161 or Textphone: or 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) Commission for Social Care Inspection (CSCI). 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