Care Home: Summerley

What the care home does well Residents` needs are assessed prior to admission. The staff has an ability to treat residents as individuals. Residents stated that the staff were "very caring and kind" The management style is open and the home is run n the best interests of the residents. What has improved since the last inspection? This is a new service and there have been improvements in the carpeting and furnishings of the home. Radiator covers and sink temperature control valves are being fitted. The occupancy which was only three when the home changed hands is now up to twelve CARE HOMES FOR OLDER PEOPLE Summerley 1 Southview Road Felpham Bognor Regis West Sussex PO22 7JA Lead Inspector Sheila Gawley Unannounced Inspection 13th November 2007 09:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Summerley DS0000069909.V355081.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Summerley DS0000069909.V355081.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Summerley Address 1 Southview Road Felpham Bognor Regis West Sussex PO22 7JA 01243 823330 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs Sally Morton Miss Samantha Helen Kewell Care Home 18 Category(ies) of Dementia (0) registration, with number of places Summerley DS0000069909.V355081.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 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: 2. Dementia (DE). The maximum number of service users to be accommodated is 18. Date of last inspection Brief Description of the Service: Summerley is a large detached property located in the seaside town of Bognor Regis and provides accommodation and personal care to 18 older people. The new registered provider and registered manager have been working towards improving the fabric of the home. It provides personal care for up to 18 service user whose primary care needs result from dementia. The fees charged range between £400 and £500. Summerley DS0000069909.V355081.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This site visit as part of the inspection process took place on the morning and afternoon of 13 11 07. The deputy manager and the registered manager facilitated the inspection. The commission was in receipt of an Annual Quality Assurance Assessment (AQAA) and any documents required on the day were made available. Twelve residents were accommodated on the day of inspection. Three residents were case tracked, their care plans and Medicine administration charts were inspected and they were also spoken to. They expressed satisfaction with all aspects of the home saying that staff were very caring and the food was very good. All residents spoken to throughout the day stated great satisfaction in the care they receive, that they are always treated in a respectful manner and that they enjoyed the activities provided. One relative was spoken to on the day and she expressed great satisfaction with the home “I cannot speak highly enough of the home and the care on offer”. She stated that the staff were very approachable and any concerns were quickly dealt with. Another relatives spoken to on the telephone stated that she was “very impressed” with the admission process and that having her mother there “s a great weight off her mind” A specialist nurse visiting the home to give some training on continence was spoken to and she stated that care in the home is very good and she is contacted appropriately to meet residents’ needs. Staff were observed offering care in a respectful and encouraging manner. The atmosphere in the home was very relaxed and sociable. The majority of the residents were sitting in the sitting room; others were sitting quietly in their rooms or were being cared for in bed. This report is compiled using information as described above and also information held on file at the Commission. The majority of the standards were met today mostly judged as good. Summerley DS0000069909.V355081.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: There are some shortfalls in the administration, recording and disposal of medicines and in the laundry provision, these were discussed with the registered manager and will be requirements of this inspection. Please contact the provider for advice of actions taken in response to this Summerley DS0000069909.V355081.R01.S.doc Version 5.2 Page 7 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Summerley DS0000069909.V355081.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Summerley DS0000069909.V355081.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3, Standard 6 is not applicable People who use this service experience good outcomes in this area, as there is a clear assessment and admission process. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Pre admission assessment is evident in care plans inspected; residents and a relative spoken to confirmed this. The relative spoken to on the day also confirmed that the prospective resident was assessed at home. The relatives spoken to on the telephone said she was very impressed with the admission process The assessment covers all areas of need, health, personal and social. Residents are admitted on a trial basis. Summerley DS0000069909.V355081.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7-10 People who use this service experience good outcomes in this area because all needs are assessed and met, set out in a plan and residents are treated with respect. There were however shortfalls in the standard on medication. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All residents had a plan of care. Three residents were case tracked. The care plans inspected contained comprehensive information on health, personal and social need. The care plans were drawn up following an assessment of their needs. These included nutritional assessments, mobility, hygiene, continence, and pressure areas, lifestyle summary and risk assessments. The care plans were up to date and had evidence of monthly review. Access to specialist health support is available as required including general practitioner, chiropodists, dentists and outpatient appointments. A specialist nurse visiting the home to give some training on continence was spoken to and Summerley DS0000069909.V355081.R01.S.doc Version 5.2 Page 11 she stated that care in the home is very good and she is contacted appropriately to meet residents’ needs. The residents are involved in the development and maintenance of their care plans as are their relatives/representative where appropriate. New documentation has been being put in place to support this process. Medicines are stored appropriately. There are some shortfalls in the administration, recording and disposal of medicines. Some residents not requiring medicines at regular intervals did not have clear instructions on the medicine administration charts and there were blank spaces where the residents did not wish the medication. Where more that one resident was on a liquid medication, this was dispensed to both from just one resident’s bottle. This practice was discussed with the deputy manager and the registered manager. The last two months supply of a controlled drug was still stored in the controlled drug cupboard along with the current months supply. The need for this to have been returned was discussed with the deputy Manager and registered manager. One resident self medicates at present and a locked space is provided in the bedroom. Staff were observed offering care in a respectful and encouraging manner and residents spoken to stated that they are treated with respect. Summerley DS0000069909.V355081.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12-15 People who use this service experience good outcomes in this area because lifestyle in the home meets their expectations. Activities and events provided satisfy social, cultural and recreational needs. There is a variety of nutritional food on offer. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is an activities programme in the home, which is displayed on the notice board. This includes in house activities and some external entertainers who provide armchair exercises, a sing along and mosaic design. There were details of a Christmas show on display also. Residents are free to join in activities as they wish; a resident spoken to confirmed this. There are regular residents and relatives meetings. The minutes of these meetings were seen. Residents’ social interests and activities are recorded. Residents spoken to stated that they had choice in times to go to bed and to get up. Visitors are welcome in the home and a relative spoken to confirmed Summerley DS0000069909.V355081.R01.S.doc Version 5.2 Page 13 this. The Registered Manager stated that as the numbers of residents accommodated increases the activities programme will be modified and increased to meet the needs of new residents. There is a four-week menu in place, which appears nutritious and offers variety and choice. There is a choice of hot meal on offer for lunch and supper. The meal on offer for lunch today was not that listed on the menu and as it was spare ribs some residents had difficulty with these. Staff did assist in helping the residents to cut the ribs up. Residents spoken to expressed satisfaction with the meals. Residents requiring assistance was offered this in a respectful manner. There were some items in the fridge uncovered and undated, this was discussed with the cook and with the registered manager. Summerley DS0000069909.V355081.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): People who use this service experience good outcomes in this area because there is a complaints procedure, and trained staff protect residents from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is a clear and accessible complaints procedure in place which residents spoken to stated that they were aware of, although all stated that they did not have reason to complain. A relative spoken to also stated that she did not have reason to complain but would know how to do so. There are policies and procedures in place regarding safeguarding adults and whistle blowing. Staff spoken to were clear about their responsibilities towards the people living in the home. A specialist nurse visiting the home was spoken to and she stated that care in the home is very good and she is contacted appropriately to meet residents’ needs. Staff receive safeguarding adults training in their induction and there are planned have updates. An update is to be given once the manager has attended a workshop on revised safeguarding adults procedures. Summerley DS0000069909.V355081.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 22, 26 People who use this service experience good outcomes because the home is safe, clean and well maintained. Laundry provision is not at present suitable for the needs of the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is a pleasant sitting and dining room and a conservatory. The home provides a well-maintained environment and provides specialist aids and equipment to meet the needs of the people who use the service. The home is pleasant, well decorated and bedrooms are personalised. There is new carpeting and furniture in the communal areas. Not all radiators are as yet covered but there is a programme of fitting in place and the covers were seen in the home awaiting fitting. Temperature control Summerley DS0000069909.V355081.R01.S.doc Version 5.2 Page 16 valves on sink taps are being fitted, bath and shower have been done. Since taking over the home the requirements of a health and safety inspection have been met and evidence of this was seen (such as risk assessments, lift maintenance, testing of lifting appliances and staff training documentation) The laundry is very small and it would be difficult to meet the needs of residents if the home was full. Its size makes it difficult to wash all areas of floor and walls. It has the necessary machines to wash at appropriate temperatures. The Registered Manager and proprietor are investigating a means to providing a larger more accessible laundry. A suitable soap dispensed needs to be put in place to control the spread of infection. Summerley DS0000069909.V355081.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27-30 People who use this service experience good outcomes in this area because a suitably recruited and trained staff meets their needs. There is some reliance on agency staff. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staff rota showed sufficient staff on duty at all times although there is a strong reliance on agency staff at present. The registered manager stated that one new member of staff has been recruited and is to start Monday and two others are being processed, this should reduce the reliance on agency staff. An agency carer on duty was spoken to and she stated that she was given a tour of the home and information on the alarm systems and fire procedure before commencing work this morning. Residents spoken to stated that staff always attend when they are called. They also confirmed that they feel their needs are met by competent staff and in a respectful manner. One resident stated that she has communication difficulties with some carers from overseas. Staff spoken to were very enthusiastic about their work and were knowledgeable on the needs of the residents. A key worker system is being Summerley DS0000069909.V355081.R01.S.doc Version 5.2 Page 18 developed. Staff meetings are in place to discuss issues and promote best practice in the home. Personnel files inspected showed that the home follows a recruitment policy and all documents required were in place. Staff do not commence work without having Criminal Records Bureau Clearance and a POVA check. Induction and training records show that staff are trained to do their job. There was a training session ongoing during the inspection on continence care. One carer is presently doing National Vocational Qualification Level 2. Two others are doing Train to Gain training on dementia and safe handling of medicines. Summerley DS0000069909.V355081.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38 People who use this service experience good outcomes in this area as the home is well managed and is run in their best interests. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Registered Manager has the qualifications and experience necessary to obtain registration with the Commission. She communicated a clear sense of direction for the home and is looking forward to all work being completed and accommodating the full number of residents. Staff and residents state that the manager is approachable. Summerley DS0000069909.V355081.R01.S.doc Version 5.2 Page 20 Small amounts of money are held for residents. These are held individually, securely and are recorded and receipted. This is audited fortnightly. Effective quality assurance monitoring systems have been developed to elicit opinion from residents, relatives and staff. These include surveys, relatives, residents and staff meetings. The health safety and welfare of residents and staff are protected by the homes induction and training programme and the provision of health and safety policies and procedures. Summerley DS0000069909.V355081.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/a HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X 3 X X X 2 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Summerley DS0000069909.V355081.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP9 Regulation 13(2) Requirement Timescale for action 31/12/07 2 OP26 13(3) The registered person ensures that staff adhere to the procedures for the receipt, recording, administration and disposal of medicines, Soap dispenser to be placed in 31/12/07 the sluice room to improve handwashing facilities and prevent the spread of infection laundry. Laundry floor and wall finishes to be impermeable and easily cleanable RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Summerley DS0000069909.V355081.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Summerley DS0000069909.V355081.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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