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Care Home: Sunningdale House, Honiton

  • 31 Kings Road Honiton Devon EX14 1HW
  • Tel: 0140441677
  • Fax: 0129724912

Sunningdale House is a residential care home for older people. It is registered to provide care for older people and the care of older people with dementia. There are two lounges and a dining room. There are thirteen single rooms and three double rooms. The home is non-smoking. The first floor is reached by stairs or a chairlift. There is one assisted bathroom in the home. Sunningdale House is situated on the edge of Honiton town in East Devon. It is accessible by bus and has a car park. The weekly fees range from £322.00 to £595.00. Items not included in the weekly fee are dry cleaning, weekly visits by the hairdresser, monthly visits by the chiropodist, private phone installation and calls, newspapers, toiletries, transport i.e. to hospital, entrance fees to outings and continence aids.

  • Latitude: 50.798999786377
    Longitude: -3.1789999008179
  • Manager: Mrs Iris Larcombe
  • Price p/w: £459
  • UK
  • Total Capacity: 19
  • Type: Care home only
  • Provider: Adelaide Lodge Care Home LLP
  • Ownership: Private
  • Care Home ID: 15106
Residents Needs:
Old age, not falling within any other category, Dementia

Previous Inspections

This may not be the latest inspection for this service as we are having techinical problems updating from CQC - please check directly on the regulators website for the most recent report; bestcarehome hopes to be back to regular updates shortly.

For extracts, read the latest CQC inspection for Sunningdale House, Honiton.

CARE HOMES FOR OLDER PEOPLE Sunningdale House, Honiton 31 Kings Road Honiton Devon EX14 1HW Lead Inspector Louise Delacroix Key Unannounced Inspection 09:10 1st May 2008 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 Sunningdale House, Honiton DS0000070977.V360597.R02.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. Sunningdale House, Honiton DS0000070977.V360597.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Sunningdale House, Honiton Address 31 Kings Road Honiton Devon EX14 1HW 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) 01404 41677 01297 24912 Sunningdale.hse@btconnect.com Adelaide Lodge Care Home LLP Mrs Iris Larcombe Care Home 19 Category(ies) of Dementia (19), Old age, not falling within any registration, with number other category (19) of places Sunningdale House, Honiton DS0000070977.V360597.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (Code OP) Dementia (Code DE) The maximum number of services users who can be accommodated is 19. 21/12/07 2. Date of last inspection Brief Description of the Service: Sunningdale House is a residential care home for older people. It is registered to provide care for older people and the care of older people with dementia. There are two lounges and a dining room. There are thirteen single rooms and three double rooms. The home is non-smoking. The first floor is reached by stairs or a chairlift. There is one assisted bathroom in the home. Sunningdale House is situated on the edge of Honiton town in East Devon. It is accessible by bus and has a car park. The weekly fees range from £322.00 to £595.00. Items not included in the weekly fee are dry cleaning, weekly visits by the hairdresser, monthly visits by the chiropodist, private phone installation and calls, newspapers, toiletries, transport i.e. to hospital, entrance fees to outings and continence aids. Sunningdale House, Honiton DS0000070977.V360597.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. People who use the service experience good outcomes in this area. We have made this judgement using available evidence including a visit to this service. The inspection was unannounced and took place over approximately eight hours with two inspectors, Louise Delacroix and Viv Stephens, visiting the home. There were fifteen people living at the home on the day of inspection. People living at the home contributed to the inspection, as did their visitors. The management team and staff members also contributed. Time was also spent in communal areas observing the experience of people living at the home, and their relationships with other people living and working in the home. Surveys were sent to people living at the home who were helped to complete them by staff or a relative (ten returned), staff members (six returned), visitors/relatives (five returned), health and social care professionals (two returned), which have been incorporated into the report. As part of this inspection, four people were case tracked, this means that the records linked to their care and stay were inspected in detail, their rooms were also visited and where possible, we spoke with them about their views of the home. During the inspection, a tour of the building and garden took place and records including care plans, staff recruitment, training and medication were looked at. Prior to this inspection, the home completed an annual quality assurance assessment (AQAA), which provides the commission (CSCI) with current information about the service, and information from this document has been included in this report. Since the last key inspection, the home has been bought by a new company and has a new manager in place. There have been significant improvements to the way the home is run which benefits the people living there. A relative told us ‘since the new owners have taken over they have already improved conditions etc.’ and another visitor said ‘it provides a home from home feeling with very caring staff’. What the service does well: People are given information about the home before they move in and are encouraged to visit. People are consulted about their care needs and their Sunningdale House, Honiton DS0000070977.V360597.R02.S.doc Version 5.2 Page 6 health is well monitored. We saw that people living at the home are treated with dignity and respect by staff, and they told us that staff were kind. We saw that generally people appeared occupied by the variety of activities on offer at the home, and we heard from people about their positive thoughts about the garden. People were also seen exercising choice about how they spent their time. People visiting the home told us they felt welcomed. People benefit from good meals served in a relaxed and caring atmosphere. People told us that staff listen to them and staff know what to do if people have concerns about the home. Staff are clear about their duty to challenge poor practice and to raise concerns. A health professional commented that the home provides a ‘warm and caring enviroment’. Staff are busy but create a calm and friendly atmosphere. The recruitment process helps ensure that people are suitable for working with vulnerable people. Training is promoted and encouraged. The new manager has a great deal of experience in running homes and has already used this knowledge to make noticeable positive changes to the home to benefit the people living there. Equipment is well maintained. What has improved since the last inspection? The new manager ensures that she can meet people’s care needs by gathering information from them and the people involved in their lives before they move into the home. Visitors felt that there was good attention to detail before their relative moved. There have been significant improvements to care planning, which provide greater guidance to staff about people’s individual care needs. We saw staff following guidance and people being discreetly supported with their continence. There have been improvements to how medication is managed and stored, and the manager and a senior member of staff have undertaken training to assess the competency of staff to administer medication. People are supported in a discreet manner to manage their continence, and records are kept. Since buying the home in November 2007, there have been positive changes to the garden, which makes it a more accessible and attractive place for people to use. There has been investment to improve the home’s environment, which has included internal and external decoration. Training records are now easier to audit and the home is already making progress in creating a quality assurance system for the home, through meetings with people living, visiting and working at the home, and surveys are due to be sent out shortly. Sunningdale House, Honiton DS0000070977.V360597.R02.S.doc Version 5.2 Page 7 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Sunningdale House, Honiton DS0000070977.V360597.R02.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 Sunningdale House, Honiton DS0000070977.V360597.R02.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): We looked at standards 1,3 and 5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides information, which sets out the details of the service and facilities offered, to enable people to make an informed decision about whether the home is right for them, and also encourages people to visit. The home has a good and thorough admission process to ensure that they can meet the care needs of people. EVIDENCE: As part of the home’s registration in 2007, a statement of purpose was submitted to us, which contains the required information. A visitor to the home told us they had been provided with a copy of this document before their spouse moved to the home. They also confirmed that the manager had visited their spouse before they moved to the home to ensure that their care needs Sunningdale House, Honiton DS0000070977.V360597.R02.S.doc Version 5.2 Page 10 could be met, which is good practice. We saw paperwork, which reflected this visit and the assessment that was made. We also looked at the admission procedures for those people who had recently moved in, including one person who moved in on the day of this inspection. We talked to people and their relatives about the information they had been given before moving in, and the opportunities to visit and get to know the home. One person told us they had not been able to visit as they had been in hospital, but they were confident that their family had made the right choice. We talked to their relatives who were visiting the home on the day of this inspection. They told us they had looked at a number of homes, they had gathered brochures and looked at CSCI reports, and had talked to people in the area about their experiences of care homes and had chosen Sunningdale as the most suitable one. They were very happy with all aspects of the admission procedure, and pointed to a vase of flowers on the table provided by the home and said that the attention to detail, and small welcoming gestures such as the flowers, had made the moving-in procedure feel very welcoming. The manager told us that where possible they have asked people about their preferred décor for their room before they move in. Another person said she moved in recently, and that she didn’t want to look at any other homes, as she knew some people who were already living at Sunningdale. She said she had definitely made the right choice and was very happy – she described the home as “comfortable, casual and caring.” All the relatives who returned our surveys said that they had received enough information about the home to help them make a decision. We looked at the assessments for two people who had moved in recently. The home had gathered information by visiting each person and finding out from them what their normal daily routines are and how they want to be assisted. The home had also gathered information from other agencies, including hospitals where appropriate. The information covered all areas of need and gave staff sufficient information to ensure that they were prepared and knew about the person’s basic needs. People’s care files also contained shared assessments, which showed that the home had been provided with information from the health and social care professionals involved, which also helps ensure that they can meet people’s care needs. The manager told us that she asked if people wished to visit the home before they move in. From talking to people and to a visitor, relatives generally visit the home on their behalf. The home does not provide intermediate care. Sunningdale House, Honiton DS0000070977.V360597.R02.S.doc Version 5.2 Page 11 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): We looked at standards 7,8,9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There has been significant improvements to care plans which benefits people by being clear about their individual health and social needs, which are well meta and regularly reviewed. Medication is generally well managed and people have their dignity respected. EVIDENCE: Since the home has been registered with a new company, the new manager has worked hard to address a previous requirement, which was in place when the home was bought. She has tried to ensure that people’s care plans are up to date, by reflecting people’s care needs and by making them working documents so that staff have clear guidance and can work consistently. We looked at four care plans and saw that there had been significant improvements as well as further areas of development. Care plans are becoming more person centred and detailed but further risk assessments are needed i.e. how to recognise changes in a person’s well-being based on a Sunningdale House, Honiton DS0000070977.V360597.R02.S.doc Version 5.2 Page 12 previous concern or how to monitor people’s skin care due to incontinence or discussions with relatives around specific care needs. We were told that only two care plans were left to be transferred to the new system and that these would be completed as a matter of priority. Care plans are still being developed but staff told us that communication at the home was good with handovers before each new shift, which ensured that changes to people’s care were highlighted. We saw evidence of recent verbal guidance being followed by staff as to how to support a restless individual during mealtimes in order to maintain their independence and monitor their food intake. Two staff members told us in their surveys that they were always given up to date information about the needs of people they cared for. Five visitors told us that the home always met the needs of their relative and one said they usually did. We saw that care plans are being reviewed and updated to reflect changing needs. There is also good information about how concerns have been resolved. The manager recognised the importance of the knowledge of staff who previously worked at the home before it was bought, and plans to involve them in future reviews. We saw from care plans and talking to staff that the home liaises with healthcare professionals and ensures that people can access services i.e. opticians and hospital appointments. The manager also discussed how she plans to ensure that people’s care needs are reviewed i.e. a person with high incontinence needs. She told us that staff discreetly monitor people’s need to go to the toilet, which reflected practice on the day. We saw up to date records for baths, one person told us that staff were keen for everybody to be clean. The manager told us how people’s health is being monitored by being weighed regularly using seated scales and by using a nutritional tool called MUST, and by the use of supplements. Two people have been identified by the home as needing particular attention in this area. The manager also told us that the care staff keep records of the actual amounts of food people have eaten. This means that they are keeping a careful watch on those people who may be experiencing difficulties with their food and may as a result be at risk of weight loss or malnutrition. A visitor told us that their spouse ‘s physical health had significantly improved since their move to the home, which they felt was helped by the meals provided. We also saw how medical concerns are being monitored i.e. suspected seizures. One care plan indicated the person had been discharged from hospital with a high risk of skin problems such as pressure sores. Pressure relieving equipment was in place before the person moved in. We talked to the manager and she told us that they had contacted the district nurses for treatment, correct equipment, and guidance on the safest methods of caring for this person’s skin. Two health care professionals told us that the home Sunningdale House, Honiton DS0000070977.V360597.R02.S.doc Version 5.2 Page 13 always seeks advice and act upon it to manage and improve individual’s health care needs and could generally meet health care needs. One said that ‘they seek my advice and follow it well’ and another said ‘will promptly call for advice’. The home has made significant improvements to the way medicines are stored, administered and recorded since the last inspection. Medicines are now stored in just one cupboard instead of two, a new trolley has been purchased and a controlled drugs cupboard and medicines refrigerator (these had not been fixed in place yet – the workman was due to do this in the next few days.) They were also in the process of providing suitable baskets in order to store additional medicines neatly on the shelves. The home uses a monitored dosage system supplied by a local pharmacist. We looked at the records and found there were good systems in place for recording each stage of the medicines received into the home, administered and returned. The only exception to this was for creams – we were told that creams are stored in people’s wardrobes and they were planning to put administration sheets in the wardrobes with the creams in the next few days so that staff sign each time a cream is administered in a person’s room. Many of the staff have received training on medicines administration, but this training in most cases has been short courses. However, the manager and a senior have recently attended an assessor’s course in medication administration. We talked to the manager about checking the competency of the staff who administer medicines, to ensure that each staff members’ training and knowledge covers the standards laid down by nationally recognised training specialists known as Skills for Care. We found that the company have introduced new policies and procedures but that the staff to spoke to have not yet been made fully aware of the policy on the safe administration of medicines. We were told that they already have plans to address this and it will be done in the next few weeks. We looked at how people’s privacy and dignity is respected in the home. We talked to people living at the home about their views on staff. People said that staff have a ‘grin and a smile’ and were ‘kind, don’t shout’. One person told us that staff knocked before entering their room. A visitor gave us examples of how their wife’s dignity is maintained i.e. the use of a screen in her double room and care taken over the washing and care of her clothes. Other people told us that their clothes are well looked after and said they enjoyed visits from the hairdresser as it made them feel good. We saw that people looked well cared for. The manager has plans for the home to provide a room specifically for hairdressing, which she told us will ensure greater privacy and dignity. She has also started to make changes to shared bedrooms to ensure that people’s belongings are clearly separated. Two health care professionals said that the dignity and privacy was always respected and Sunningdale House, Honiton DS0000070977.V360597.R02.S.doc Version 5.2 Page 14 one commented that staff had done ‘a brilliant job’ caring for someone who was terminally ill. We observed staff listening to people, and responding appropriately to people when they were anxious, which was done in a respectful manner, although occasionally there was an over use of endearments. A visitor told us in their survey that the staff are ‘always caring and ready to listen and do anything they can to help’. We sat in the dining room during the midday meal and saw how those people who needed assistance were helped by observant staff who were also discreet. Some people had special bowls that enabled them to eat without assistance. Some people just needed a little bit of help and this was offered in a quiet and sensitive manner. Sunningdale House, Honiton DS0000070977.V360597.R02.S.doc Version 5.2 Page 15 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): We looked at standards 12,13,14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Social activities and meals are well managed, and provide daily variation and interest for people living at the home. People are encouraged to maintain their independence, exercising choice and control over their lives. EVIDENCE: During the day of our inspection we observed various activities taking place. When we arrived the husband of one of the people living in the home was sitting in the main lounge playing a keyboard and some people were singing along. We were told that this happens regularly. We were also told that the home regularly have special ‘themed’ days when they celebrate the culture and foods from other countries. The home has a number of external entertainers visiting the home, such as Tranquil Moments, singers and the donkey sanctuary. Later in the morning an activities organiser visited the home. She provided a variety of activities including singing, ball games, and a quiz. Most people Sunningdale House, Honiton DS0000070977.V360597.R02.S.doc Version 5.2 Page 16 joined in and clearly enjoyed the session. Just a couple of people chose not to join in and the activities organiser discretely checked with them a couple of times to see if they wanted to join in, but their wishes were respected. The others were clearly enjoying the sessions, and one person showed us the prize she had won and said that some of the games were simple but fun, and helped her to keep her joints moving that might otherwise be stiff. Later in the day, we saw staff encouraging gentle physical exercise. A member of staff told us that care staff now have more time to spend with people and the home’s AQAA states that there will be more investment in activity equipment, some of which we saw. We talked to one person who did not join in and she told us that she was quite happy to sit and watch, but the activities “weren’t her thing”. She told us about the things she likes to do including going out for walks and gardening. She enjoys sitting by the window and looking out over the garden. Another person told us they enjoyed their ‘work’, which includes drying dishes. A third person said they could get bored and would like to fly planes. The manager discussed how they planned to find activities related to this person’s interest. There have been significant improvements to the garden, which have been achieved in a short space of time. We saw from some peoples’ care plans that they enjoyed gardening and people told us they liked being outside. The manager told us that some people had gone to a local garden centre to reflect their interest. People that we spoke to who were visiting the home felt welcomed, as did other visitors they knew. The visitors’ book reflected that there were people regularly coming to the home to visit. Visitors told us in their surveys that the home helped them keep in touch with their relative/friend. They all said that they were kept up to date with important information. We saw evidence of choice being offered. For example, the staff offered alternatives to everyone, including a choice of water, fruit juice or wine before the meal, home made soup, and a choice of main meals and puddings. Staff took the time to show the different puddings on offer to help people make an informed choice, and we also saw people eating cheese and biscuits after their meal, which proved popular with two people who had previously been restless. Staff told us about the different times that people got up and go to bed, and we saw evidence of this on the day of inspection. A health professional told us that someone had chosen to sleep in a chair rather than their bed and that ‘staff had coped well with this and did not make an issue regarding this’. We talked to the cook about the meals provided at the home. Two cooks are employed at the home – one works four days a week and the other works three days a week. There is a four weekly menu cycle. Each mealtime there are always at least two alternatives plus special meals for those people who have specific dietary needs. The cook said she is told about the dietary needs, Sunningdale House, Honiton DS0000070977.V360597.R02.S.doc Version 5.2 Page 17 likes and dislikes of people before they move in. She goes and meets them on the first day to get to know them and find out more about their likes and dislikes. Peoples like and dislikes are also noted on their care plans. The menus are regularly adjusted to suit people’s tastes. The menus are discussed with people in residents’ meetings and any ideas/suggestions are incorporated into the menus. The menus were about to be adjusted for the summer months. People told us they were happy with the food and a visitor told us that the home had ‘very good food’. At the time of this inspection special diets catered for included diabetics and also pureed foods where necessary to prevent choking. The home had sought specialist advice on this in the past and the manager told us she was going to seek advice once again to check on specific foods such as chocolate. The cook has not had any training on nutrition or special dietary needs. She has, however, received training on health and safety and food hygiene. The dining room was attractively decorated and tables were laid with tablecloths making mealtimes a special occasion. People appeared to be enjoying their meals, and those we talked to said the meals are always good. During the afternoon staff went around offering people a selection of sliced fresh fruits and this was clearly very popular with people. At tea time home made cake was offered. We also saw a selection of fruit juices offered during the day as well as hot drinks. Sunningdale House, Honiton DS0000070977.V360597.R02.S.doc Version 5.2 Page 18 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): We looked at standards 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People feel that they are listened to and staff understand their role in ensuring that people living at the home are safe. EVIDENCE: CSCI have not received any complaints since the new owners bought the home and this was confirmed by the home’s AQAA. . People told that us staff listened to them and we saw evidence of this happening. One person told us in their survey that ‘if I had a problem I feel I can easily talk about it to the senior staff’. Generally visitors said they knew how to make a complaint if they needed to and all said that the home had responded appropriately to any concerns. A visitor to the home told us that they had received a copy of the home’s complaint procedure. The manager told us that she is encouraging better documentations of ‘grumbles’ so that there is documentation of how concerns are resolved. Staff explained what they would do if a person or a visitor had concerns about the home. We spoke to a staff who was clear about their responsibilities to report poor practice, and knew about internal and external contacts to report safeguarding issues to. Staff files showed that POVA training provided to staff. One member of staff were clear about their duty to report changes of behaviour that might Sunningdale House, Honiton DS0000070977.V360597.R02.S.doc Version 5.2 Page 19 indicate that a person living at the home needed more attention to maintain the well-being of others living there. Sunningdale House, Honiton DS0000070977.V360597.R02.S.doc Version 5.2 Page 20 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): We looked at standard 19,21 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The standard of the environment is good providing people with an attractive and clean place to live, although the home would benefit from an adapted bath on both floors. EVIDENCE: There has been considerable investment by the new company that owns Sunningdale House. We toured the building with the manager and could see the changes outlined in the home’s AQAA. For example, improvements include a larger car park, new windows, internal décor in communal areas and bedrooms, better lighting, replacing armchairs and buying new bedroom furniture. There have been significant improvements to the garden, which have been achieved in a short space of time and have positively impacted on the lives of Sunningdale House, Honiton DS0000070977.V360597.R02.S.doc Version 5.2 Page 21 the people living at the home. It is an attractive space, complete with a water feature and new plants, with a seated area under a large tree. The manager told us how they would like to provide raised flowerbeds to encourage people to plant their own flowers or vegetables if they want, and that they plan to have gardening sessions. During our tour of the garden, we spoke about potential risks to people living at the home such as gardening equipment and the manager advised us how these would be addressed. We also talked about how creating a circular path leading to different seating areas in the garden would help enable people to walk in the garden more independently and have a choice where they sit. The home’s AQAA mentions completing a sensory garden. A large decked area has already been created with new garden seats just outside the main lounge windows, and people told us how much they enjoyed being able to sit outside. The home has a number of baths as part of en-suite facilities but they are not assisted baths i.e. with equipment to help people with mobility difficulties. There is only one communal bath on the ground floor, which is adapted so that people with a physical disability can use it. The manager plans to redecorate this room to make it more homely. However, an assisted bath on the first floor has been removed and is to be replaced by a staff room. This limits people’s choice i.e. if they choose not to come downstairs or are unable to use the stair lift due to ill health. There has been investment in the laundry room with a new washing machine and tumble dryer. Staff were able to tell about the infection control procedure for soiled laundry and were clear about their use of protective clothing. The home was generally odour free and clean, which people living and visiting the home confirmed to be the norm. One room we visited did have an odour and the manager told us that she planned to replace the carpeting around a toilet with more appropriate flooring. The sluice room has been removed to make a single communal toilet upstairs. Staff told us that the sluice was rarely used and that alternative arrangements work well. Sunningdale House, Honiton DS0000070977.V360597.R02.S.doc Version 5.2 Page 22 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): We looked at standards 27,28,29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff are employed in sufficient number and recruited in a manner to help protect the people living at the home. Staff development is encouraged, and the new owners are currently in the process of promoting further training. EVIDENCE: Staff told us in their surveys that there were usually enough staff. On the day of the inspection, one staff member had phoned in sick but a colleague had come in on their day off to cover. There were three care staff on duty, a cook, a handyperson and a cleaner, plus the manager. Staff were busy but the atmosphere was calm and friendly. The home has two waking night staff on duty. One person said they had more time to spend with people since the home had bought but another member of staff felt they would like more time to spend with people living at the home. Three visitors told us in their surveys that staff always had the right skills and experience, although one commented this was once training was complete, and three other visitors told us that staff usually had the right skills and experience. One commented that a staff member only listened to a person’s choice because of they were aware of the visitor’s presence. Other visitors commented that staff are ‘very kind and caring’ and that staff take of their relative’s needs ‘very well and understand her’. Sunningdale House, Honiton DS0000070977.V360597.R02.S.doc Version 5.2 Page 23 The manager told us that in future she would be overseeing the recruitment of staff, including the paperwork. We looked at three staff files and saw that they could be audited, although one needed some minor improvements, which the manager told us they have now done i.e. details about a break in employment. The manager told us that they were promoting NVQ training as detailed in the home’s AQAA but currently it is below the expected 50 due to staff changes and the recruitment of new staff who are currently studying for this qualification. Staff training files are clearer to audit and showed us that a number of staff have received introductory training sessions on a variety of subjects via training videos and a questionnaire. The manager plans to supplement this type of training with face-to-face training sessions. Staff told us in their surveys that their induction had mostly covered everything they needed to know and felt they usually had the right support and experience and knowledge of the different needs of people. Staff told us in conversation and in their surveys that they felt training kept them up to date with new ways of working and was relevant to their role. In a survey, one person said they would like more training. Some newly recruited staff do not come from a care background, although some are already studying for care qualifications. It is important that they also receive training in understanding the needs of people with dementia, as well as receiving mandatory training. A health professional told us that staff would benefit from further training in dementia particularly for people with complex needs. Another told us that the service could be improved by ‘a general update/education for all carers’. Sunningdale House, Honiton DS0000070977.V360597.R02.S.doc Version 5.2 Page 24 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): We looked at standards 31,33,35 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well run with new quality assurance systems in place and regular safety checks. EVIDENCE: The new manager has a great deal of experience in running homes and has already used this knowledge to make noticeable positive changes to the home to benefit the people living there. She is clear about her position to act as a positive role model for staff. Staff told us that they felt well supported, had regular contact with the manager and felt able to express their views. A staff member told us ‘since change over in November everything is going well. Standards of care have risen, décor is a lot better, communication is better’. Another staff member said ‘the service we give now is a lot better than it use Sunningdale House, Honiton DS0000070977.V360597.R02.S.doc Version 5.2 Page 25 to be. I feel a lot happier in my job now than what I did before’ and ‘the new management are very good’. A health professional commented that it is a ‘lovely home, lovely atmosphere. Will go from strength to strength with this new leadership’. Since the new owners acquired the home they have introduced a variety of quality assurance methods. We were shown comprehensive questionnaires that are about to be given out to people living in the home and their relatives or advocates. We were told that the results from these questionnaires will be collated and the results will be discussed at the next Relative’s Meeting. The home holds Resident’s Meetings and these are a useful way of seeking people’s views on the services provided, the environment, and the way the home is managed and staffed. The meetings are minuted. Two meetings have already been held since the new owners took over the home. Staff meetings are held regularly and these are also an important part of the quality assurance systems. Since taking over the home the new management have met with all staff at least once. Separate meetings have taken place for the night and day staff, cook and senior care workers and they have also had one full staff meeting. Staff told us that the manager was approachable and they felt well supported. The senior management team meet every month to discuss all aspects of the management of the home. Copies of the monthly meetings are forwarded to the Commission and these have given us a good insight into how all aspects of the home are running. We saw that close checks have been made to ensure all services are satisfactory. We also saw where improvements have been made as a result of their quality assurance systems. We looked at the way the home holds cash on behalf of those people who are not able to (or don’t want to) hold cash for day-to-day items such as toiletries or hairdressing. The manager told us they have taken over a system from the previous owners that she was not happy with. Cash is held in separate wallets and they keep a running record of the amounts spent on behalf of each person. Receipts are retained where possible. We checked four records and the balances held and found that in two cases the balances were slightly wrong (just a few pence out in each case). Iris told us that she hadn’t checked the balances since taking over, but she explained that they intend to move to a system where they don’t hold any cash at all. In other homes owned by the company the home pays for items such as toiletries, hairdressing and chiropody and a bill is given to the person each month. The manager also said that some people are able to hold cash in their rooms if they want, and they can use this for small purchases such as sweets, birthday cards, and they can therefore take cash with them if they go out. Sunningdale House, Honiton DS0000070977.V360597.R02.S.doc Version 5.2 Page 26 The home’s AQAA states that the maintenance of equipment is up to date and we saw from our tour of the building that radiators are covered to help protect people from burns and windows restricted to protect people from falling out of windows, which we spot-checked. Sunningdale House, Honiton DS0000070977.V360597.R02.S.doc Version 5.2 Page 27 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 3 x 3 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 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 2 x 2 x x x x 3 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 2 x x 3 Sunningdale House, Honiton DS0000070977.V360597.R02.S.doc Version 5.2 Page 28 Are there any outstanding requirements from the last inspection? NO. 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 OP21 Regulation 23 (2) (j) Requirement The number of assisted baths in the home must be reviewed with people living at the home and their relatives to ensure that everyone living at the home has access to an assisted bath, and their preference recorded regarding personal care i.e. bath/shower, how often and time of day. Information must be provided to show how people’s bathing needs will be met if they are unable to access the ground floor bathroom. CSCI must be sent written information about the how the review was carried out and the outcome. Timescale for action 31/08/08 Sunningdale House, Honiton DS0000070977.V360597.R02.S.doc Version 5.2 Page 29 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP7 Good Practice Recommendations Risk assessments should be in place where concerns have been identified i.e. how to recognise changes in a person’s well-being based on a previous safeguarding concern or how to monitor people’s skin care due to incontinence needs or discussions with relatives around specific care needs of their spouse. All staff administering medication should be assessed to ensure they meet Skills for Care competency standards. The home’s cooks should receive training in specialist dietary needs i.e. diabetes and the nutrition needs of older people with dementia. Steps should be taken to make the garden a safer place i.e. an additional side gate and the safe storage of equipment. 50 of care staff should have an NVQ 2 in care. Cash balances to be checked regularly where the home holds money on behalf of people who live in the home. The record sheet should be signed by the person concerned (if possible) to agree the transaction and the balances held. The record sheet should also be signed by the member of staff responsible for handling the cash on each transaction. 2. 3. 4. 5. 6. OP9 OP15 OP19 OP28 OP35 Sunningdale House, Honiton DS0000070977.V360597.R02.S.doc Version 5.2 Page 30 Commission for Social Care Inspection South West Colston 33 33 Colston Avenue Bristol BS1 4UA 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 Sunningdale House, Honiton DS0000070977.V360597.R02.S.doc Version 5.2 Page 31 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!

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Sunningdale House, Honiton 01/05/08

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