Care Home: Sunningdale Lodge

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What the care home does well On arrival at the home there was a warm, busy atmosphere as staff prepared for the beginning of the Christmas festivities. The home was filled with items to be raffled and Christmas decorations were going up. There is a well-advertised Christmas Activities programme that includes visitors to the home, trips to see the Christmas lights and parties. There are to be weekly visits to a local garden centre to see decorations and enjoy coffee and mince pies. There was lots of evidence that people are well looked after at Sunningdale Lodge. Staff were seen and heard interacting with people during the inspection. They were very kind and assisted in a professional and friendly manner. In particular one person who the manager considered to be "needing reassessment soon" was guided and supported with gentleness and care. In cards sent to the home there were comments from relatives praising the care people had received. "The level of care, attention and thoughtfulness was first class" Care plans are of a good standard overall and it was reassuring to see that documented interventions in the care plans were occurring. For example arrangements made to enable a person to eat lunch in the manner she felt comfortable with. People are able to spend their days as they wish. While a high proportion of people came to the main sitting area and participated in a range of activities others were happy to spend time in their rooms. One person enjoyed knitting and crotchet. A person who had very recently come to the home said, "I am still settling in but it seems nice." She had been pleased with the welcome her visitors received and the attention received when she was ill one night. There was evidence that staff at Sunningdale work as a team, feel well trained and supported. A relative wrote, "They are a dedicated team who give so much to residents..." A member of staff said "This is a lovely home...I am very happy here." Staff said that if someone is sick other staff would try and help. "We try and make sure the home is covered." There are 26 staff at the home. 15 of these have a National Vocational Qualification and a further 7 are registered and working towards NVQs. There are opportunities for staff with Level 2 to gain Level 3 and to progress to other training. The Somerset Care central office reviews policies and procedures regularly. What has improved since the last inspection? Requirements made at the last inspection have been met. What the care home could do better: There are plans to develop the outside area now that a new conservatory has been completed. This will be a great improvement. The addition of shrubs and raised beds will provide interest and the opportunity for outdoor activities for those who want it. Documents in peoples individual care files provide evidence that people are receiving appropriate care. It is good practice however to use a care plan sheet to record all the action being taken to meet a need in one place. This is useful if a person becomes acutely ill for a short period or if their needs change suddenly. CARE HOMES FOR OLDER PEOPLE Sunningdale Lodge Sunningdale Road Yeovil Somerset BA21 5LD Lead Inspector Shelagh Laver Unannounced Inspection 30th November 2007 09:30 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 Lodge DS0000016089.V353375.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. Sunningdale Lodge DS0000016089.V353375.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Sunningdale Lodge Address Sunningdale Road Yeovil Somerset BA21 5LD 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) 01935 422980 01935 706334 Somerset Care Limited Mrs Patricia Anne Ellesmere Care Home 38 Category(ies) of Dementia - over 65 years of age (19), Old age, registration, with number not falling within any other category (38) of places Sunningdale Lodge DS0000016089.V353375.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. Up to a maximum of 38 persons in category OP. Up to a maximum of 19 persons in category DE(E), all of whom will reside on the middle floor of the home. The category of DE(E) will be reviewed when alternative accommodation in Yeovil provided by Somerset Care Ltd is registered for this category. The named servise user under 65 years may be admitted for regular periods of respite care as agreed between the home and the Care Manager One named service user, as per request 16/5/06, in the category of MD, under 65 years may be admitted. 21/02/07 Date of last inspection Brief Description of the Service: Sunningdale Lodge provides personal care services for up to 38 older people. The home is part of Somerset Care Ltd. The home is located in a residential area of Yeovil, close to local shops, Post Office, GP practice and Church. The town centre is within walking distance but only for those who are physically fit and can manage traffic safely. All bedrooms in the home are single and have washing facilities. Service users accommodation is on three floors, made accessible by a passenger lift. Each of the floors has a number of small sitting areas. Those accommodated on the top and ground floors have use of the ground floor dining room and lounges, the top floor has quiet seating areas. Access to all floors is through a keypad system. There is a new conservatory giving access to a large patio with seating areas and summerhouse. Sunningdale Lodge DS0000016089.V353375.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of this inspection visit was to inspect relevant key standards under the Commission’s ‘Inspecting for Better Lives 2’ framework. This focuses on outcomes for service users and measures the quality of the service under four general headings. These are: - excellent, good, adequate and poor. At the time of this inspection there were 24 people living at Sunningdale Lodge. There has been some planned changes to the home in the previous months as people from the Specialised Residential Unit for people with dementia have moved to the purpose built unit at Groveland’s. The home will now provide accommodation for people needing residential care. The second floor of the home has been painted and refurbished. The registration certificate is being amended and the statement of purpose had been up-dated. Prior to the visit the manager completed a comprehensive and informative Annual Quality Assurance Assessment (AQAA) detailing work undertaken in the past year. This inspection took place over one day. Prior to the inspection comment cards were sent to people who lived in the home and their relatives. Comment cards were also sent to staff, GPs and health and social care professionals All comments indicated that people were very satisfied with the quality of the service they receive. Comments from staff indicated that they were pleased with the training received at the home and received regular supervision. They felt that they were kept informed of changes to peoples’ condition. Staff stated that the service met the needs of people living in the home. Care practice and interaction between staff and people living the home were observed. The inspector had lunch with people in the home and observed the serving of food and the administration of medication. The inspector toured the building, spoke with staff on duty and spoke with people living in the home. The inspector sampled of the service user documentation along with records relating to staff and other records required by regulation. What the service does well: Sunningdale Lodge DS0000016089.V353375.R01.S.doc Version 5.2 Page 6 On arrival at the home there was a warm, busy atmosphere as staff prepared for the beginning of the Christmas festivities. The home was filled with items to be raffled and Christmas decorations were going up. There is a well-advertised Christmas Activities programme that includes visitors to the home, trips to see the Christmas lights and parties. There are to be weekly visits to a local garden centre to see decorations and enjoy coffee and mince pies. There was lots of evidence that people are well looked after at Sunningdale Lodge. Staff were seen and heard interacting with people during the inspection. They were very kind and assisted in a professional and friendly manner. In particular one person who the manager considered to be “needing reassessment soon” was guided and supported with gentleness and care. In cards sent to the home there were comments from relatives praising the care people had received. “The level of care, attention and thoughtfulness was first class” Care plans are of a good standard overall and it was reassuring to see that documented interventions in the care plans were occurring. For example arrangements made to enable a person to eat lunch in the manner she felt comfortable with. People are able to spend their days as they wish. While a high proportion of people came to the main sitting area and participated in a range of activities others were happy to spend time in their rooms. One person enjoyed knitting and crotchet. A person who had very recently come to the home said, “I am still settling in but it seems nice.” She had been pleased with the welcome her visitors received and the attention received when she was ill one night. There was evidence that staff at Sunningdale work as a team, feel well trained and supported. A relative wrote, “They are a dedicated team who give so much to residents…” A member of staff said “This is a lovely home…I am very happy here.” Staff said that if someone is sick other staff would try and help. “We try and make sure the home is covered.” There are 26 staff at the home. 15 of these have a National Vocational Qualification and a further 7 are registered and working towards NVQs. There are opportunities for staff with Level 2 to gain Level 3 and to progress to other training. The Somerset Care central office reviews policies and procedures regularly. What has improved since the last inspection? Requirements made at the last inspection have been met. Sunningdale Lodge DS0000016089.V353375.R01.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 Lodge DS0000016089.V353375.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 Sunningdale Lodge DS0000016089.V353375.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 4 2Quality in this outcome area is good. The home has thorough pre-admission procedures that provide information and opportunities to assist the service user when making a decision about moving in. Care assessments are clear, concise and generally reflect the needs of the individual. People are protected by a contract that specifies terms and conditions of occupancy and includes the complaints procedure. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There have been changes made to the Statement of Purpose since the last inspection to reflect the changes within the home. People who returned comment cards confirmed that they had been received sufficient information about the home before they moved in. Sunningdale Lodge DS0000016089.V353375.R01.S.doc Version 5.2 Page 10 All service users have a contract that includes a statement of terms and conditions of occupancy. There is a structured assessment process. Peoples’ files contained evidence of assessments by health and social care professionals and a sufficient range of information to enable a robust care plan to be developed. Sunningdale Lodge DS0000016089.V353375.R01.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): 7 8 9 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The care planning and review of existing plans demonstrate how needs are being met. Good links with health professionals have been maintained to enable service users’ health needs to be met. The home has a good medication management system ensuring the safety of service users. People are treated with kindness and respect. EVIDENCE: There was evidence that some people’s health improved at the home. One relative wrote that the improvement had been “remarkable.” Four care plans were examined in detail. These include details of individuals’ needs, daily routines and preferences. Care plans were thorough and included detailed directions to staff of the level and type of assistance to be provided to each Sunningdale Lodge DS0000016089.V353375.R01.S.doc Version 5.2 Page 12 person. A moving and handling assessment had been completed for each service user. Pressure area and falls risk assessments had been completed. Pressure-relieving equipment is provided as required care plans had been regularly reviewed and updated as required. Feedback from visiting professionals given via questionnaires informed the inspector of the good professional relationships They further confirm that people attend appointments and have their health care needs met through partnership working. Care plans are regularly reviewed with the involvement of people in the home. A holistic “person-centred” model had been adopted that provided detailed account of care needs. Staff are friendly and respectful to people in the home. The storage and administration of medication is safe. The Medicine Administration Records were appropriately completed and signed. There are clear rationales for the administration of medication via the per required needs route. Whilst overall care plans give a good account of the care provided it is recommended that the individual care need sheet is used frequently to record the ways in which short term or changed care needs are recorded. For example in one plan a person was seen to be losing weight. There had been several steps taken to try and address this situation but much was recorded in the daily records. Sunningdale Lodge DS0000016089.V353375.R01.S.doc Version 5.2 Page 13 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 13 14 15 Quality in this outcome area is good. People appear to be happy with the way of life at this home. Visitors are welcomed and service users are assisted with maintaining contact with relatives and friends. There are a range of social activities available in the home. The food is home cooked and appears to offer a balanced diet. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People are able to make choices about how they spend their day. People have a key to their bedroom and can keep it locked if they wish. There is access to a range of communal facilities. People get up at different times in the day and were heard being offered tea at different times in the morning. There is a range of activities available. The co-ordinator discusses with the people in the main sitting room what they would like to do on a daily basis. On the day of the inspection several small group and individual activities were taking place. People played games or did drawing. People are encouraged to take part but others were happy to sit and watch. There was someone in the main sitting room all morning talking with people and providing assistance Sunningdale Lodge DS0000016089.V353375.R01.S.doc Version 5.2 Page 14 when needed. In a smaller sitting room the television was on and people were watching or having a doze. Some events are more organised. Groups visit to provide music and a “Hawaiian” event had been popular. There is a regular program of bingo and trips out advertised on the home notice boards. There is a regular exercise group. There are activities co-ordinators on duty both morning and afternoon. Christmas is hoped to be “as much fun as possible….a bit like home.” People spoken with were happy with their life in the home. Visitors were observed entering or leaving the home. All visitors were warmly welcomed. The menu of the day was displayed. There was a choice of main meals but people also said that individual choices were accommodated. Sweets are served on a trolley and there is a good choice. There is a large bowl of fresh fruit available. It is worth remembering that whole pieces of fruit can seem daunting to some people whereas prepared fruit or a small fruit salad might encourage people to eat fruit regularly. Meals are served at nicely laid tables with people able to serve their own vegetables if they wish. People are pleased with the meals provided. It was good to see that macaroni pudding was requested at a residents meeting and did appear as a choice on the menu. Sunningdale Lodge DS0000016089.V353375.R01.S.doc Version 5.2 Page 15 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): 16 18 Quality in this outcome area is good. There is a robust complaints procedure. Complaints are taken seriously by the home. Policies and practices protect people in the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Somerset Care complaints procedure is in place and clearly displayed. People in the home said that they felt able to complain and said they would have no concerns complaining to any staff member should they have need to. They felt that the manager and staff are very approachable. The home keeps a record of any complaints made. There was one concern that had been fully investigated by the home. It was clear that evidence had been collected and evaluated. The relative had been satisfied with the outcome. No complaints have been made to CSCI. All staff who returned comment cards said that knew what to do if anyone had concerns about the home. The POVA training records were available. Recruitment procedures are robust. The manager confirmed that a POVA check is performed at the time of requesting CRB check prior to starting work. Sunningdale Lodge DS0000016089.V353375.R01.S.doc Version 5.2 Page 16 Sunningdale Lodge DS0000016089.V353375.R01.S.doc Version 5.2 Page 17 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 20 21 22 23 25 26 Quality in this outcome area is good. People live in a pleasant warm environment that has been adapted to meet their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The environment at Sunningdale Lodge is clean and homely. Communal rooms are well equipped and welcoming. Bedrooms are comfortable and personalised. There are several small spaces where people can sit quietly. A new conservatory has been built that opens onto a paved area. There are plans to develop this outside space that will be a welcome improvement. Bathrooms were clean, warm and well equipped. Staff were observed wearing gloves and using antiseptic gel to reduce the risk of infection. Visitors to the home are asked to use gel on entering and leaving the home. Sunningdale Lodge DS0000016089.V353375.R01.S.doc Version 5.2 Page 18 Sunningdale Lodge DS0000016089.V353375.R01.S.doc Version 5.2 Page 19 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 28 29 30 Quality in this outcome area is good. The numbers and skill mix of staff meets people’s needs. Staff have a good range of training opportunities. This judgement has been made using available evidence including a visit to this service. EVIDENCE: On the day of the inspection there was a good number of staff on duty. There is an organised staff structure including a deputy manager and supervisors. All staff met during the inspection were knowledgeable about the people in the home. Staff who returned comment cards stated that there had been CRB checks and references obtained prior to commencement of employment. Four staff files were reviewed and found to comply with good practice. Files are organised and information is easily accessible. New staff had been given a thorough induction and all checks had been completed. Long-term staff had received regular supervision, appraisal and training. There are varied training opportunities in the home. One member of staff had been promoted within the home and was undertaking NVQ3 in management. One member of staff spoken to had been on Dementia Mapping training and felt well supported by senior staff. Sunningdale Lodge DS0000016089.V353375.R01.S.doc Version 5.2 Page 20 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 Quality in this outcome area is good. People live in a home that is well run. The health and safety of people in the home is promoted through planned maintenance. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager leads a team of staff that have clear job roles. All senior staff met on the day of the inspection were enthusiastic and demonstrated a commitment to the service they were providing to people. There was evidence that regular meetings are held for carers and people living in the home. Residents meetings are held quarterly and minutes are recorded. Sunningdale Lodge DS0000016089.V353375.R01.S.doc Version 5.2 Page 21 People are asked for suggestions for activities and menu changes. There is a Quality Assurance system in addition to on-going consultation with people in the home. There is key worker system. A relative wrote “Mum’s key worker formed a lovely bond with her.” A review of records showed regular maintenance of hoists and fire equipment. Maintenance records were organised and clear showing compliance with requirements. Sunningdale Lodge DS0000016089.V353375.R01.S.doc Version 5.2 Page 22 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 3 3 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 3 X 3 3 STAFFING Standard No Score 27 3 28 3 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 3 3 X X 3 Sunningdale Lodge DS0000016089.V353375.R01.S.doc Version 5.2 Page 23 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 OP38 Regulation 13(4) Requirement There must be a risk assessment for the small bed rail as discussed during the inspection. Timescale for action 16/12/07 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. 1. Refer to Standard OP7 OP19 Good Practice Recommendations The appropriate care plan sheet should be used to show how peoples current health needs are being met. The plans to improve the outside environment should be fully implemented. Sunningdale Lodge DS0000016089.V353375.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Taunton Local Office Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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 Lodge DS0000016089.V353375.R01.S.doc Version 5.2 Page 25 - 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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