Care Home: Sunnydene

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What the care home does well The home presented as clean, tidy and homely. Peoples own rooms reflected their personality. The people living in the home are encouraged to be involved with the recruitment of new staff, updating of the Statement of Purpose (brochure) and any changes in routine or new ideas that are introduced into the house. Record and documentation seen was well constructed and organised and kept securely, with staff and Service Users having access to information they need to have at all times. What has improved since the last inspection? The medication system has been improved and staff who administer medications have had suitable training. All staff files seen included all of the information required including 2 written references. MENCAP have introduced a new induction system. The 2 new staff members who have recently started will be the first to benefit from it at Sunnydene. What the care home could do better: There were no requirements made following this inspection. It was recommended following the last inspection that training about Asperger`s Syndrome should be available to staff. This has yet to be achieved. The fitting of a small wash hand basin should be considered outside the back of the house by the laundry and where people come in from the garden and may have dirty hands. This would minimise the risk of cross infection. CARE HOME ADULTS 18-65 Sunnydene 5 Mill Hill Lostwithiel Cornwall PL22 0HB Lead Inspector Mandy Norton Unannounced Inspection 11 September 2008 14:15 th Sunnydene DS0000009227.V366748.R02.S.doc Version 5.2 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 Sunnydene DS0000009227.V366748.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 Adults 18-65. 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. Sunnydene DS0000009227.V366748.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Sunnydene Address 5 Mill Hill Lostwithiel Cornwall PL22 0HB 01208 872602 01208 872602 jane.ackerley@mencap.org.uk www.mencap.org.uk Royal Mencap Society 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 Jane Margaret Ackerley Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Sunnydene DS0000009227.V366748.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Service users to include up to 8 adults with a learning disability (LD) Total number of service users not to exceed a maximum of 8 Date of last inspection 20th September 2006 Brief Description of the Service: Mencap provides care for up to 8 adults with learning disabilities at Sunnydene. The home is situated in the town of Lostwithiel which is between St Austell and Liskeard. The home is within walking distance of the town centre. The registered manager is Mrs Jane Ackerley who has worked at the home for 9 years the last three of which she has been the manager. The home is a large detached property with pleasant grounds. Currently all residents have their own bedrooms, although one bedroom is registered for two people. The home has a large lounge, dining room, kitchen and bathroom and toilet facilities. An example of a current fee is £503.86 per week. Each fee level is different depending on other services, such as day centre visits, that the local authority pays for and are included in the fees. There are additional charges e.g. for hairdressing, newspapers etc. All residents have up to date contracts and tenancy agreements. These are explained to each person in a way they can understand and are kept on their personal file for reference. Sunnydene DS0000009227.V366748.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. The short notice inspection was carried out between 2.15 pm and 5.30 pm on 11th September 2008. It was conducted with the manager. The report includes information taken from the completed Annual Quality Assurance Assessment (a self assessment document completed and sent to The Commission prior to the inspection). A tour of the home was carried out and a number of people who live at the home and care staff were spoken to, some of their comments are reflected in the report. There were 7 people living at the home on the day of the inspection. What the service does well: What has improved since the last inspection? What they could do better: Sunnydene DS0000009227.V366748.R02.S.doc Version 5.2 Page 6 There were no requirements made following this inspection. It was recommended following the last inspection that training about Asperger’s Syndrome should be available to staff. This has yet to be achieved. The fitting of a small wash hand basin should be considered outside the back of the house by the laundry and where people come in from the garden and may have dirty hands. This would minimise the risk of cross infection. 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. Sunnydene DS0000009227.V366748.R02.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Sunnydene DS0000009227.V366748.R02.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 & 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use this service have information about the home in order to make an informed decision about whether the service is right for them. EVIDENCE: There is a clear pre admission assessment procedure in place that is completed prior to admitting anybody. This ensures that the home can meet the persons needs and that the person will ‘fit in’ with the current residents. The manager showed the inspector the new Statement of Purpose that they have been working on with the residents. It contains practical information about the people who work at Sunnydene, what the service can offer and pictorial representation of activities that the residents are involved with in and outside the home. This will be available to people on an individual basis. There is visual information displayed in the home about the staff so residents can recognise who is on duty at any particular time. Contracts with MENCAP, terms and conditions of residency and tenancy agreements were seen in the care plans examined. Sunnydene DS0000009227.V366748.R02.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8 & 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The practice regarding the planning and delivery of care means that service users can be sure that their health and personal care needs will be met. EVIDENCE: The 2 care plans examined had a lot of information about the individual and their abilities and lifestyle choices. They had been regularly evaluated and were generally up to date. The plans showed when other health care professionals are involved with care and support such as GP’s, district nurses, opticians and any restrictions on choice or freedom. The people spoken to were clearly able to express themselves and are actively involved in decisions about how they spend their time. Each person has access to their own money and the manager said that those able to manage their finances independently are encouraged to do so, with support from staff as required. She demonstrated the system in place to manage people’s money: this includes recording income and expenditure (in Sunnydene DS0000009227.V366748.R02.S.doc Version 5.2 Page 10 ink) and keeping receipts as evidence. The records seen were clear and had 2 signatures (including the residents where possible) against all transactions. Residents are charged 10p per mile when using the minibus which is documented and any top ups required to the fee charged are clearly detailed in the fee breakdown records. The manager described how people are involved in the day to day running of the home this includes deciding on what meals to have and the housework rota. They are also consulted/involved when any changes are being bought in, and with the interviewing and selection of staff. Residents spoken to confirmed that they are involved with changes that may affect them and that support is given by the staff when it is needed. The home has policies and procedures about confidentiality and records seen were accurate and kept safely. Sunnydene DS0000009227.V366748.R02.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A number of activities within the home and community means that people have opportunities to participate in stimulating and motivating activities. Meals and mealtimes are not rushed making them an enjoyable experience for people, whether they are eating as a group or individually. EVIDENCE: Residents spoken to (and observed) were able to say/ demonstrate how they spend their time in the house, what they do outside the home and what they like to do as individuals. Some of the residents have paid employment and they all have local links and are included in the local community when they are out and about independently. On the day of the inspection all of the residents were out engaged in day centre activities or at work. They got home at different times Sunnydene DS0000009227.V366748.R02.S.doc Version 5.2 Page 12 and began preparing for their tea and /or activities they were going to take part in during the evening. The communal lounge had a TV and the 2 residents rooms seen had TV’s, CD players and personal collections of music. The manager said the staff discuss with the residents about what they like to do and arrangements are made to go to the local college or day centres for example to access opportunities to learn and develop new skills. Visitors are welcomed at all times. The manager said that the residents often go on separate holidays and day trips as they all have different interests and was able to give examples (and show some photographs) of some of the places they had been recently. The weekly shopping was being delivered during the inspection and later on residents were seen deciding what they were having for their meal, and most of them were preparing their own meal (some with support). All of the residents have their own cupboard in the kitchen where they can keep food items that they have bought and like that are not for general consumption. Residents spoken to said that they do not go into each others rooms unless they are asked to. During the inspection people were heard interacting appropriately with each other and the staff. The resident s have access to all parts of the home and gardens. People help with the household chores and there is a rota in place which fits in with peoples outside activities. People spoken to knew what their responsibilities were and when it was their turn for jobs. Sunnydene DS0000009227.V366748.R02.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The providers commitment to the delivery of care means that service users can be sure that their health and personal care needs will be always be met. EVIDENCE: The residents spoken to said that they can go to bed when they want to, but realise they have to get up at a certain time in order to attend work, education or day centre activity. A number of them go out when they want as long as they tell somebody where they are going. Care plans seen included individual records that detailed peoples preferred routines and likes and dislikes. The manager said that minimal personal support is needed and the residents are encouraged to be as independent as possible. She said that people visit the GP, practice nurse, optician and dentist as required. One person spoken to said that the care staff help her to keep her regular appointments at the surgery to see the practice nurse. Sunnydene DS0000009227.V366748.R02.S.doc Version 5.2 Page 14 The care worker on duty was seen administering medication during the inspection. Correct procedures for administering medication were being observed. A record is maintained of the current medication for each person. The manager said that they have to make sure that people take any medicines they need out with them if they have to be taken during the day. All of the staff who administer medications have done training provided by Boots in medication administration (certificates seen in staff files examined). The new MENCAP induction programme includes a distance learning module on medicines management. The home uses a blister pack system and an inspection carried out by the local pharmacist in May 2008 found the systems in place to be satisfactory with only one recommendation made. This was for a thermometer to be used in the office (where the medicines are kept) to ensure that the temperature is always within acceptable limits for storage of medications. This is in place and is regularly monitored. The manager said that MENCAP have introduced a system for managers to ensure they assess the care staff administering medications on a 3 monthly basis. Sunnydene DS0000009227.V366748.R02.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Formal complaints and reporting of abuse policies and procedures are in place. They are available to anybody working with the Service Users and people visiting the home at all times. People feel their concerns are listened to and acted upon making them feel supported and safe. EVIDENCE: There is a formal complaints procedure in place which is also in the Statement of Purpose and displayed in the home. Care plans seen had information in a format suitable to the person concerned about how to make a complaint or discuss a concern if necessary. The Commission have received no concerns or complaints about this service. During discussion with the manager it was clear that there is an aware ness of adult protection/safeguarding procedures and people would know who to contact if necessary. MENCAP have policies and procedures around complaints and protection and offer safeguarding training during induction and as part of their ongoing training programme. The policies and procedures are available to staff at all times. The residents visit day centres and have contact with outside agencies to whom they are able to talk if they have any concerns that cannot be shared with staff at the home. Sunnydene DS0000009227.V366748.R02.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 28 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People have a homely, comfortable and safe environment in which to live. EVIDENCE: Sunnydene is owned and managed by MENCAP (www.mencap.org.uk). It is near to the centre of Lostwithiel and local facilities. The home has transport to use if people want to go further a field or to go shopping. On the day of the inspection the home was clean, tidy and homely. The 2 individual rooms seen were decorated appropriately, had personal possessions and ornamentation chosen by the residents themselves. There is one communal bathroom and toilet on the first floor and a toilet on the ground floor. There is a communal lounge on the ground floor that is used by all the residents and meals are taken in the spacious dining room. No specific adaptations are required for the current residents. Electrical appliances seen had up to date PAT stickers on them. Washing is done in a domestic machine in the laundry area and the cleaning and other household chores are done by the staff and the residents. The area at the back Sunnydene DS0000009227.V366748.R02.S.doc Version 5.2 Page 17 of the house where the laundry is and where people would enter the house having been working in the garden would benefit from a hand - wash basin to enable people to clean their hands to minimise the risk of spreading infection. Ongoing repairs and maintenance are done by MENCAP in association with the local housing association but decorating of people’s rooms can be done by the staff as required with people choosing their own fixtures and fittings (if possible). People spoken to said that they liked their rooms. One person said the dining room is great for meeting up with the others, as is the kitchen. Sunnydene DS0000009227.V366748.R02.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 & 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The provider, manager and care staff show a responsible attitude and implement changes and improvements in order to keep improving quality and outcomes for people living in the home. MENCAP have a training programme generally designed to give staff the skills they need to ensure people are being looked after appropriately EVIDENCE: The manager said that the current staffing levels are OK and that they have just recruited 2 new care staff and once they have completed their induction the staffing levels will be right for the number and dependency of the current residents. The duty rota seen showed that the manager works days during the week. Hours worked are flexible around the needs of the residents, there are less staff available when the residents are out during the day and more staff when they are in the house. Overnight there is one ‘sleeper’ on duty. Residents spoken to like the staff and can have fun with them. Staff interaction with the residents during the inspection was appropriate: discussing where Sunnydene DS0000009227.V366748.R02.S.doc Version 5.2 Page 19 people are going in the evening and what they had achieved during the day at their varied activities. MENCAP have a robust recruitment procedure. Included in the staff files seen were a CRB check, 2 written references and previous employment history. There was also evidence of regular supervision sessions (one to one) and appraisals having taken place. The manager said that Mencap have a ‘learning programme’ that includes first aid, manual handling, fire safety and other training appropriate to the conditions of the current residents. Infection control training is carried out in house by a staff member who is also a nurse. The manager said that other care staff have designated responsibility for different subjects such as food hygiene, health and safety, training and medication. Following the last inspection it was recommended that training regarding Aspergers Syndrome was received. This has still not been achieved. Sunnydene DS0000009227.V366748.R02.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager and care staff work to meet the needs of the service and to continually improve what the home offers to meet the needs and welfare of the people that live there. EVIDENCE: Since the last inspection (September 2006) the home has notified the Commission of any incidences that they are required to report. The current manager has worked at Sunnydene for 9 years and has been the manager since 2006. She has an National Vocational Qualification level 4 in care and has just completed a Registered Managers Award. MENCSAP have a formal quality assurance system in place which is based on seeking the views of those that live in the home and other people who visit the Sunnydene DS0000009227.V366748.R02.S.doc Version 5.2 Page 21 home in a professional capacity. Surveys, questions are designed so that the current residents can understand them and are able give their opinions. A completed Annual Quality Assurance Assessment was returned to the Commission prior to the inspection as required (July 2008). It was detailed and included all the information the Commission asks for. As part of the ‘learning programme’ MENCAP provide training in manual handling, fire safety, first aid and food hygiene. The manager has records of risk assessments that are carried out for individuals and generally for the house. These are updated as required and available to staff at all times. The accident book seen was completed appropriately and is available to all staff to record incidences as necessary. The induction programme recently introduced covers aspects of health and safety relevant to the current residents (when they are in and out of the house), the staff group and Sunnydene including security of the premises, safe storage of hazardous substances and risk assessments. Sunnydene DS0000009227.V366748.R02.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 Adults 18-65 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 3 2 3 3 X 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 X 27 X 28 3 29 X 30 3 STAFFING Standard No Score 31 3 32 X 33 3 34 3 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Sunnydene DS0000009227.V366748.R02.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. Standard Regulation Requirement Timescale for action 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 YA30 Good Practice Recommendations MENCAP should consider installing a hand wash basin at the back of the house by the laundry to enable people to clean their hands before going back into the house, either after handling the laundry or being dirty from being in the garden. Staff should receive some training regarding Asperger’s Syndrome (carried over from the last inspection) 2. YA35 Sunnydene DS0000009227.V366748.R02.S.doc Version 5.2 Page 24 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 Sunnydene DS0000009227.V366748.R02.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. 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. 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