Care Home: Sunnyhill Residential Care Home

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What the care home does well Sunnyhill provides residents with a comfortable and homely environment, and support is offered in such a way that independence is promoted, and residents are able to make choices Relatives and visitors are welcome at any time, those spoken with were very positive and they said `the staff are very good` and `look after us very well`. What has improved since the last inspection? The requirements made following the last inspection have been met. The manager confirmed that pre admission assessments identify the home can meet the needs of prospective, and this is confirmed in writing. The care plans identify the specific needs of the residents and include appropriate risk assessments with regard to their behavioural needs. What the care home could do better: Areas that the home should address have been included in the body of the report, these are concerned with reviews of the activities of daily living in the care plans, and obtaining relevant information regarding smoking legislation. Key inspection report Care homes for older people Name: Address: Sunnyhill Residential Care Home 14 Selwyn Road Eastbourne East Sussex BN21 2LJ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Kathy Flynn     Date: 0 9 1 0 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 24 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 24 Information about the care home Name of care home: Address: Sunnyhill Residential Care Home 14 Selwyn Road Eastbourne East Sussex BN21 2LJ 01323430386 01323721191 karen.sunnyhill@hotmail.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Sunnyhill Residential Care Home Ltd care home 20 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users to be accommodated is 20 The registered person may provide the following category of service: Care home only (PC) to service users of the following gender: Either whose primary care needs on admission to the home are within the following category: Mental disorder, excluding learning disability or dementia (MD) Dementia (DE) Date of last inspection Brief description of the care home Sunnyhill Residential Care Home provides specialist, residential and social care for up to twenty older people with a mental disorder, including dementia type illness. This large, detached house is situated in a quiet, residential area of Eastbourne, within easy walking distance of town centre shops and the mainline railway. It has parking to the front and private gardens on three sides, which are accessible to wheelchair users. Accommodation is on three floors, with a passenger lift providing level access. Residents private rooms are all equipped with an alarm call system and en suite toilet Care Homes for Older People Page 4 of 24 Over 65 0 0 20 20 Brief description of the care home facilities. Some are also fitted with a shower. Bathrooms on all floors are equipped with assisted baths. On the ground floor there is a choice of two communal lounges and a dining area. Information about the service, including the Statement of Purpose, Service Users Guide and CSCI reports is made available to prospective residents or their relatives, on request, as part of the admission process. Information about the range of weekly fees can be obtained from the home. Additional charges, not included in the fees, include hairdressing, chiropody, newspapers and transport. Care Homes for Older People Page 5 of 24 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. The reader should be aware that the Care Standards Act 2000 and Care Homes Regulation Act 2001 often use the term service user to describe those living in care home settings. For the purpose of this report those living at Sunnyhill Residential Care Home will be referred to as residents. This was a key inspection that included an unannounced visit to the home, and a range of documentation was reviewed including care plans, medication charts, recruitment files, and menus. The manager, care staff and cook were happy to discuss the support they provide. They were very positive and felt they could meet the residents needs. Care Homes for Older People Page 6 of 24 The Annual Quality Assurance Assessment (AQAA) was completed by the manager, within the required timescale, and identified areas where improvements have been made, and where others are planned for the benefit of residents. Care Homes for Older People Page 7 of 24 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 8 of 24 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 24 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Assessments are completed for all prospective residents to ensure the home has the capacity to meet peoples individual needs. Evidence: The Statement of Purpose and Service Users Guide provide relevant information about Sunnyhill and the services it offers. The manager confirmed that assessments are carried out for all prospective residents to ensure that the home has the capacity to offer appropriate support. Four care plans were viewed and found to contain clear information about the residents individual needs prior to moving into the home. People interested in moving into the home are encouraged to visit a number of times to meet the residents and staff, and stay for a meal if they wish. They are also able to move in on a trail basis before they decide if they want to remain at the home Care Homes for Older People Page 10 of 24 Evidence: permanently. Care Homes for Older People Page 11 of 24 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The care planning systems enables staff to offer residents the support and care they need and want. Medication training is provided for staff to protect residents. Evidence: The care planning system provides staff with information about the needs of the residents and how the home can meet these. Five care plans were examined and found to include details of the care provided, with the residents personal and social history and relevant risk assessments. The care plans are based on activities of daily living, with the needs of the residents identified and an action plan of how these can be met. However it was noted that these are not reviewed when the needs of the residents change, and for some these have not been updated since the residents admission. The deputy manager, who is responsible for the care plans, said she would be looking at updating the activities of daily living as the residents needs change, and on a regular basis in addition to the monthly record of care provided. Care Homes for Older People Page 12 of 24 Evidence: Residents are registered with GPs and records are kept of any visits from allied health professionals, including chiropodists and dietitians. A keyworker system is in place and staff said this works very well. They were able to demonstrate a good understanding of the needs of the residents and how they are able to meet these. Staff were noted to treat residents with respect and communication between them was relaxed and friendly. Training is provided for staff with regard to medication and those spoken with have attended this. The medicine administration records MAR charts were viewed and completed appropriately. A number of residents have medication that is prescribed on a PRN basis, however there was no specific policy for staff to follow when administering this medication. The manager addressed this during the inspection and advised that additional training would be arranged for all staff. Care Homes for Older People Page 13 of 24 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The routines of the home are flexible and encourage residents to make decisions about all aspects of their day to day lives. The meals at the home are good, choices are available and special dietary needs are catered for. Evidence: The manager and staff advised that their role is to encourage residents to make choices about all aspects of their day to day lives. Activities are organised for residents to participate in if they wish, on the day of the inspection a motivation exercise session had been arranged and a number of residents were enjoying taking part. Other residents spent time in their rooms, playing games in the quiet lounge at the front of the house, or going into town shopping. The atmosphere at Sunnyhill was comfortable and residents involved in the inspection said the staff are very good, they look after us very well and they have become my family. They also said that they are able to choose what they want to do, and if they want to go out arrangements are made for staff to accompany them if required. The meals at the home are good, choices are offered and the Chef confirmed that they Care Homes for Older People Page 14 of 24 Evidence: can have something different if they change their minds. Residents said the food is very tasty, there is always something nice and the puddings are very good. Care Homes for Older People Page 15 of 24 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The homes complaints procedure enables residents and visitors to raise concerns and there is evidence that appropriate action is taken. Evidence: Policies and procedures are in place regarding complaints, and information about how residents and their representatives can raise concerns is included in the Statement of Purpose and Service Users Guide. One complaint has been made to the Commission since the last inspection, and the home investigated this and resolved the issues raised. A safeguarding referral was made by the home to the local authority and appropriate action was taken to support the residents involved. Training in protecting vulnerable adults is provided for staff, and those spoken with have attended this and were able to demonstrate an understanding of abuse and what action they would take if they have any concerns. Care Homes for Older People Page 16 of 24 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Sunnyhill Residential Care Home offers residents a comfortable and homely environment, infection control training is provided for staff to protect residents. Evidence: The home is a converted older building, situated in a residential area of Eastbourne, and within walking distance of the town centre. Sunnyhill is comfortable and homely, with a quiet lounge at the front, and a lounge/dining room to the rear overlooking a large attractive garden. A shaft lift enables residents to access the three floors of the building, and the rooms on the top floor are allocated to people who are mobile and can safely access four steps. Residents are encouraged to personalise their rooms and many have done this with furniture, pictures and ornaments. Residents who took part in the inspection said that they are very comfortable, one likes to look after the plants in the front lounge, and they enjoy sitting in the garden when the weather permits. The home was clean and the manager advised that there is ongoing maintenance and repair programme, and as the AQAA states all but one bedroom has been completely redecorated. Care Homes for Older People Page 17 of 24 Evidence: Training in the control of infection is provided for staff, and those spoken with have attended this and are aware of the appropriate use of aprons and gloves. Care Homes for Older People Page 18 of 24 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Appropriate training and support is provided for staff, they are aware of their roles and responsibilities. The homes robust recruitment procedures protect residents. Evidence: The home follows robust recruitment procedures. Three staff files were examined and found to contain relevant information including application forms, two references and Protection of Vulnerable Adults (POVA) and Criminal Records Bureau (CRB) checks to protect residents. New staff are required to completed induction training in line with Skills for Care, and when successfully completed they are encouraged to work towards National Vocational Qualifications (NVQs). The home meets the requirement of 50 of staff with NVQ level 2 or above. Mandatory training is provided for staff and includes, first aid, fire training, infection control, food hygiene, moving and handling and medication training. Additional training is available to enable staff to understand the specific needs of the residents, and most of the staff spoken with said they have attended Dementia Awareness Sessions. Care Homes for Older People Page 19 of 24 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management ethos at the home is open and encourages residents, visitors and staff to be involved in the development of services. The health and safety systems in the home protect residents and staff. Evidence: The manager has over 10 years of providing care for older people, and over 5 years as the registered manager of Sunnyhill Residential Care Home. She has completed NVQ level 4 and the Registered Managers Award, and confirmed in the AQAA that she attends appropriate training. Feedback from residents and their representatives is obtained through daily discussions with residents and visitors, and using questionnaires yearly. Residents involved in the inspection said they are very happy, the staff are like our friends and they do anything to help, you just have to ask. The staff feel that they work well together as a team, they are well supported by the Care Homes for Older People Page 20 of 24 Evidence: management, and feel they can offer the residents good quality care. Residents are encouraged to take responsibility for their own finances, however if they prefer not to do this the home has a computerised deposit account that can be used to support them. The AQAA states that the health and safety of residents and staff is protected through ongoing maintenance of the home, with regular checks of the electrical system, the lift, hoists and water temperatures, as well appropriate staff training. A number of residents smoke in the home, risk assessment have been completed to ensure their safety and that of the other residents and staff working in the home. To ensure that the home follows the legislation regarding smoking the manager said she would contact the local authority for up to date advice, in particular concerning the closing of residents doors if they smoke and the installation of extractor fans. Care Homes for Older People Page 21 of 24 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 22 of 24 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 23 of 24 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). 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