Care Home: Sunnymeade

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What the care home does well The people living at Sunnymeade we spoke to and those who returned surveys told us that the staff were friendly and approachable. They all confirmed that their room was kept clean and tidy, and that the home always smelt pleasant. Everyone enjoyed the food that was described as ""First class"; "Different [menu] every day"; [I have a]"good appetite always". One person wrote "I am always made welcome and feel really at home".The care plans were up to date and had a lot of relevant information about peoples assessed needs meaning the care is based on individual need. The people living at Sunnymeade are consulted and involved in decisions that may affect them and their home. The staff we spoke to and those who returned surveys confirmed that they had all had thorough recruitment checks before they started working at Sunnymeade. They all praised the training opportunities they are given so they can keep up to date with current practices and maintain high standards of care. They all felt confident that they could seek advice and guidance if they were unsure about anything. The staff were friendly and worked together to deliver care to the people living in the home. Mrs Dunn manages the home in a style that is positive and inclusive for everyone living there and staff working there. What has improved since the last inspection? The refurbishment and upgrade of Sunnymeade has continued sine the last inspection and was nearing completion at the time of this inspection. An application for a grant to assist towards the purchase of a mini bus was successful. A bus had been ordered, built to specification, and was due to be delivered in the near future. CARE HOMES FOR OLDER PEOPLE Sunnymeade 323 Tavistock Road Derriford Plymouth Devon PL6 8AE Lead Inspector Megan Walker Unannounced Inspection 08:00a 21 August 2008 st 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 Sunnymeade DS0000003470.V361496.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. Sunnymeade DS0000003470.V361496.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Sunnymeade Address 323 Tavistock Road Derriford Plymouth Devon PL6 8AE 01752 781811 01752 781811 sunnymeadepl6@btopenworld.com Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of Registered Provider (if applicable) Type of registration No. of places registered (if applicable) Mrs Wendy Karen Dunn Position Vacant Care Home 30 Category(ies) of Dementia - over 65 years of age (30), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (30), Old age, not falling within any other category (30), Physical disability over 65 years of age (30) Sunnymeade DS0000003470.V361496.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Age 60 Date of last inspection 22nd August 2007 Brief Description of the Service: Sunnymeade is registered to provide residential accommodation and personal care, for up to 30 persons over the age of 60 who may also have a dementia, a mental disorder and/or a physical disability. The home does not provide intermediate care and it is not registered to provide nursing care. Sunnymeade is a detached property standing within its own grounds in the residential area of Derriford. It is privately owned and managed by Ms Wendy Dunn. The home is nearing completion of a major refurbishment and improvement plan. Accommodation is provided on two floors with a stair lift providing access to the 1st floor. On the ground floor there are three lounges, one of which is a designated smoking room, and two dining rooms. There is a call bell system throughout the home. The changes include the provision of more single bedrooms on the ground and first floors, with some having ensuite facilities and French doors providing direct access to the garden. At the rear of the home is an enclosed walled garden with level access to paved and bricked walkways, lawns, seating areas, raised flower- beds and a fountain. The owner plans to further improve the existing garden areas to create a sensory garden. Car parking is available in the grounds at the front of the home. Weekly fees range from £475.00 to £600.00 according to assessment of the person’s personal care needs, and choice of bedroom. Additional charges include hairdressing, chiropody, toiletries, newspapers, magazines, journals etc, all charged at commercial rates, and escort for hospital/GP appointments. All charges’ information was provided to the CSCI in August 2008. Written information including information about additional charges is available for people considering going to live at Sunnymeade and for those who are resident. A copy of the most recent CSCI inspection report is also available. Sunnymeade DS0000003470.V361496.R01.S.doc Version 5.2 Page 5 Sunnymeade DS0000003470.V361496.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is two star. This means the people who use this service experience good quality outcomes. This was a Key Inspection undertaken by one regulation inspector. The fieldwork part of this inspection was unannounced and took place over nine and a half hours on Thursday 21st August 2008 between 08:00 and 17:35. This inspection included talking to people who live at the home, care staff working on the day shifts, relatives, and other visitors to the care home including local healthcare professionals. Also, observation of interactions between the staff and the people using this service, a tour of the premises, and inspection of care plans, staff files, medication and other records and documentation. The Registered Provider/Manager, Mrs Dunn, and the Care Manager were present during the day, and provided relevant information such as the day-to-day routines as well as the management of the home. The Registered Provider’s partner provided an update of the refurbishment to date, and further plans for the existing ground floor rooms and the garden. “Have Your Say About Sunnymeade” Care Home Surveys were sent out to people living in the home and to staff. Ten people using this service and eight staff completed and returned surveys to the CSCI by the time this draft report was sent to the Registered Provider. In addition other information used to inform this inspection: • The Annual Quality Assurance Assessment (AQAA) completed by the Registered Provider. • The last Key Inspection report • All other information relating to Sunnymeade received by the CSCI since the last inspection. No requirements and two “good practice” recommendations were made as a consequence of this inspection. What the service does well: The people living at Sunnymeade we spoke to and those who returned surveys told us that the staff were friendly and approachable. They all confirmed that their room was kept clean and tidy, and that the home always smelt pleasant. Everyone enjoyed the food that was described as “”First class”; “Different [menu] every day”; [I have a]”good appetite always”. One person wrote “I am always made welcome and feel really at home”. Sunnymeade DS0000003470.V361496.R01.S.doc Version 5.2 Page 7 The care plans were up to date and had a lot of relevant information about peoples assessed needs meaning the care is based on individual need. The people living at Sunnymeade are consulted and involved in decisions that may affect them and their home. The staff we spoke to and those who returned surveys confirmed that they had all had thorough recruitment checks before they started working at Sunnymeade. They all praised the training opportunities they are given so they can keep up to date with current practices and maintain high standards of care. They all felt confident that they could seek advice and guidance if they were unsure about anything. The staff were friendly and worked together to deliver care to the people living in the home. Mrs Dunn manages the home in a style that is positive and inclusive for everyone living there and staff working there. What has improved since the last inspection? 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. Sunnymeade DS0000003470.V361496.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 Sunnymeade DS0000003470.V361496.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): 1, 2, 3, 4, 5 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People choosing to use this service and their families can feel confident that their needs will be assessed before moving into the home and that they can have the information they need to make an informed choice about where to live. EVIDENCE: People using this service who completed surveys commented that they had chosen Sunnymeade for the following reasons: “Came from hospital to Sunnymeade and thought it would be a nice place to stay.” “Thought it sounded nice” “Sounded ok” “It sounded like a nice home” Sunnymeade DS0000003470.V361496.R01.S.doc Version 5.2 Page 10 Anyone considering moving in to Sunnymeade is offered an informal tour of the home and an opportunity to talk to people using the service. A copy of the home’s brochure giving an overview of the home’s facilites and what is offered at the home, and scale of care fees are given to all prospective residents. The Service User’s Guide (a booklet/brochure explaining the terms and conditions of living in the care home including how to make a complaint), is also given to people so they have information about this service. We looked at three care files and found good pre-assessments of care needs, completed by the Registered Provider or the Care Manager. For anyone who was able, they have the opportunity to visit Sunnymeade for a few hours. The Registered Provider or Care Manager would offer to go and see anyone unable to visit the home to answer any questions they may have. There is a six week trial period after moving into the home. This ensures that the person moving in is receiving the service they expected, and that the staff are able to meet the assessed needs of the person. People move into the home for a variety of reasons. Some people had come to Sunnymeade for a short respite stay so knew of the home. They may have made a private arrangement, or the local authority may have referred them to the home via the Social Services Department. One person we spoke to had come to Sunnymeade via the RITA scheme (a short term rapid intervention team that enables people during a ‘crisis’ period to have a short respite stay, without the need, necessarily, for hospital admission). The AQAA states: “We receive very few referrals via PCC social services because we are unable to accept their funding levels without a top-up….. We rely on looking to admit privately funded service users. Talking to PCC [Plymouth City Council] representatives regarding funding levels.” People using this service who completed surveys confirmed that they had received a contract. The files we inspected also all had a contract of terms and conditions of residency. Increase of fees is given in writing in advance. Sunnymeade DS0000003470.V361496.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 excellent. This judgement has been made using available evidence including a visit to this service. People who use this service can feel confident that a staff team that is respectful and sensitive will ensure that all their health, personal and social care needs are met. EVIDENCE: People using this service who completed surveys confirmed that they receive the care and support they need, the medical support they need, that the staff listen and act on what they say, and that the staff are available when they need them. Some of the comments included: “I get medication ordered for me” “Get doctor when needed” “They help me get up” “If I want anything I shout” Sunnymeade DS0000003470.V361496.R01.S.doc Version 5.2 Page 12 We chose three people, both men and women, to look at their care files and care generally because they were, for example, people with more complex needs (such as health care needs), and/or people with changing needs. Each care file seen stated the name by which the person preferred to be called. Each had a full assessment of care needs, and a care plan that was reviewed monthly by the person who’s care this concerned and the Registered Provider. If the person’s health deteriorated so they were limited in their ability to be involved with their care planing, then a family member/representatives or an independent advocate would be invited to become involved (if not already). The care plan continued to focused on the person. Daily Records showed that any medical condition was monitored and recorded. There was evidence of recording of allergies, blood tests, weight checks, urine tests, and fluids in/out where this was appropriate and necessary. People were able to choose to have dental checks, eye-sight checks and chiropody services. On the day of this visit a local chiropodist was visiting the home and people were treated in the privacy of their own rooms. Any history of falls was recorded to monitor anyone living at the home that was at risk of falling. We looked at Incident/Accident records. These were kept securely according to relevant guidelines and also recorded in chronological order in the person’s care file. This provided the Care Manager with an overview to monitor and take preventative action. We received positive feedback from health and social care professionals who visit the home on a regular basis. They commented that there was good communication between themselves and the staff working in the home. A Community Nurse told us that the staff always followed instructions and were open to her suggestions regarding individual people’s healthcare needs. A senior staff member told us that they would always have training for any new equipment provided such as new style hospital beds or hoists to assist with moving people. She also confirmed that moving and handling training was mandatory for all the care staff every year, and it was included as part of the induction programme. A family member told us that the care provided for her relative was “excellent and could not be faulted”. She described the staff as very patient and said that they never shouted or raised their voices. Medication was seen kept in a lockable trolley. The Controlled Drugs Box was a lockable box and kept secured in a lockable cupboard. At the time of this visit no one required controlled drugs. The medication records each had a photograph of the person for whom the medication was intended at the back of the medication records’ file. The medication records seen were signed and dated appropriately. A senior staff member told us that three senior day carers Sunnymeade DS0000003470.V361496.R01.S.doc Version 5.2 Page 13 and the night staff were responsible for medication. They had attended a handling and administration of medicines training course and were due to attend a ‘refresher’ course in November 2008. We also found evidence of training on the staff training programme and on individual staff files. Sunnymeade DS0000003470.V361496.R01.S.doc Version 5.2 Page 14 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 excellent. This judgement has been made using available evidence including a visit to this service. People living at Sunnymeade are encouraged to exercise choice and control over their lives. People are supported to continue to enjoy familiar supportive relationships with family and friends, and within the local community. EVIDENCE: The people who returned surveys all confirmed that activities were arranged at the home for them to take part in if they chose to. Two people described the activities as “Fun” and “Excellent”. During this visit we saw photographs of a recent garden party held at the home. A visiting Community Nurse told us that the garden was regularly used by the people living in the home. The cook told us that birthdays were celebrated with everybody living at the home and she made a birthday cake. Friends and families would be invited to join the occasion. Sunnymeade DS0000003470.V361496.R01.S.doc Version 5.2 Page 15 Those people who choose to smoke may do so in a designated lounge at the front of the home. They may also smoke in the garden in a designated area also used by the staff. On the day of this visit a senior staff member was advised that all staff should be reminded that cigarette stubs should be disposed of immediately after smoking to avoid leaving an unsightly mess when it rained. There was no evidence of odour in the lounge used for smoking or its vicinity. Following a successful application for a grant at the time of this visit the Registered Provider was awaiting confirmation of completion and delivery of a mini bus (suitable for wheelchair use). It is intended that this will be used for personal or group outings. The AQAA explains that “At present we liaise closely with outside transport agencies e.g. taxi firms, mini bus hire firms and our own company vehicles to give service users a choice of services available to them.” Everyone we spoke to and the surveys returned by people living at Sunnymeade were all very complimentary about the food they are provided at the home. The cook was enthusiastic about the flexibility she has to try out new recipes. She said that all the food was home cooked including pastries, pies and pasties. She bakes cakes every day for teatime. At the time of this visit she was trying out different gluten-free and diabetics recipes with people who had these diets, to find cakes they liked and could eat. She had already prepared three different Christmas cakes (suitable for different dietary needs). The cook emphasised that meals were every important for the people living at Sunnymeade as”it was the highlight of their day”. Snacks were available throughout the day and night if anyone asked for something and the cook had prepared different sandwich fillings should anyone ask for a sandwich. All the food in the fridge and freezer was stored appropriately. Meals could be provided at different times if someone was out for the day. One person, for example, goes out twice a week and is provided with a packed lunch and dinner in the evening. Meals that had to be pureed had each part prepared and served on the plate separately. The cook told us that she talked to people using the service in order to get their feedback. People moving into the home/coming to stay for respite were asked about their preferences and/or any health care needs. This information and feedback the cook told us she took into consideration as part of the menu planning and meals’ provision. The cook confirmed that all the staff had done basic food hygiene training. The cook evidently took a pride in her work as well as a keen promotion of health and safety awareness for all staff entering the kitchen. Sunnymeade DS0000003470.V361496.R01.S.doc Version 5.2 Page 16 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. This judgement has been made using available evidence including a visit to this service. The people living at Sunnymeade and their families and friends can feel confident that any issues of concern or complaints raised by them will be dealt with appropriately. People are protected by the home’s policies and procedures, and by a robust recruitment process. EVIDENCE: The people using this service who returned surveys confirmed that they all knew who to speak to if they were not happy about something, and how to make a complaint. Written comments all confirmed that people knew what to do and they would speak to the staff and or “the boss”. Since the last inspection the home has received two complaints. Both were resolved and one was upheld. At the time of this inspection there was an ongoing safeguarding investigation following an alert made to the Care Manager. The Registered Provider referred the allegation to the local authority Safeguarding Team in accordance with local policies and procedures for protecting vulnerable adults. Sunnymeade DS0000003470.V361496.R01.S.doc Version 5.2 Page 17 We saw the complaints procedure displayed in the main hall on the notice board next to the front door. The training records showed that all the staff had received training about the protection of vulnerable adults from by the local authority or as part of their NVQ training. This means that they will be competent in recognising any signs of abusive or neglectful behaviour. They know how to take appropriate measures to prevent any harm coming to the people who use this service. We made a random selection of staff personnel files and found that all the required checks including police checks and references had been completed correctly. The people we spoke to during this visit were confidence that they could talk to a member of staff or to the Care Manager about any matters that bothered them, no matter how small. The staff we spoke to were also confident that should they have any concerns or niggles about anything they too could go to the Registered Provider or Care Manager to discuss their worries. The AQAA states that “the home adopts the opinion that each service user has the capacity to make all their decisions unless proved otherwise. Carers are also aware that service users’ capacity changes daily and may need to assess this at each individual decision.” Mental Capacity Advocates are currently used to assist some people living at Sunnymeade and the Registered Provider plans to introduce individual assessments and relevant documentation on each care plan based on the Mental Capacity Act. Sunnymeade DS0000003470.V361496.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 22, 26 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People using this service have access to indoor and outdoor communal facilities that maximise their choice and independence. The extensive refurbishment and redecoration programme is nearing completion and provides people with a more comfortable and safe environment in which to live. EVIDENCE: People’s rooms seen were personalised with furniture, pictures and photographs and were homely even when they had clinical equipment in them. Doors were lockable and lockable space was provided. Each room had a call bell facility. Sunnymeade DS0000003470.V361496.R01.S.doc Version 5.2 Page 19 There were toilets and bathrooms throughout the home, with adaptations to meet the needs of the people currently living at Sunnymeade. A number of rooms had en-suite facilities and this number will increase once the refurbishment programme is complete. There is a choice of lounges and through out this visit people were seen using these. These have been upgraded as part of the refurbishment programme and have furniture that is suitable for the needs of the people living at Sunnymeade. The dining room at the front of the house has also been redecorated and refurnished. At the rear of the home is an enclosed walled garden with level access to paved and bricked walkways, lawns, seating areas, raised flower- beds and a fountain. The owner plans to provide direct access via French doors from some ground floor bedrooms into the garden. She has applied for a grant to ‘match fund’ a sensory garden to further improve the existing garden areas. This will be created with guidance and support from a local college that has a specialist interest in such gardens. At the time of this visit parts of the garden were fenced for security and protection of anyone using the garden during the ongoing building works. The home was clean and tidy with no offensive odours. The housekeeping staff were seen to be going about their duties throughout this visit. There was no evidence of dust and dirt or building materials from the building work. Sunnymeade DS0000003470.V361496.R01.S.doc Version 5.2 Page 20 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. This judgement has been made using available evidence including a visit to this service. The provider and manager show a responsible attitude and continue to implement changes and improvements in order to keep improving quality and outcomes for people living in the home. The staffing levels must ensure people’s needs are being met at all times. EVIDENCE: On the day of this visit there were twenty people residing at Sunnymeade. In the morning there was a senior carer and two care assistants responsible for the provision of personal care and assistance. In the afternoon there was a senior carer and one care assistant. Additionally, the provider confirmed she works at the care home Monday to Friday, and on the day of this visit the Care Manager was attending to administrative tasks, a job she does one day a week, and there was a cook and two cleaners. The AQAA shows that 18 care Sunnymeade DS0000003470.V361496.R01.S.doc Version 5.2 Page 21 staff and four other staff are employed to work at Sunnymeade. They are all female. We spoke to five members of staff (care staff and ancillary staff) about working at Sunnymeade. They all spoke enthusiastically about the home, and how they felt about working there. They confirmed that they had the opportunity to go on training courses. We confirmed from the training records that all the staff working at Sunnymeade had attended either the local authority or an external training provider Protection of Vulnerable Adults (POVA) training. The induction training is run over a twelve week period based on “Skills For Care”. All new staff had had moving and handling training. This is renewed and updated annually for all care staff along with Health and Safety in the Care Home, Food Hygiene, First Aid and Fire training. Inspection of a random selection of five staff files found that all the required checks had been done. No-one had signed a European Working Directive should they work over and above 48 hours in any seven-day period, including overtime. However the Care Manager confirmed that it was unlikely anyone would work this number of hours. Throughout this visit our observation of the staff found they were friendly and caring towards everyone. They were gentle and respectful as they assisted people with daily living tasks, and mindful of preserving people’s dignity and self respect. Sunnymeade DS0000003470.V361496.R01.S.doc Version 5.2 Page 22 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. This judgement has been made using available evidence including a visit to this service. Health, safety and welfare is promoted and protected by a competent and capable Registered Provider who is keen to achieve positive outcomes for residents and staff. EVIDENCE: The Registered Provider is pro-active about ensuring that the home provides a service that meets the care needs of the everyone living or staying there. She is actively involved in the day-to-day running of the home and responsible for staffing and overseeing the provision of care. The management of the home was transparent and honest. Throughout this visit the Registered Provider was found to be keen to promote the welfare and general well being of the people Sunnymeade DS0000003470.V361496.R01.S.doc Version 5.2 Page 23 living at the home with no discrimination or pre conceptions. She encouraged residents and their families to raise their concerns or worries about any matters. At the time of this visit people who were able, handled their own affairs otherwise it was done on their behalf by a relative or a solicitor. The Registered Provider does an annual audit to check quality against each of the national minimum standards. She also uses an action and improvement planning framework that links to the AQAA. People living at Sunnymeade were recently given questionnaires about the care they receive and the home in general as part of this process. Residents’ meetings are held monthly and the Care Manager chairs these. The Care Manager confirmed that all the necessary maintenance checks as reported in the AQAA were correct and up to date. Smoke detectors, emergency lighting and fire alarms the Registered Provider confirmed were checked weekly. All the fire extinguishers had been checked annually. The Accident Book was seen and accidents had been recorded correctly. The CSCI had been notified of any incidents affecting the health, safety or well being of any of the residents. Care plans inspected had risk assessments included in them that were relevant to the individual person. Hand gel was provided in the entrance hall with a notice for visitors to use this on arriving and leaving the care home. On the day of this visit, the home was clean and tidy, free from offensive odours throughout. Sunnymeade DS0000003470.V361496.R01.S.doc Version 5.2 Page 24 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 4 4 3 3 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X 3 X X X 4 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 4 X 3 X X 3 Sunnymeade DS0000003470.V361496.R01.S.doc Version 5.2 Page 25 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 OP27 Good Practice Recommendations Staffing levels should be reviewed to ensure there are sufficient staff so people’s needs can be met at all times of the day and night and the staff can give sufficient time to each person. Sunnymeade DS0000003470.V361496.R01.S.doc Version 5.2 Page 26 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 Sunnymeade DS0000003470.V361496.R01.S.doc Version 5.2 Page 27 - 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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