Care Home: Sunnyside

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Sunnyside 83 Marine Approach South Shields Tyne And Wear NE33 2TE two star good service The quality rating for this care home is: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Carole McKay Date: 1 2 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. They reflect the things that people have said are important to them: 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 Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. Internet address www.csci.org.uk Information about the care home Name of care home: Address: Sunnyside 83 Marine Approach South Shields Tyne And Wear NE33 2TE 01914551609 NOFAX jeffbest14@yahoo.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mr Jeffrey Best Name of registered manager (if applicable) Miss Gillian Robson Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 3 0 care home 3 learning disability Additional conditions: Date of last inspection 1 4 0 8 2 0 0 6 A bit about the care home Sunnyside can provide personal care for three people who have a learning disability. The service cannot provide for those people who require nursing care. 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 Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home How we did our inspection: This is what the inspector did when they were at the care home Unannounced visits were made on 22 October 2008 and 12 November 2008. These visits lasted a total of 10 hours. During the visit we talked with people who use the service, staff and the manager. We looked at information about the people who use the service and how well their needs are met. What the care home does well The people who live at the service are encouraged to make choices. Each person has a care plan which sets out their preferences and needs. The service adapts to the changing needs of the people who live there. What has got better from the last inspection The registered manager keeps up to date with the changing needs of the people who live at the home and has developed their service user plans accordingly. What the care home could do better More up to date guidance for staff to do with individual needs and how they should support service users will ensure that service user stay safe. More staff hours and more staff training would allow the service to develop in a more individualised way around service user needs. If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Carole McKay St Nicholas Building St Nicholas St Newcastle upon Tyne NE1 1NB 01912333300 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 set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line - 0870 240 7535 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection 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, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. 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 the person 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 . The home is equipped to provide information to people who may wish to live at the home and it will ensure that the persons needs are fully assessed. Evidence: No admissions have taken place at the home for several years and the people living at the home have known each other most of their lives. Information about the home is available should any vacancies arise. The homes service user guide is comprehensive and has easy to read sections that include photographs and room sizes. The home has a clear written process for assessing the needs of people coming to live at the home. The assessment is used to periodically review the needs of the people who live at the home. Each person has a service user plan based on the outcome of the assessment process. Individual needs and choices 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 needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. 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 people living at the home have their needs met and their preferences respected. Their gradually changing needs will be addressed as the service adapts to these. Evidence: Each person living at the home has an individual service user plan. These bring together relevant information to support staff in delivering the correct level of care and to respect the preferences of each individual. The manager is developing these further around the needs of each individual. For example, there is work to be done around capacity and decision making and managing risks where people have changing needs. Lifestyle 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 can take part in activities that are appropriate to their age and culture and 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 and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. 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 home supports the people who live at the service to enjoy the lifestyles they prefer. Evidence: The people who live at the home have been supported to continue to enjoy a structured lifestyle. Opportunities for leisure time are spent together as far as possible. This is their preference. How the service will continue to do this as peoples needs and abilities change should be planned for. Use of more individualised assessments of need and care planning will support this. People are encouraged and supported to keep in touch with family and friends. The meals at the home are planned week by week and in response to the known preferences of the people who live at the home. One of the people at the home has recently developed some specific needs to do with eating. The team has not reached an agreed plan of care to manage this and as yet have not consulted with any specialists. Personal and healthcare support 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 receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people 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. If people are approaching the end of their life, the care home will respect their choices and help them to 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 . People who live at the service are supported with health and personal care in a manner that matches their needs and expectations. Medication will be administered safely and as people require. Evidence: Each service user plan includes records that show that the people who live at the home have their routine health needs addressed through regular visits to dentists, opticians and other health professionals as required. Each person has an individual health file. These include detailed plans for delivering health and personal care for the individual concerned. The records also show that special needs, such as diabetes, are monitored carefully. The home has forged good links with specialists. This has helped with managing health related needs and in responding to the changing needs of the people who live at the home. Medication is managed by having clear protocol and procedures for staff to follow along with specialist procedures, where these are required. The system of recording medications as they are administered to service users is up to date, although it has an unnecessary level of duplication. This could be simplified and would thereby avoid errors occurring. Staff have been trained in medication administration, but some of the staff training to do with specialised procedures has not been updated for several years Concerns, 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. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. 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 people who live at the service will be supported to raise concerns. Their interests will be safeguarded by informed and experienced staff who would benefit from further training related to specific needs. Evidence: The home provides information to people who use the service about the way in which they can raise their concerns or make complaints. This information is openly available in the home and easy to read. Pictures and symbols are included. Staff are provided with information also. This includes in house procedures for raising concerns and the local inter- agency procedures for working together to protect people from harm. Staff have also had training in these procedures recently. The home has experienced a safeguarding referral and staff from the home were supported in their actions. The home does not have information to do with guidance around the use of physical intervention in preventing harm, nor have staff had training in this. The manager acknowledges that this is relevant to the needs of people who live at the service. 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, comfortable, 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. People have enough privacy when using toilets and bathrooms. 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 people using the service live in a homely, stable, comfortable and safe environment that has been adapted in small ways to make sure that people can continue to live there safely for as long as possible. Evidence: The home is very in keeping with other properties in the neighborhood. It is not purpose built and it blends well with the terrace of properties adjacent. People who live at the home need to be able to negotiate stairs. Some minor adaptations have been made to accommodate the people who live at the home in the long term, in keeping with the aims and objectives of the service. Local town centre facilities are a short car drive away and public transport is nearby. Two people share a room and have done so since the home opened. All three people who live there are close in age and background and are very settled in the accommodation. The premises are homely, clean and well maintained and modern kitchen fittings have been added. The bedrooms at the home are rather bare but attempts have been made to personailse them as far as the people using them wish to do so. Some of the communal living areas are personalised to reflect the people who live there. The home is kept clean throughout to a homely rather than clinical standard. Basic good hygiene practice has not yet been adopted. The owner is planning to make some physical changes to the environment, so that the sleep in staff are more accessible to service users through the night, should they be needed. 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, qualified 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. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The people who live at the service are supported by a small very stable and flexible team of staff who have known them for many years. The staff are qualified and have had basic and some specialised training. Evidence: The home has a team of three full time staff. This includes the registered manager and the owner of the home. Staff cover is managed by including periods of time in the rota when the home is not staffed. For example, through the day and at times when all three service users are out. But one staff will be available to be contacted at these times as necessary. All three staff hold National Vocational Qualifications ( NVQ) to at least level 2 standard. No new staff have been recruited to the home for several years, but the staff files show that staff were required to provide police clearance checks when these came into being in 2003. There is no evidence that these have been updated since then. The registered manager said that she has good links with a local training agencies and has identified some additional training for the team. This will be to do with mental health, dementia and learning disability. Staff undertook training in safeguarding vulnerable adults in 2006, and in medication. The routine mandatory training is now due for renewal. Conduct and management of the 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 have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because 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. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. 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 people who use the service live in a home that is managed in their best interests. The way the service measures how well it meets the needs of the people who live at the home is not yet fully developed. Evidence: The home is closely managed as the provider and the registered manager both work in the home on the rota. The registered manager is qualified and has forged good links with other professionals and other trainers. And demonstrates that she develops her training and keeps up to date with current trends in care. Training is a focus of the manager and she has a remit to provide this within budget constraints. But as yet there is no system for quality assurance to test out the plans for the future. The registered manager demonstrates an awareness of good safety practice. The home has a quality assurance process for maintenance and safety, but this does not take account of basic infection control procedures. Routine checks of the building and safety are up to date. The fire risk assessment and fire safety system has been upgraded. Are there any outstanding requirements from the last inspection? Yes  No  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 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 Description 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 Description Timescale for action 1 20 13 The registered manager 30/04/2009 must arrange for staff to have training in specialised techniques for handling medicines up dated and their competence to be reassessed. This will ensure the continued safety and well being of service users. 2 35 18 The registered manager 15/06/2009 must carry out an assessment of the staff training needs and develop a staff training plan. This must include updating mandatory training, equal opportunity training and identified specialised training needs with timescales. This will ensure that there is a well trained staff team will be able to respond to the changing needs of the people who live at the home. 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 1 6 The registered manager should continue to develop a person centred style of service user plan so that the individual preferences and abilities of each service user are further emphasised. Where people are at risk of losing their capacity to consent arrangements to address this in the future should be included in the service user plan The registered manager should consider making use of specialised risk assessment tools for falls and for general age related dependency. The registered manager should refer matters to do with eating to the service users GP for specialist advice The registered manager should avoid duplication in the recording of medicines administered by discontinuing the use of codes for each medicine. The manager should obtain a copy of the DH guidance to do with physical intervention. Staff should receive training in the guidance. The registered manager should develop the quality assurance process further. So that it takes account of the views of other interested parties on how well the home meets the needs of the people who live there. The use of liquid handsoap and paper towels should be introduced to avoid cross infection. 2 7 3 9 4 5 17 20 6 23 7 39 8 42 Helpline: 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 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) Commission for Social Care Inspection (CSCI). 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. 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