Care Home: Sunnyside Residential Home

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What the care home does well Management make sure that they assess the needs of people before they are admitted to the home. This is to make sure that staff only care for those people whose needs they feel they can meet. Residents feel that they are well looked after by the staff. Residents and relatives made the following comments: "If you need anything it is there". "I am well looked after". "They are really good to me". "Staff are very attentive and are always there". The care plans contain a lot of information about how people are to be cared for, what they can do for themselves and what they need help with. The meals provided are varied, nutritious and the residents have a good choice of menu. Enough suitably trained staff are on duty to care for the residents safely. A large percentage of the staff have the nationally recognised qualifications NVQ2 or NVQ3, in care. They have exceeded the standard in this area. Management make sure that they check people out thoroughly before offering them a job. This is to prevent the residents being cared for by unsuitable people. Management make sure that the staff are properly trained so that they have the knowledge and skills they need to protect and meet the needs of the residents. What has improved since the last inspection? Nearly all the staff have now received training in the safeguarding of people. This training is done to protect people from abuse. Safety door locks have been fitted to all bathrooms and toilets. This ensures the privacy and dignity of the residents. The garden has been further enhanced by the addition of more flower beds. New lounge furniture has very recently been provided and several more bedrooms have been redecorated. Better systems are in place for controlling infection. This helps protect the residents` health and well being. The hot water heaters in the toilets have been fixed so that they do not discharge water that is too hot. This helps protect the residents` health and well being. What the care home could do better: They must continue with the redecoration and refurbishment programme so that the residents can live in an even better environment. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Sunnyside Residential Home Adelaide Street Bolton Lancashire BL3 3NY     The quality rating for this care home is:   two star good service 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: Grace Tarney     Date: 1 8 0 6 2 0 0 9 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. 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. 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 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. Care Homes for Older People Page 2 of 26 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. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Sunnyside Residential Home Adelaide Street Bolton Lancashire BL3 3NY 01204653694 0120461448 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Parfen Limited care home 27 Number of places (if applicable): Under 65 Over 65 27 old age, not falling within any other category Additional conditions: 0 The registered person may provide the following category/ies of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP The maximum number of service users who can be accommodated is: 27 Date of last inspection Brief description of the care home Sunnyside is operated as a limited company by the owner Mr A Jonas and Mr Jonass family. The Registered Manager Mrs B Hardman runs the home on a day-to-day basis. The home can provide 24-hour care for up to 27 older people. The property is on Adelaide Street in Bolton and is about two miles from the town centre. There is a bus stop on the main road that is fairly close to the home and there are shops nearby. The accommodation is provided on three levels with a lift giving access to all floors including the basement. The home has 27 single bedrooms; three bedrooms have an en-suite toilet and hand basin. Care Homes for Older People Page 4 of 26 Brief description of the care home There is a comfortable lounge, a dining room and a conservatory that is the designated smoking area. Toilets and bathrooms are provided on all floors. The home has a pleasant garden area with seating that can easily be reached from the conservatory. The fees for the home are 367 pounds 68 pence per week. For a room with an en-suite toilet the fees are 372 pounds 68 pence per week.. Additional charges are made for private chiropody, hairdressing and newspapers. This information was received on the 18th June 2009. A copy of the most recent inspection report is displayed in the main office. Care Homes for Older People Page 5 of 26 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 staff at the home were not told that this inspection was to take place although many weeks before the inspection questionnaires (comment cards) were sent out to some of the residents and to the staff. The questionnaires asked what people thought about the care and quality of the service provided. We received 2 comment cards back from residents and 2 from the staff. What they felt about the care and services provided is written in different sections throughout this report. Also before the inspection we (The Care Quality Commission) asked the manager of the home to complete a form called an Annual Quality Assurance Assessment (AQAA) to tell us what they did at present, what they felt they did well and what they needed to do better. This helps us to determine if the management of the home see the service they provide the same way that we do. Care Homes for Older People Page 6 of 26 We spent 8 hours at the home and during this time we examined care and medicine records to make sure that the health and care needs of the residents were being met. In addition we looked at what activities were available for the residents and whether they were given choices about how they spent their day. We looked at what the residents were having for their meals, to make sure that there was a choice of meals and that they were varied and wholesome. We also looked around the building at some of the bedrooms, bathrooms, toilets and sitting areas to check if they were clean, warm and suitably decorated. We checked how many staff were provided on each shift to make sure that the residents needs were being met. We then looked to see if management recruited and trained the staff properly and safely. This is so the staff can do their jobs properly and the residents are protected from being cared for by unsuitable people. We also looked at how management check that the care and services they provide is what the residents and their relatives want, or expect. How the residents spending money is managed was also checked. In order to get further information about the home we spent time talking to 3 residents, and 2 staff members. What the care home does well: What has improved since the last inspection? What they could do better: They must continue with the redecoration and refurbishment programme so that the residents can live in an even better environment. Care Homes for Older People Page 8 of 26 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.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 9 of 26 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 10 of 26 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. People are properly assessed before they are admitted to the home and this gives an assurance to everybody that a person is only admitted if the staff can meet their needs Evidence: Before any resident was admitted to the home a senior member of staff from the home undertook an assessment of their needs. The assessment looks at what help and support the prospective resident needs in all aspects of their daily life. The 1 assessment that we looked at was detailed and gave a clear indication of the residents needs and what the resident could and could not do for herself. It was stated in the AQAA document sent to us that wherever possible the management of the home arrange for prospective residents to spend some time with them at the home to help them make an informed choice about whether the home is the right one for them. Standard 6 does not apply. The home does not provide Intermediate Care. Care Homes for Older People Page 11 of 26 Care Homes for Older People Page 12 of 26 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 plans show what care needs the residents have and care practices ensure that their needs are met in a caring and dignified way. Evidence: Individual care plans were in place for each resident. The care plans of 2 of the residents were looked at. They were detailed and gave clear instruction and guidance on how the care needs of the residents were to be met. They also provided a lot of information about the residents daily routine, their past life and their interests. One of the residents had a condition that at times could cause her to need immediate attention and possibly even hospital admission. Whilst the staff knew what to do if an emergency occurred they had not written down in the care plan what signs and symptoms to look for and what to do if an emergency did happen. The manager agreed to write this information into the care plan as soon as possible. The care plans were reviewed regularly so that any change in the residents condition could be identified and appropriate action taken. Management confirmed that this was what they did in the AQAA document sent to us. The staff looked at whether or not there Care Homes for Older People Page 13 of 26 Evidence: was any risk in relation to the residents developing pressure sores or if they were at risk of falling. They also looked at whether or not the residents were at risk due to problems with their diet and fluid intake. They also assessed how any resident was to be assisted with being moved around and by how many members of staff and what equipment, if any, was to be used to assist in safe moving and handling of the residents. We saw that staff wrote in the care notes when the residents had received visits from health care professionals, such as dentists, opticians, district nurses and chiropodists. We saw that residents were weighed regularly and their weight recorded in their care records. We also saw that staff were quick to identify any weight loss and act upon this by contacting the residents GP. The following were some of the comments made by relatives and residents: Top marks on all fronts. The whole staff have been very supportive towards my family at this very difficult time. I do not think I could have come through this without their help and support. A safe system of managing the medicines was in place. There is a room that is kept locked and is used for the safe storing of medicines. The medicine trolley is kept secured to the wall when not in use. The medicine keys were kept securely and identification photographs of each resident are kept with the medication administration records. Only staff trained in medication management deal with the medicines. We looked at how medicines, including controlled drugs, were ordered, stored and recorded. Medicines were stored securely and recorded accurately. Staff were discreet when providing assistance to the residents. There was lots of friendly banter with the staff and residents whilst we were there however the staff spoke to the residents in a very respectful way. Staff confirmed that the importance of ensuring privacy, respect and dignity is part of their initial training. The residents looked clean and comfortable and were suitably dressed. Care Homes for Older People Page 14 of 26 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 residents are supported and encouraged by staff to make choices about what they do, so that they can find enjoyment and satisfaction in their daily life and with the activities available to them. Evidence: The residents routines of daily living, such as when they go to bed and when they get up, plus their social interests were recorded in their care plans. Throughout the day we saw that the residents were able to spend their day wherever they wished to. It was stated in the AQAA document that the staff try to give the residents maximum flexibility and control in their daily lives so that this can foster and preserve their independence. We did see that 1 resident did go out driving in his van. Management told us that they were in the process of updating a risk assessment for this resident to ensure that everything possible was done to make sure that he was safe to drive on his own. We were told that various people come into the home to undertake activities with the residents. They have film shows, music sessions where they have the opportunity to play musical instruments, and armchair aerobics. Every Wednesday they have somebody coming in to do Crafts and Chats. The staff also do activities with the residents. Whilst we were visiting the home we watched the residents Care Homes for Older People Page 15 of 26 Evidence: enjoying a sing a long with the staff in the lounge. Several of the residents were also dancing with the staff along to the music. The care plans gave information about the residents religions and whether they practiced their faith. Staff told us that visiting clergy of different faiths visit the home and are always welcome. We were told that 1 resident was taken out to church every Sunday. At the time of the inspection there were no residents of any ethnic minority. Neither were there any residents who required special diets to meet their religious or cultural needs. One relative told us: My relative is very rarely bored. We did not eat with the residents but saw what they were having for their lunch. It was home cooked, looked nutritious and there was plenty of it. The residents have a choice of food at breakfast, lunch and teatime. Hot and cold drinks were served during the meal and throughout the day. Residents made the following comments: The food is very good. I enjoy my food. Care Homes for Older People Page 16 of 26 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. People know how to complain and staff have a good knowledge and understanding of what abuse is, thereby reducing the possible risk of harm to residents. Evidence: A complaints procedure was in place. It is easy to understand and gives an assurance that complaints will be responded to within 28 days. It did not state that an acknowledgement of the complaint would be sent out to the complainant within the first few days. The manager agreed to include this. A record is kept of any complaint made and includes details of the investigation and any action taken. No complaints have been made to us since the last inspection. A discussion with the senior staff showed that they were very aware of the procedure to follow in the event of any allegation of abuse. Training in the protection of vulnerable adults has been undertaken by most of the staff and is ongoing. Records of training were kept on their file. The manager also confirmed this in the AQAA form that was sent to us. Care Homes for Older People Page 17 of 26 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents live in clean,suitably adapted surroundings that are gradually being improved Evidence: The home has a well laid out enclosed garden to the front of the home that has plenty of seating. New flower beds have recently been added. Accommodation is provided on 3 floors and can be reached either by a lift or stairs. Downstairs there is one large lounge, a smaller lounge, a large dining room and a conservatory that is the designated smoking area. We saw that several new lounge chairs had been delivered on the day of our visit. Toilets were close by to bedrooms and lounge areas and they had a lock on the doors for privacy. We saw that the downstairs bathroom was in need of redecoration. The flooring was stained, the walls and door were marked and the hoist to the bath was badly marked. It was not a pleasant area for residents to relax when bathing. The flooring in one of the downstairs toilets was also marked. We did not look at all the bedrooms during this visit. The ones that we did look at had recently been redecorated. Some doors had recently been fitted with locks that had keys. This was for those residents who wanted to lock their doors when they left their Care Homes for Older People Page 18 of 26 Evidence: rooms. Some of the bedrooms looked quite sparse and they had low metal framed beds. This continues to give them an institutionalised feel. We were told that the management are continuing to undertake redecoration of the bedrooms, bathrooms and toilet areas. The radiators throughout the home were suitably covered and we were informed that thermostatic control valves were fitted to baths and showers. This reduces the risk of residents being harmed by protecting them from being burnt or scalded. The home was clean and there were no unpleasant smells. Disposable hand washing equipment (liquid soap and paper towels) was in place in bathrooms, toilets and bedrooms and disposable gloves and aprons were provided for the staff to wear. Providing this equipment helps to reduce the spread of infection and therefore helps to protect the residents health and wellbeing. Care Homes for Older People Page 19 of 26 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. Residents needs are met by caring, experienced staff that are suitably trained and safely recruited. Evidence: Inspection of the duty rotas and a discussion with staff and residents showed that there was enough staff on duty over a 24-hour period to meet the needs of the residents living at the home. Residents and relatives told us: The staff are very attentive and always there. As well as providing exceptional care they make all the residents smile and keep them occupied. The whole staff have been very supportive towards my family at this very difficult time. I do not think I could have come through this without their help and support. The information from the AQAA document sent to us, and the information that we looked at in the training file showed that 84 of the staff had obtained their NVQ level 2 or above in care. This exceeds the standard expected. The personnel files of 2 staff members were inspected to check on how they had been recruited. All were in order and these staff had been properly and safely employed. We did note that whilst management did undertake these checks, the recruitment procedure document needed to be amended to include what staff were to do in relation Care Homes for Older People Page 20 of 26 Evidence: to obtaining one of the initial police checks. These are called a POVA 1st. These are checks to show that prospective staff are not on a register of people who mistreat others. Management were also advised to put in place a system whereby they recorded the results of an applicants interview. Induction training is provided for all newly employed staff. This is to make sure that they understand what is expected of them and that people are cared for properly and safely. The information received from the AQAA document also told us about the training that the staff received. From a discussion with the manager and inspection of the records we saw that a wide range of appropriate and ongoing training in moving and handling, dementia care, safeguarding training, basic food hygiene, fire safety, health and safety, medicine management and other relevant topics are provided to staff at the home. 1 staff member commented that the training they received from the manager ensured that they understood clearly the importance of quality care. Care Homes for Older People Page 21 of 26 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 home is well managed and this ensures that the welfare of the residents is protected. Evidence: The registered manager has lots of experience in caring for the elderly and has been the manager of the home for 5 years. She has a management qualification and keeps herself regularly updated with training, both in management and care issues. We saw how the residents responded to her. Every resident we spoke to knew who she was and called her by her first name. It was obvious that they trusted her to sort out any little problems that they had. Staff spoke very positively of her and said that she was supportive, approachable and was very good at showing them how things should be done. Management have developed their own quality assurance system within the home so that they can regularly check on the care and facilities they provide. We discussed the Care Homes for Older People Page 22 of 26 Evidence: responsibilities that different staff members undertake. Whilst it has been the practice for the administrator to check the majority of practices, we discussed with the manager the fact that some of the areas of practice should be checked by the manager or senior care staff. Some of the areas that we felt needed to be checked on by the manager or senior care staff were: care plans, medicines, complaints and accidents. These are care issues that we feel need to be checked by care staff. The manager and the owner agreed that this was something that they would consider as they could see the reasoning behind it. In addition to checking the facilities within the home management also send out survey forms to the residents and their relatives, seeking their views on the facilities and services provided. The system for the safekeeping of residents money was satisfactory. This ensures that the residents money is kept safe. Individual records are made of all transactions and balances. Receipts are held for any purchases made and receipts are given to relatives when they deposit any money. Information received from the AQAA sent to us showed that the homes fixtures, fittings and equipment were properly maintained and regularly serviced. We looked at the fire log book and saw that the fire detection system, fire exits and emergency lighting was checked on a regular basis. This ensures the health and safety of the residents, staff and visitors to the home. Care Homes for Older People Page 23 of 26 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 24 of 26 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 1 2 19 33 Management need to continue with the redecoration and refurbishment of the environment. The responsibility for undertaking the checking of the quality of care issues should be delegated to senior care staff. Care Homes for Older People Page 25 of 26 Helpline: Telephone: 03000 616161 or Textphone: or 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) 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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