Care Home: Sunrise of Westbourne, Reminiscence Neighbourhood

What the care home does well The Reminiscence Neighbourhood provides sensitive, kind and appropriate care to people with dementia and memory impairment. The premises are clean, spacious, light, comfortably furnished and well equipped. Staff are properly recruited and checked for suitability, and receive training to ensure their competency and understanding of the work they carry out. The registered manager is enthusiastic about the care of people of dementia and highly skilled in this work, providing an excellent role model for staff. The programme of recreational and social activities is varied and frequent, comprising small group and one-to-one activities designed to suit the differing preferences of each resident. Food provision is of high standard, with a choice of food available at every meal, and flexible mealtimes. What has improved since the last inspection? The home has an ongoing programme of maintenance and refurbishment, to ensure that the condition of the premises does not deteriorate. The provider organisation operates a comprehensive process of assessment and audit of all aspects of the home, to effectively monitor standards and as necessary, to promptly carry out improvements. The Reminiscence Neighbourhood has recently extended from the top floor, to include part of the second floor, which it shares with the separately registered Assisted Living Neighbourhood. What the care home could do better: This report contains no requirements for improvement; the National Minimum Standards are met and exceeded.Sunrise of Westbourne, Reminiscence NeighbourhoodDS0000066196.V376877.R01.S.doc Version 5.2 Key inspection report CARE HOMES FOR OLDER PEOPLE Sunrise of Westbourne, Reminiscence Neighbourhood 16-18 Poole Road Westbourne Bournemouth Dorset BH4 9DR Lead Inspector Gloria Ashwell Key Unannounced Inspection 5th August 2009 10:00 DS0000066196.V376877.R01.S.do c Version 5.2 Page 1 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care homes for older people can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop. The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Sunrise of Westbourne, Reminiscence Neighbourhood DS0000066196.V376877.R01.S.doc Version 5.2 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Sunrise of Westbourne, Reminiscence Neighbourhood DS0000066196.V376877.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Sunrise of Westbourne, Reminiscence Neighbourhood 16-18 Poole Road Westbourne Bournemouth Dorset BH4 9DR 01202 760966 01202 762130 westbourne.rc@sunriseseniorliving.com Address Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Sunrise Operations Westbourne Limited Lynne Carol Petty Care Home 45 Category(ies) of Dementia - over 65 years of age (45) registration, with number of places Sunrise of Westbourne, Reminiscence Neighbourhood DS0000066196.V376877.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home providing personal care only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: 2. Dementia, over 65 years of age - Code (DE(E) The maximum number of service users who can be accommodated is 45. 14th August 2007 Date of last inspection Brief Description of the Service: Sunrise Senior Living Limited was developed in the United States of America and now operates across the United States and in Canada, Germany and the United Kingdom. The Sunrise establishments are known as ‘Sunrise Senior Living Communities’. The Community at Westbourne in Bournemouth provides two types of service within the same establishment, an ‘Assisted Living Neighbourhood’ and a ‘Reminiscence Neighbourhood’. The Assisted Living Neighbourhood is located on the ground and first floor, and shares part of the second floor with the Reminiscence Neighbourhood. The Reminiscence Neighbourhood, the subject of this report, is situated on the second and third floors. It is a Care Home for people with dementia or memory impairment. There are stairways and two lifts and entry is by coded keypad. The Community is accessible to people with mobility difficulties, including wheelchair users. Bedrooms are single with en suite hygiene facilities; for people who want to share there are companion suites with two bedrooms, a shared bathroom and kitchenette. Communal areas include a kitchen, lounge, dining room and multi sensory room. The wide corridors have alcoves and areas where people may sit or use the memorabilia items available throughout the home. There is an outside terrace area on the top floor, and a ground floor garden shared with the Assisted Living Neighbourhood. (Most residents need staff to Sunrise of Westbourne, Reminiscence Neighbourhood DS0000066196.V376877.R01.S.doc Version 5.2 Page 5 accompany them when using the ground floor garden.) The home is staffed to provide 24-hour personal care. Laundering of personal clothing and household linen is carried out on the premises. All meals are prepared and cooked within the Community. A choice of menu is offered at meal times, with a variety of alternatives available to suit individual taste and preference. A range of activities is available every day and there are regular opportunities for outings. The organisational structure includes a Wellness Co-ordinator, responsible for health and medication, and a Maintenance Co-ordinator, responsible for cleanliness and health and safety issues including fire safety. The Community is close to Westbourne and within a short journey of Bournemouth town centre and the seafront. There is plenty of on-site car parking. The fee range quoted in the service user guide at the time of this inspection was between £850 and £1400 per week. These fees include up to 3 hours care per person per 24 hour period, and include any staff time taken up by handling medicines for the resident. If more personal care staff time is required a separate charge is made. Up to date information on fees is available from the care home. Additional charges apply for hairdressing, chiropody, newspapers, personal toiletries etc. Sunrise of Westbourne, Reminiscence Neighbourhood DS0000066196.V376877.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 3 star. This means the people who use this service experience excellent quality outcomes. This was a statutory inspection required in accordance with the Care Standards Act 2000. Throughout the report the term we is used, to show that the report is the view of the Care Quality Commission. This inspection was unannounced; the regulation inspector arrived at 10:00 on 4 August 2009 and spoke with the registered manager to plan the visit. Later that morning the inspector was joined by an Expert-by-experience, supplied by the support organisation Help the Aged. The expert-by-experience toured the premises and spoke to residents, visitors and staff, and observed staff interaction with residents and the carrying out of routine tasks, while the inspector and the registered manager Mrs Petty discussed and examined documents regarding care provision and management of the home. On 12 August 2009 a Pharmacy Inspector from the Care Quality Commission visited the home and inspected arrangements for medicines handling. This report includes the findings of the expert-by-experience, regulation inspector and pharmacy inspector. The duration of the inspection was 8 hours. During the inspection, particular residents were ‘case tracked’; for example, for evidence regarding Standards 3, 7 and 8, records relating to the same residents were examined and the residents spoken with. In advance of the inspection an Annual Quality Assurance Questionnaire was completed by Mrs Petty and returned to the Commission; the information it contained has been used to inform the findings of this inspection. During this inspection compliance with all key standards of the National Minimum Standards was assessed. Sunrise of Westbourne, Reminiscence Neighbourhood DS0000066196.V376877.R01.S.doc Version 5.2 Page 7 What the service does well: The Reminiscence Neighbourhood provides sensitive, kind and appropriate care to people with dementia and memory impairment. The premises are clean, spacious, light, comfortably furnished and well equipped. Staff are properly recruited and checked for suitability, and receive training to ensure their competency and understanding of the work they carry out. The registered manager is enthusiastic about the care of people of dementia and highly skilled in this work, providing an excellent role model for staff. The programme of recreational and social activities is varied and frequent, comprising small group and one-to-one activities designed to suit the differing preferences of each resident. Food provision is of high standard, with a choice of food available at every meal, and flexible mealtimes. What has improved since the last inspection? What they could do better: This report contains no requirements for improvement; the National Minimum Standards are met and exceeded. Sunrise of Westbourne, Reminiscence Neighbourhood DS0000066196.V376877.R01.S.doc Version 5.2 Page 8 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line – 0870 240 7535. Sunrise of Westbourne, Reminiscence Neighbourhood DS0000066196.V376877.R01.S.doc Version 5.2 Page 9 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 Sunrise of Westbourne, Reminiscence Neighbourhood DS0000066196.V376877.R01.S.doc Version 5.2 Page 10 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 3&6 People using the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prior to admission, the needs of each proposed resident are thoroughly assessed to ensure the home will be properly able to meet them. EVIDENCE: Individual care records are kept for each resident and four of these were examined. All showed that, prior to moving to the home, care needs had been fully assessed to identify any potential risks, such as a history of falls, and the steps needed to minimise them on admission. Wherever possible details of the prospective resident’s usual routine over a 24-hour period are recorded, including for example when they choose to go to bed, what they prefer to wear in bed, when they like to get up, their favourite meals etc. This information Sunrise of Westbourne, Reminiscence Neighbourhood DS0000066196.V376877.R01.S.doc Version 5.2 Page 11 will help the resident settle into the Reminiscence Neighbourhood more easily on admission. Prospective residents or their representatives are also invited to complete a Residents Profile to provide information about their life story, family background and social preferences. With consent, a doctor’s report is also requested so that relevant health information can be incorporated into the care plan. The full care plan is developed from the findings of the various assessments. Prospective residents and their relatives or representatives are invited to visit the Reminiscence Neighbourhood, to look around, perhaps enjoy a meal, meet with the manager, staff and other residents and ask any questions before making a decision about whether or not to move in. At this point, discussions are held about whether the prospective resident wishes to fully or partly furnish their own room or use the furniture provided by the home. A months trial period is available to help ensure the placement will be successful. Copies of the Statement of Purpose and Service User Guide are provided to each resident and their relatives or representative. Following the pre-admission assessment, a letter of confirmation is written to assure the prospective resident (or their relatives or representative) that the home can meet their needs. Sunrise of Westbourne, Reminiscence Neighbourhood DS0000066196.V376877.R01.S.doc Version 5.2 Page 12 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 People using the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and social care needs of residents are met by suitably trained staff; doctors and other professionals visit as necessary and residents receive the medicines they have been prescribed. The standard of care is excellent and in accordance with each persons individual needs. EVIDENCE: We combined the information we obtained from the documents we read, with the things we saw taking place in the home during our inspection, and with what we were told by staff and visitors. This provided evidence that the standard of care is excellent, with the frequently complex and changing needs of residents properly managed by Sunrise of Westbourne, Reminiscence Neighbourhood DS0000066196.V376877.R01.S.doc Version 5.2 Page 13 competent and caring staff who skillfully combine meeting the physical needs of people with consideration for their individuality and emotional and social needs. The care records of 6 people who live at the home were examined and found to contain risk assessments forming the basis for care plans and daily records describing the care of each person. There was evidence that individual residents or their representatives had been involved in the development and review of planned care provision. For some people who are known to be at risk of accidental falling, alarm mats are used to alert staff when they get out of bed at night. The potential risks associated with the mats have been assessed, and the care plans refer to the use of the mats, but to further improve the standard of documentation and to ensure that these monitoring devices are correctly used it is recommended that the assessment include evidence that alternative methods of reducing the falling risk have been considered, and the consent of the resident or their representative obtained to the use of the alarm mat. Medicine handling is carried out by staff trained in this work. Medication records were properly kept indicating that residents receive prescribed medicines at the correct times and in correct amounts. We watched them give medicines to residents at lunchtime and saw that system was safe; staff followed procedures but managed to give everyone the time and individual attention they needed. The information about medicines and medicine audits was good. There were individual medication profiles and protocols to support staff in the use of medicines prescribed ‘As required’. These protocols told care staff what the medicines were to be used for, for example for agitation, and the maximum dose to be given but did not give them sufficiently detailed information to allow them to make a consistent decision about when to give them. An associated recommendation is included in this report. Residents spoken to during the inspection said they are treated with respect and their privacy and dignity is protected at all times. Sunrise of Westbourne, Reminiscence Neighbourhood DS0000066196.V376877.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 People using the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents have extensive opportunities to engage in social and recreational activities and are encouraged and supported to pass the time according to individual preference. A choice of menu is provided and meals are nutritional and appetizingly served. EVIDENCE: The Expert-by-experience assessed the standards of daily life with particular regard to choices, social activities, and times of getting up and going to bed. As many of the residents have some form of memory impairment or dementia time was spent observing the interaction between staff and residents to find out dignity is maintained and residents choices are met. Time was also spent Sunrise of Westbourne, Reminiscence Neighbourhood DS0000066196.V376877.R01.S.doc Version 5.2 Page 15 talking with three residents and two sets of relatives who were visiting at the time, and with the activities coordinator and assistant. Sunrise Reminiscence Neighbourhood is situated in a purpose built building on a busy road leading into Bournemouth town centre. The Reminiscence Neighbourhood has been divided, with people in the earlier stages of dementia on the middle floor and those with more advanced memory loss on the third floor. One relative commented that he thought it had been an improvement, in that there was more space, and that residents with less memory loss were not frustrated by those with more challenging behaviour. The environment on both floors was very homely with warm colours, and all was very clean with no lasting odours anywhere in the building. Corridors and doorways were wide enough to allow wheelchairs and people to pass with no need to wait, and there were a number of different areas where people could sit so that no-one needed to feel crowded. Throughout the two floors there were points where different forms of memorabilia e.g. wedding outfits, work tools, baby’s cot and clothes etc. were located. A resident was seen taking an item of baby clothes and folding it into a tight bundle and happily walking off with it in her hand. Another resident had a baby doll carefully wrapped in a bag on the bars of her walking aid. There is a terraced, safely enclosed garden on the third floor, and a garden on the ground floor which could be made secure for residents to safely wander and sit. Each resident has a box outside their rooms with their own photos and personal memorabilia and a brass name plaque to help them identify their own rooms. New residents are encouraged to bring possessions and furniture to make their room as much like home as possible. There were plenty of staff to deal with any occurrences, which led to a calm atmosphere, as any issues between residents were quickly diverted. One resident who was repeatedly banging the table was given a brightly coloured soft, feely toy, which diverted her from banging, and one person who had a toileting accident was quickly and calmly taken off to be changed. At all times staff responded warmly and calmly to residents, using physical touch with those who welcomed it. Visitors said they were always made welcome and could stay for meals, as well as make drinks, toast etc for the person they were visiting. Those residents and visitors we spoke with had nothing but praise for the staff. Visitors told us they were always kept well informed of any occurrences at the home and encouraged to go on trips or go to hospital with their relative if possible. On both floors of the home are small kitchenettes where drinks and snacks can be made at any time. Breakfast was clearly a very flexible occasion with people still being served anything from full cooked breakfast to toast at 11.00 a.m. Sunrise of Westbourne, Reminiscence Neighbourhood DS0000066196.V376877.R01.S.doc Version 5.2 Page 16 Fresh fruit was available for residents to help themselves and drinks were in plentiful supply. The menu for lunch was displayed in all areas, and the hot trolley brought from the main kitchens had sample choices of the hot meal laid out on plates so that they could be shown to residents who could best express choice by pointing. Staff checked temperatures of the hot food before serving, and on the day of inspection offered soup or prawns and salad as a starter, roast pork or mushroom gratinee and fresh vegetables as a main course, and a range of puddings to all residents, who were helped to eat by an individual member of staff as appropriate. Residents could choose where they ate, although most came to the dining room which seemed to be the main hub of activity. There are staff in the main kitchen throughout the day who can make a hot meal when it is required. Five different activities are provided each day in different parts of the home by a combination of the activities co-ordinator, activities assistant and volunteers. One volunteer comes in two days a week and others at differing times. Volunteers are CRB checked, and given three days training, covering POVA, lifting and handling and activities. Residents are taken from the 2nd and 3rd floors to join in activities with other residents when appropriate, but largely have activities adapted to their own needs. This includes some individual time such as manicures, massage or just being with a resident for those residents who prefer not to join group activities. There is a multi-sensory room and a trip out of the Home is organised on four days of the week, with all residents including users of wheelchairs and those with quite challenging behaviour included on these. One visitor said he often joined his relative on these trips. Activities staff meet with the Residents Committee once a month to ensure they are meeting needs and providing suitable variety. They also adapt activities according to information held in residents life histories to ensure individual needs and interests are met. Activity records are kept to show how people respond to different activities and those which are most or least enjoyed. Sunrise of Westbourne, Reminiscence Neighbourhood DS0000066196.V376877.R01.S.doc Version 5.2 Page 17 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 People using the 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 are confident their complaints would be listened to. Residents are safeguarded against risks of abuse in its various forms. EVIDENCE: The home has a complaints policy and procedure. From discussion with the registered manager and examination of records there was evidence that there is a reliable process ensuring that any complaints received would be competently managed to ensure that if weaknesses in service were identified they would be unlikely to recur. All staff receive training on the safeguarding of vulnerable persons and the home has a written policy and procedure for the protection of vulnerable adults. Sunrise of Westbourne, Reminiscence Neighbourhood DS0000066196.V376877.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 People using the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is comfortable, clean and well-maintained, and designed for the specific needs of the people for whom the service is intended. It provides an exceptionally high standard of accommodation. EVIDENCE: The Reminiscence Neighbourhood is situated on the second and third floors of the Community and is accessed by means of stairways or two lifts. To ensure the safety of residents, access is only by coded keypad at both entrances to the Reminiscence Neighbourhood. Sunrise of Westbourne, Reminiscence Neighbourhood DS0000066196.V376877.R01.S.doc Version 5.2 Page 19 The communal areas include well-equipped kitchens on each floor, for the preparation of snacks and drinks, in addition to activities such as cake baking, where residents can safely participate with staff supervision. The Reminiscence Neighbourhood has comfortable lounges, dining rooms and a multi-sensory room for relaxation. The wide corridors have numerous alcoves and areas where people may sit or use the memorabilia available throughout the Neighbourhood. For example, residents may try on different items of clothing, makeup or jewellery, or sit at a workbench with tools, or at a desk and use a typewriter or write letters. The environment is carefully arranged so that as residents walk around the Reminiscence Neighbourhood, the walls have sensory pictures and wall hangings for them to touch and enjoy. There is a furnished outside terrace area that residents may safely access at any time. Furniture and cushions are rain proof and quickly dry after a shower. Residents can also use the ground floor garden shared with the Assisted Living Neighbourhood, but are accompanied by staff when doing so. Each bedroom door displays a number and the name of the person living there. To further assist with identification, on the wall outside every bedroom is a memory box containing items of significance for each occupant. Bedrooms are single and all have en suite hygiene facilities. For those who wish to share there are companion suites with two bedrooms and a shared bathroom and kitchenette. Bedrooms exceed the minimum size requirement of 12 sq. metres. All electric sockets are placed at a height suitable for disabled residents. Lights in en suite facilities, toilets and bathrooms turn on automatically on entry. Adjustable beds are provided for residents with specialist care needs. Door locks are fitted so that residents may lock their doors but the lock automatically disengages if the door handle is turned to exit the room. Staff can gain entry from the outside with a key in an emergency. The Maintenance Co-ordinator ensures that cleaning staff work to a schedule that ensures every bedroom is cleaned thoroughly on a weekly rota, in addition to the daily tidying and emptying of waste bins etc. There were no unpleasant smells at the time of the inspection and the home was clean throughout. Household linen is laundered in the Community’s main laundry. Residents’ personal clothing is washed in the small laundry in the Reminiscence Neighbourhood. Each resident’s clothing is washed separately, for hygiene reasons and to help ensure that personal clothing is kept together and does Sunrise of Westbourne, Reminiscence Neighbourhood DS0000066196.V376877.R01.S.doc Version 5.2 Page 20 not get mislaid. Suitable facilities and procedures are in place for the disposal of clinical waste. Sunrise of Westbourne, Reminiscence Neighbourhood DS0000066196.V376877.R01.S.doc Version 5.2 Page 21 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 People using the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home employs enough staff to meet the needs of residents and to ensure their safety and comfort and maintenance of the good condition of the premises. Staff receive training for their work and in particular, training in dementia care is regularly and frequently provided, to ensure their understanding of this essential aspect. EVIDENCE: Staffing levels are provided in accordance with the assessed needs of residents to ensure that at all times sufficient staff are available to properly meet their needs. All staff spoken with during the inspection were enthusiastic about their work and felt that they provided a good standard of care to residents and are properly supported by the management and training provision. Sunrise of Westbourne, Reminiscence Neighbourhood DS0000066196.V376877.R01.S.doc Version 5.2 Page 22 The records of two recently employed staff members, and two volunteers, were examined and found to contain all essential information including written references and evidence of identity. Criminal Records Bureau (CRB) disclosures are obtained for all staff in advance of employment. There is a comprehensive induction process for all staff, designed to ensure their familiarity with all aspects of the home and a clear understanding of their responsibilities. All staff undertake and as necessary update training in core subjects including dementia care (training in this subject is provided by the registered manager for one day each month), fire safety, moving and handling, food hygiene and emergency aid. Sunrise of Westbourne, Reminiscence Neighbourhood DS0000066196.V376877.R01.S.doc Version 5.2 Page 23 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 People using the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is properly managed and operated in the best interests of service users. EVIDENCE: Registered manager Lynne Petty is a highly competent care worker and manager. She is liked and respected by staff and is familiar with each resident and their needs and circumstances. Sunrise of Westbourne, Reminiscence Neighbourhood DS0000066196.V376877.R01.S.doc Version 5.2 Page 24 The home has extensive systems for quality assurance; there is a regular Residents Meeting and reliable processes of audit and monitoring of all aspects, including care practice and record keeping, medicine handling, staff training, administrative and household aspects. There is a selection of clear and appropriate policy and procedure documents, ensuring that staff have available the necessary guidance and instruction. The home does not manage the personal finances of any resident, there are facilities for the temporary storage of monies and valuables which residents may no longer wish to personally hold. Staff trained in First Aid and health care are on duty in the home at all times. There are good processes for staff recruitment, induction and formal supervision. Records are kept of all accidents and there is subsequent review of the care plan and periodic audit to identify any trends e.g. time, place, person, activity. Records indicated that fire safety equipment is routinely checked and tested at the required frequencies and during the inspection a sample of records regarding equipment servicing and maintenance were examined and found to be in good order. There is a written assessment of the Health & Safety of the premises and working practices designed to ensure the continued safety of all who live in, work and visit the home. Sunrise of Westbourne, Reminiscence Neighbourhood DS0000066196.V376877.R01.S.doc Version 5.2 Page 25 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 X X 4 X X N/a HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 4 10 4 11 4 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 X 14 X 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 X X X X X X 4 STAFFING Standard No Score 27 3 28 X 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 4 X 3 X X 3 Sunrise of Westbourne, Reminiscence Neighbourhood DS0000066196.V376877.R01.S.doc Version 5.2 Page 26 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 OP8 Good Practice Recommendations The use of alarm mats should be in accordance with a risk assessment showing that alternative methods of reducing risk of falling have been considered, and that the consent of the resident or their representative to the use of the item has been obtained. Protocols for the use of medicines prescribed as required should contain sufficient information for staff to be able to give the medicine safely and consistently. 2. OP9 Sunrise of Westbourne, Reminiscence Neighbourhood DS0000066196.V376877.R01.S.doc Version 5.2 Page 27 Care Quality Commission Care Quality Commission Citygate Gallowgate Newcastle Upon Tyne NE1 4PA National Enquiry Line: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. 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