Care Home: Sunrise Operations Chorleywood Limited (Assisted Living)

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What the care home does well People are supported by a team of people who provide them with information and opportunities to visit and try out meals before they make their decision to move in. A new resident told us that it was ‘very good here’, there is a ‘lovely atmosphere’ and ‘staff were very attentive’. People enjoy the range of activities and entertainment that are arranged to take place during the day but also in the evening and at weekends which is very much appreciated. Sunrise Operations Chorleywood Limited (Assisted Living) DS0000069972.V376473.R01.S.doc Version 5.2 Some residents have taken the opportunity to have their well-behaved dogs living with them in this pet friendly environment. The dogs all appear to get on and other people enjoy the contact with them. The Assisted Living complex provides people with spacious living accommodation in elegant surroundings. People are able to invite guests for coffee and help themselves to supplies of coffee, tea, fruit juices, fruit and biscuits from the Bistro area which encourages a sociable atmosphere where people can maintain their independence. A resident told us “even if I come in at 11pm I can still sit here and have a coffee which is a nice way to round off the evening”. People are very positive about the staff who support them. People who completed surveys and those we spoke with during our visits described them as ‘lovely’, they ‘can’t do enough’, and ‘people are lovely’. The expert by experiences said ‘I spoke to many residents and the majority of them were very pleased to be staying at Sunrise and many had looked at several other homes before selecting Sunrise. The comments ranged from “the staff are so polite”, “everyone is so kind” to “I know I can no longer live at home but this is almost as nice”.’ What has improved since the last inspection? People have told us that the cleaning has improved. There are mixed views about the catering arrangements between those who enjoy more homely style cooking and people seeking a high quality restaurant style experience. The expert by experience said ‘I did stay for lunch which was perfectly acceptable home cooked food but I believe the residents are used to a much higher standard of cooking which is more likely to be found in a top class restaurant and that is why there are complaints’. To make sure people’s views are being heard residents are involved in discussions about the catering arrangements and menu choices. We also received very positive comments about the standard of catering. A reminder system has been put in place to make sure people who are on medicines who need regular blood tests receive them on time. We have been told a new system for analysing information received as a result of any concerns and complaints is being introduced. It will enable the company to monitor the effectiveness of their complaints process and identify any emerging trends that need to be addressed.Sunrise Operations Chorleywood Limited (Assisted Living)DS0000069972.V376473.R01.S.docVersion 5.2 What the care home could do better: People need to be confident that detailed plans of their care will be put in place, shortly after their arrival, and kept up to date during their stay. This is to make sure staff have the information they need to provide consistent care according to the individual’s needs and preferences. To make sure people are getting the medicines they need staff need to follow up any gaps in recording when they are identified the next time the person is due to have their medicines. The company need to put forward a formal application to register the current manager under the Care Standards Act as this is a legal responsibility. Care staff need regular one to one supervision with a senior member of staff to make sure they are promoting the aims of the service and their practice and personal development is discussed. Key inspection report CARE HOMES FOR OLDER PEOPLE Sunrise Operations Chorleywood Limited (Assisted Living) High View Chorleywood Rickmansworth Herts WD3 5TQ Lead Inspector Sheila Knopp Key Unannounced Inspection 8th July 2009 09:00 DS0000069972.V376473.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 Operations Chorleywood Limited (Assisted Living) DS0000069972.V376473.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 Operations Chorleywood Limited (Assisted Living) DS0000069972.V376473.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Sunrise Operations Chorleywood Limited (Assisted Living) High View Chorleywood Rickmansworth Herts WD3 5TQ 01923 287750 01923 287751 chorleywood.alc@sunriseliving.com www.sunrise-care.co.uk Sunrise Operations Chorleywood Limited Address Telephone number Fax number Email address Provider Web address Name of registered company Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Manager designate in post - registration with CQC required. Care Home 70 Category(ies) of Old age, not falling within any other category registration, with number (70) of places Sunrise Operations Chorleywood Limited (Assisted Living) DS0000069972.V376473.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 with Nursing - Code N to service users of the following gender: Either whose primary care needs on admission to the home fall within the following category: 2. Old age, not falling within any other category - Code OP The maximum number of service users who can be accommodated is: 70 22nd October 2007 Date of last inspection Brief Description of the Service: The Assisted Living Unit is on the ground and first floor of the purpose built Sunrise Senior Living complex at Chorleywood. The service, which was first registered as a care home in 2007, provides accommodation, support and care for 70 older people. Since our last inspection the home has been registered to provide nursing care. However at the time of this inspection the company had not started providing this service. Sunrise Senior Living manage the service on behalf of Sunrise Operations Chorleywood Ltd. The studio rooms, suites and apartments all have on suite facilities. Car parking spaces are available for residents and visitors at the front of the building. A lift provides access to all floors. There are landscaped gardens and a terrace to the rear of the building, which are accessible to people in wheelchairs. The home is situated in a semirural location, but close to junction 18 of the M25 motorway, near Chorleywood. Shops and amenities are a short distance away in the main town centre. Information, to help people in their choice of care home, in the form of a Statement of Purpose, Service User’s Guide, cost structure, complaints procedure and the latest inspection report, are available from the manager. Fees for accommodation range from £735 - £900 per week for suites. There are a number of larger two bedroom suites that range from £1200 to £1540 per week. The accommodation fees include care and assistance up to 30 minutes each day. The first additional hour of care is charged at £20 and thereafter £15 per hour. There is an additional one off Community fee paid Sunrise Operations Chorleywood Limited (Assisted Living) DS0000069972.V376473.R01.S.doc Version 5.2 Page 5 prior to a permanent move in. It is to cover the costs of maintaining the communal and out door areas of the home. It is refundable up to 30 days after move-in subject to the notice period set out on the Resident Agreement (contract). Sunrise Operations Chorleywood Limited (Assisted Living) DS0000069972.V376473.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 2 star. This means the people who use this service experience good quality outcomes. The information in this report is based on an unannounced visit to the Sunrise Assisted Living service by one inspector between 09:25 and 19:05. An ‘expert by experience’ was present for part of this inspection. An expert by experience is someone who has been recruited by an independent organisation, such as Age Concern, to visit a service with an inspector. They have shared experiences or knowledge to help them get a picture of what it is like to live in or use the service. Experts by experience are involved in inspections to encourage people who use care services to share their experiences more openly. To make sure we include a range of views in this inspection we made 20 survey forms available to residents and 10 staff. We received completed surveys from 11 residents and 3 members of staff. We have also reviewed the information we have received since our last review of this service. This includes notifications services are required to send us about events within the home and people who have contacted us directly to give us their views. The service has a new manager, Clare Jackson, who was present for part of our visit. Regina Heneghan, the Executive Director of services at Chorleywood, was also present. People looking to move into the Sunrise Senior Living Complex at Chorleywood need to be aware that the company are not currently providing a nursing service and are applying to have this category removed from their registration certificate. What the service does well: People are supported by a team of people who provide them with information and opportunities to visit and try out meals before they make their decision to move in. A new resident told us that it was ‘very good here’, there is a ‘lovely atmosphere’ and ‘staff were very attentive’. People enjoy the range of activities and entertainment that are arranged to take place during the day but also in the evening and at weekends which is very much appreciated. Sunrise Operations Chorleywood Limited (Assisted Living) DS0000069972.V376473.R01.S.doc Version 5.2 Page 7 Some residents have taken the opportunity to have their well-behaved dogs living with them in this pet friendly environment. The dogs all appear to get on and other people enjoy the contact with them. The Assisted Living complex provides people with spacious living accommodation in elegant surroundings. People are able to invite guests for coffee and help themselves to supplies of coffee, tea, fruit juices, fruit and biscuits from the Bistro area which encourages a sociable atmosphere where people can maintain their independence. A resident told us “even if I come in at 11pm I can still sit here and have a coffee which is a nice way to round off the evening”. People are very positive about the staff who support them. People who completed surveys and those we spoke with during our visits described them as ‘lovely’, they ‘can’t do enough’, and ‘people are lovely’. The expert by experiences said ‘I spoke to many residents and the majority of them were very pleased to be staying at Sunrise and many had looked at several other homes before selecting Sunrise. The comments ranged from “the staff are so polite”, “everyone is so kind” to “I know I can no longer live at home but this is almost as nice”.’ What has improved since the last inspection? People have told us that the cleaning has improved. There are mixed views about the catering arrangements between those who enjoy more homely style cooking and people seeking a high quality restaurant style experience. The expert by experience said ‘I did stay for lunch which was perfectly acceptable home cooked food but I believe the residents are used to a much higher standard of cooking which is more likely to be found in a top class restaurant and that is why there are complaints’. To make sure people’s views are being heard residents are involved in discussions about the catering arrangements and menu choices. We also received very positive comments about the standard of catering. A reminder system has been put in place to make sure people who are on medicines who need regular blood tests receive them on time. We have been told a new system for analysing information received as a result of any concerns and complaints is being introduced. It will enable the company to monitor the effectiveness of their complaints process and identify any emerging trends that need to be addressed. Sunrise Operations Chorleywood Limited (Assisted Living) DS0000069972.V376473.R01.S.doc Version 5.2 Page 8 What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line – 0870 240 7535. Sunrise Operations Chorleywood Limited (Assisted Living) DS0000069972.V376473.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 Operations Chorleywood Limited (Assisted Living) DS0000069972.V376473.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): Standards 1,2, 3, 4 & 5 (standard 6 does not apply to this service) 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. People looking to move into the assisted living apartments, are provided with detailed information about the fee structure and contractual arrangements so they are able to decide whether the service is right for them People are assessed by experienced staff before they move in. This is to make sure they or someone close to them has been able to discuss their individual needs and preferences and the service will be able to meet their needs. EVIDENCE: To look at the experience of people who choose to come and live within the assisted living complex we met with two people who had recently moved in. We have also reviewed the information people gave us in their surveys. Sunrise Operations Chorleywood Limited (Assisted Living) DS0000069972.V376473.R01.S.doc Version 5.2 Page 11 This told us that people had been involved in an assessment of their needs before they came to stay so the manager can be sure staff will be able to meet their needs and the home was suitable for them. It also means the manager can identify any specialist equipment people may need on their arrival. In one case we saw that an adjustable bed and equipment to reduce the risk of pressure sores had been provided. A letter confirming the service will be able to meet their needs is sent out to people before they come and stay. The expert by experience gave their first impressions of the service and said ‘I did notice that there was a very pleasant, warm atmosphere within the home and many residents were sitting in the communal area reading papers and interacting with each other’. The Sunrise Community relations team spend time with people enquiring about the service and provide a detailed ‘Moving in Pack’. They anticipate that individuals and their relatives will have several meetings and visits to the home to discuss the services offered and have a meal. Ninety percent of people who completed our surveys said they had received a contract and enough information to help them in their choice. The people who had recently come to stay had contracts in place clearly, setting out accommodation charges and the cost of their care package. A resident commenting on choosing the home said they had a ‘good positive experience when being shown round’. Thirty days after admission ‘Family Meetings’ are arranged to review the service and care arrangements. If the level of care provided needs to be increased or decreased this is subject to agreement by both parties. Sunrise Operations Chorleywood Limited (Assisted Living) DS0000069972.V376473.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): Standards 7, 8, 9, & 10 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 are provided with the personal care they need in a manner which respects their privacy and dignity. However people need to be confident that a detailed plan of their care is available for staff to refer to at all times, so staff are aware of the current needs and preferences that have been agreed. People can be confident that there are safe systems in place to make sure they have the medicines they need or support then to continue to manage their own medicines if it is safe to do so. However the auditing procedures need tightening up to make sure any gaps in people signing for the medicines given are followed up more quickly. EVIDENCE: We had discussions with people about the care and support they are receiving and reviewed the information staff record on the assessment of people’s needs Sunrise Operations Chorleywood Limited (Assisted Living) DS0000069972.V376473.R01.S.doc Version 5.2 Page 13 and the care they provide. The systems for making sure people have the medicines they need were also reviewed. Each person has an assessment of their needs which is developed into an Individual Service Plan (care plan) following their admission. The plan details how specific needs will be managed and includes regular reviews and updates. However a recent service wide review of people’s care needs had stretched resources and a number of the records we needed to look at were not available as they were being retyped. This also meant staff did not have the information available to refer to. We did not identify any unmet care needs as a result of this and have been told additional resources have been allocated to speed up this process and ensure updated care plans are available. This issue had been identified in the monthly monitoring reports completed by senior representatives of the company; therefore we have not taken any further action at this stage. People are positive about the personal care and support they receive from staff. People who need nursing care are supported by Community Nurses who visit them. Information passed between staff and the community nurses is recorded in a communication book to make sure nothing gets missed. Arrangements are made for regular visits by a local GP to hold a surgery. The practice also responds to requests for visits at other times. We are told that staff make people aware of their right to NHS as well as private services. One person raised concerns about their hearing aid which we passed on to the manager. There are systems in place to monitor people’s dietary needs, including food and fluid intake, when extra monitoring is required. People’s risk of developing pressure sores is assessed and appropriate equipment provided. At the time we visited the community nurses were treating one person for a pressure sore that had occurred while they were in hospital. Sunrise employ ‘Wellness’ nurses during the working day to carry out monthly health checks and liaise with medical services. The senior nurse monitors any accidents and incidents that are recorded. Following a notification the manager made to us earlier in the year, that identified a resident had not received a blood test they needed, a reminder system has been put in place to make sure dates are followed up as letters are sent directly to residents who may not pass them on. The senior care staff, involved in giving out medicines, receive training and their practice is observed before they are allowed to do it. Each person has a locked medication cupboard within their suite. Medicines are administered by staff when people do not wish to do this for themselves or have been assessed Sunrise Operations Chorleywood Limited (Assisted Living) DS0000069972.V376473.R01.S.doc Version 5.2 Page 14 as not being able to. There are additional fees for people who need to have their medicines administered by staff. There are clear systems in place for ordering, recording and auditing the medicines given. However we have advised that staff identifying a gap in recording need to take action to investigate the reason for this as soon as it becomes known rather than waiting for the weekly audit. For example recording on the back of the chart that the medicine has been given but the carer has not signed the chart. This was the case with the gaps we identified. The senior Wellness nurse said they would take this on board. The day after our inspection we were contacted by an individual who raised concerns about medicines running out. We are aware that, following notifications about drug discrepancies, additional auditing systems have been put in place to address medication issues. Sunrise Operations Chorleywood Limited (Assisted Living) DS0000069972.V376473.R01.S.doc Version 5.2 Page 15 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): Standards 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. People are able to take part in a range activities and events that provide opportunities for entertainment, stimulation, social interaction, exercise and visits outside the complex. People are provided with a varied menu to choose from so they are able to have meals they like in the well appointed dining room or their own suites as they wish. People are being involved in discussing the meal time arrangements, so they can give their views on an area which has become an important focus for people living within the complex. EVIDENCE: A colourful monthly news sheet provides people with information about activities and events in the home, minibus trips, church services and special Sunrise Operations Chorleywood Limited (Assisted Living) DS0000069972.V376473.R01.S.doc Version 5.2 Page 16 celebrations. Minutes of any resident ‘Council’ meetings are also included so people know what was discussed. A new resident told us they had enjoyed attending the poetry group. A resident who completed a survey said there was an ‘excellent programme of activities’, ‘a real effort is made to make seasonal events special with all members of staff contributing. Another person commenting on activity arrangements told us they were’ good fun’. The expert by experience observed ‘that the activities co-ordinator was held in high esteem by many residents and was told that “she always does her best to find us things to do” and “she is always so cheerful”. Ninety percent of people who completed surveys said there were always or usually activities they could take part in. Two people agreed they hardly ever put the TV on there was so much to do. The expert by experience told us ‘it was very pleasant to see so many of the residents interacting with each other and enjoying each others company. Several of the residents that I visited in their rooms had other residents with them who had just “popped in for a chat”. There are opportunities to attend exercise sessions as well as quizzes and musical events. The expert by experience said ‘the activities programme seemed to be quite varied and I noticed there were many activities being organised e.g. a tea dance, a visit to the aquadrome, a trip to the library and a river trip on a narrow boat’. A resident who completed a survey said they would like to see a mobile library service or more books to be provided. People can freely use the activity room on the first floor where there are lots of things to do. Entertainment and activities are also held in the evening which provides people with opportunities to get together at different times. Residents are also involved in running a shop so people can purchase items and visiting retailers display their wares so people can purchase items such as handbags and jewellery. Visitors are welcome and can use the bistro area to have drinks with their friend or relative. Arrangements can be made to book meals or rooms for special family events and celebrations. A resident who completed a survey told us it was ‘good to see a few events each year that family and friends are invited to attend’. Information in the May newsletter indicated that meals have become a focus of discussion among residents. Separate dining service meetings have been set up to discuss meal time arrangements with the executive director and chef. Discussions were wide ranging with residents giving their own ideas about what they would like to see on the menu and raising issues. On the day we visited people were offered a choice from the menu of the day and wine as they arrived at their table. The meals were nicely presented and people were offered choices of gravy and condiments to go with it. People told us about Sunrise Operations Chorleywood Limited (Assisted Living) DS0000069972.V376473.R01.S.doc Version 5.2 Page 17 their individual preferences and what they looked forward to. Someone said they had specifically sent compliments to the chef following a Sunday roast. Another person said the home made cakes were very good. One person who completed a survey said ‘If there is nothing on the menu to interest you they are only too happy to make you something else’. Quality checks are carried out on meals before they are served and residents are invited to comment on each meal. People were given sensitive assistance to eat their meal where they needed support. The catering service received a 5 Star food hygiene rating from the local Environmental Health department. Sunrise Operations Chorleywood Limited (Assisted Living) DS0000069972.V376473.R01.S.doc Version 5.2 Page 18 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): Standards 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 can be confident that they will be listened to and any concerns they have will be addressed. The company are taking action to introduce a system which will enable managers to review information collected as a result of concerns and complaints to identify any emerging themes or trends at an early stage. People can be confident that there are processes in place to make sure staff understand their responsibilities to protect people from harm and report any concerns. EVIDENCE: The people we spoke to and those who completed our survey were very confident they would be able to make a complaint or raise concerns if they needed to. Inspectors have raised concerns regarding the way complaints are recorded within Sunrise Services. We have now been advised that a company wide computer system is being installed, which will require managers to log complaints and concerns arising out of formal complaints, comments and Sunrise Operations Chorleywood Limited (Assisted Living) DS0000069972.V376473.R01.S.doc Version 5.2 Page 19 individual family meetings. This will enable the company to identify and respond to emerging themes and concerns that they need to know about to maintain good standards for people living within their services. However this meant for the purposes of this inspection, we were unable to review the range of comments, concerns and complaints being received about the service, particularly if they are directed to the company head office or arise during individual review meetings with families. Staff receive training in promoting a positive culture that protects people and supports their dignity. This includes protecting people from harm and reporting any concerns they may have. The manager has reported issues under the Hertfordshire Safeguarding Adult procedure where concerns have been raised and worked with the local authority responsible for managing and investigating issues to achieve positive outcomes for the individuals concerned. Sunrise Operations Chorleywood Limited (Assisted Living) DS0000069972.V376473.R01.S.doc Version 5.2 Page 20 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): Standards 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. People moving into the Senior Living Complex at Chorleywood are provided with spacious accommodation that they move their own furniture and belongings into, as well as extensive communal areas and landscaped gardens they can use freely. People can be confident that good standards of hygiene are in place to provide a fresh clean environment to live in. EVIDENCE: The expert by experience told us ‘the home is very spacious, clean and very attractively decorated and it would appear is maintained to a very high standard’. Sunrise Operations Chorleywood Limited (Assisted Living) DS0000069972.V376473.R01.S.doc Version 5.2 Page 21 The unfurnished rooms are decorated before people move their own furniture and furnishings in, ahead of their stay. A detailed record, including photographs of precious items, is recorded when people arrive to protect people’s property. All the areas we visited were fresh, clean and odour free. The arrangements for accommodation include a weekly room clean. In between times, the staff providing personal care carry out daily checks on cleanliness and empty bins. We have received comments about bins not being emptied at times when care staff were stretched. The care staff attend to people’s personal laundry. People are also able to do their own if they wish. On the lower ground floor there is an industrial scale laundry for bed linen and items that require a sluice wash or high washing temperatures to prevent infections. We have asked the manager to make sure the satellite laundry rooms have liquid soap and disposable hand towels available, so good hand hygiene to prevent the spread of infection can be maintained. Staff and residents had good access to these items in other areas of the home. Sunrise Operations Chorleywood Limited (Assisted Living) DS0000069972.V376473.R01.S.doc Version 5.2 Page 22 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): Standards 27, 28, 29, 30 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 will benefit from the recent increase in care staffing levels to support their changing needs. People can be confident that there are robust recruitment procedures in place to make sure suitable staff are employed within the service. People can be confident that staff receive the training they need to support their roles within the home and develop their skills over time. EVIDENCE: We are aware there has been a recent review of staffing levels, based on the dependency of people receiving a personal care service. We have been told that additional hours for care staff have been agreed and noted that agency staff were being used to support this while permanent staff are recruited. Ninety percent of residents who completed our survey confirmed that staff listened to them. Sixty percent said staff were usually available when needed. Forty percent staff were always available when needed. Sunrise Operations Chorleywood Limited (Assisted Living) DS0000069972.V376473.R01.S.doc Version 5.2 Page 23 The staff we observed were sensitive and discrete in the way they supported people during the day. In addition to the care staff people living within the complex are supported by the activity, hotel services, catering and maintenance staff who they will have regular contact with during the course of the day. One person commented on the extra little things staff do that are appreciated. They gave the example of care staff putting on a ‘pampering’ evening. Regular supervision of care staff has not been taking place. This was reported to be due to the impact of resident dependency levels that stretched staffing resources. The manager is aware of the need to put a monitoring system in place to make sure regular supervision takes place. We looked at the recruitment records for 4 staff and were able to confirm that the required checks on their working history and criminal records had been carried out. New staff gain experience by shadowing staff and there are structured systems in place to make sure they receive an induction. Care staff progress on to National Vocational Qualification (NVQ) training in care practices. The qualifications of nurses employed within the complex to carry out health checks are confirmed with the Nursing & Midwifery Council, to make sure they are currently registered to practice. Information is also available on the recruitment checks carried out on agency staff working in the home. Sunrise Operations Chorleywood Limited (Assisted Living) DS0000069972.V376473.R01.S.doc Version 5.2 Page 24 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): 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 can be confident that management resources are in place to monitor the quality of the service, listen to the views and experiences of people using the service and maintain their safety. So that people living in the home can be confident that the staff employed are accountable for the work they do, Sunrise Senior Living need to apply to register the current manager with the Care Quality Commission and ensure care staff receive regular formal supervision. EVIDENCE: Sunrise Operations Chorleywood Limited (Assisted Living) DS0000069972.V376473.R01.S.doc Version 5.2 Page 25 The current manager, who is a registered nurse, has been in post for over 6 months but the Care Quality Commission has not yet received an application to register them under the Care Standards Act as required. As part of its approach to quality assurance, an inspection will be carried out over several days by the parent company. Sunrise commission external consultants (Gallop) to send out and review surveys from residents, relatives and staff, to get their views on the service being provided. This is to enable people to remain anonymous and provide an impartial service. There are also various forums within the complex for people to give their views through resident and relatives meetings, staff meetings and heads of department meetings. Feedback is given to people living in the complex through the monthly newsletter, which is also sent to relatives to keep them in touch. Detailed monthly reports on the quality of the service are also completed by senior Sunrise managers visiting the service. The last report completed on 18/6/09 identified the care planning issues we saw and gave timescales for completion, so progress could be monitored and people held accountable. People are able to deposit up to £200 in the communities safe and records of transactions are recorded and signed by the resident and the Business Office Coordinator. A record of any valuables deposited for safekeeping is kept. Staff receive training in safe working practices which include moving and handling and first aid. There are detailed records of the risk assessments, maintenance and servicing schedules in place to ensure people are living and working is a safe environment. These include safety of hot surfaces, hot water, windows above ground level, moving and handling equipment, fire safety and fire drills. Sunrise Operations Chorleywood Limited (Assisted Living) DS0000069972.V376473.R01.S.doc Version 5.2 Page 26 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 4 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 x 18 3 4 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 x 3 x 3 2 x 3 Sunrise Operations Chorleywood Limited (Assisted Living) DS0000069972.V376473.R01.S.doc Version 5.2 Page 27 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. Refer to Standard OP36 Good Practice Recommendations 2. Formal regular supervision should be provided at least six times a year so that care staff are supported in maintaining a high standard of care and safe practices. Sunrise Operations Chorleywood Limited (Assisted Living) DS0000069972.V376473.R01.S.doc Version 5.2 Page 28 Care Quality Commission Care Quality Commission East Region 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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