Care Home: Sunrise Operations Southbourne Limited

What the care home does well The home is well designed, attractively decorated and suitably furnished, providing a comfortable living environment. Meal provision is of high standard. Residents are offered a choice of all meals and food is nutritious and well presented. The following is a summary of the improvements recently implemented to meet requirements and recommendations of the key inspection report. We examined the pre admission records of two recently admitted residents and found that thorough assessment had been recorded in advance of their admission, to ensure staff had available the necessary information upon their arrival in the home. We noted that for new residents the home is properly recording personal information including dietary preferences, clothing, behaviour, sight, hearing, taste, touch and smell, to ensure that although the changes associated with dementia may prevent the person from expressing their preferences, the home is nonetheless aware of their previous likes and dislikes and can thereby continue to respect the individuality of each person. The registered manager, Mrs Cockwell, told us that audits of medicine handling are now carried out each week, and showed us the related records which provided evidence that the home has implemented a useful and well documented system, designed to quickly identify any weaknesses in the ordering, administration and recording of prescribed medicine handling. Mrs Cockwell has attended training to further develop her knowledge and understanding of current good practice in the care of people with dementia and a care worker has been appointed Activity Champion, to promote good practise in the provision of recreational and social activities. The practise of using staff employed by the Assisted Living home (located on the ground and first floors of the premises, and comprising a separately registered care home) has ceased, with the outcome that Mrs Cockwell now has authority over all the care staffworking in the home and has implemented processes for directing and formally supervising their work. The provider organisation carries out a visit of the home each month to monitor overall standards and a detailed record is kept of each visit. The policy and procedure for the management of complaints is being adhered to. A specialist company attends the home at least once each month to carry out thorough cleaning of any carpets which require this attention. What the care home could do better: We examined the records of 2 residents and found that the plans of care recorded by the home for these people were frequently inaccurate, providing misleading information to the staff caring for them, as described in the following examples. For one person the care plan was written on admission to the home and not updated during subsequent weeks to reflect the changing condition of the person which included pressure damage of areas of skin, insufficient food and fluid intake, development of an infection for which antibiotics were administered, and severe pain for which a Controlled Drug was administered. Some daily records of the care which had been provided to this person were very good, being clear and comprehensive, but others were vague and insufficiently detailed e.g. pressure sores, vomited, and no reference to the health professional who prescribed and administered the Controlled Drug. For the other person the records of assessment for the vulnerability to pressure related skin damage stated High Risk, but the care plan did not reflect this rating, and the outcome of the assessment for the risk of accidental falls was Extremely High Risk, but the care plan states No Risk. We examined records of recent medicine administration and found evidence that residents receive prescribed medicines as directed, but recommend that when directions for administration are handwritten the entry be signed and dated by the writer, and countersigned by a competent person to confirm the accuracy of the directions. We examined the records of two recently employed staff and found that one of these people had commenced work in the home in advance of a Criminal Records Disclosure being obtained without a related risk assessment having been recorded, and without clarification of the overseas worker visa conditions being known to the home. This report contains an associated recommendation. Random inspection report Care homes for older people Name: Address: Sunrise Ops Southbourne Ltd (Reminiscence Neighbourhood) 42 Belle Vue Road Southbourne Dorset BH6 3DS zero star poor service 18/02/2010 The quality rating for this care home is: The rating was made on: 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 review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Gloria Ashwell Date: 1 0 0 5 2 0 1 0 Information about the care home Name of care home: Address: Sunrise Ops Southbourne Ltd (Reminiscence Neighbourhood) 42 Belle Vue Road Southbourne Dorset BH6 3DS 01202437600 01202437601 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Eileen Mary Cockwell Type of registration: Number of places registered: Conditions of registration: Category(ies) : Sunrise Operations Southbourne Ltd care home 33 Number of places (if applicable): Under 65 Over 65 0 dementia Conditions of registration: 33 The maximum number of service users who can be accommodated is 33. The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: Dementia (Code DE) Date of last inspection Brief description of the care home The first Sunrise Community opened in the USA in 1981 and the Company has expanded both in the USA and, more recently in Europe. Sunrise provides care services to older people and has developed in the UK along the lines of the model operated in the USA. The first Sunrise community opened in South East London in Care Homes for Older People Page 2 of 11 1 8 0 2 2 0 1 0 Brief description of the care home 1998. Sunrise Operations Southbourne Ltd is a large purpose-built building set in its own grounds in a residential area of Southbourne, relatively close to a wide range of local amenities and the sea front. There is extensive vehicle parking to the side and a large landscaped garden with patio areas to the front and rear, and a roof garden exclusively forthe use of residents of the Reminiscence Neighbourhood (the subject of this report). Access to all parts of the building is via the reception area on the ground floor. The Reminiscence Neighbourhood specialises in the care of elderly people with dementia and comprises the second (top) floor of the building. On the ground and first floor levels is the Assisted Living Neighbourhood being a separately registered service operated by the same provider organisation. Private accommodation is provided by a variety of suites for single and shared occupancy. In total there are 18 rooms/suites for single occupancy and 8 suites potentially for shared occupancy. Every bedroom has en suite hygiene facilities including a toilet. All double suites are designed so that each of the two residents can have his/her own bedroom or share the bedroom and have a lounge. The home provides all meals, laundry and domestic services. Care Homes for Older People Page 3 of 11 What we found: This unannounced and focused inspection was carried out by two inspectors and was undertaken in order to view the homes progress towards meeting the requirements of the last key inspection which took place during February 2010 and determined the quality rating that this is a 0 star service, meaning that the people who use the service were experiencing poor quality outcomes. At that key inspection it was identified that arrangements for management of the home, social and health care practice and associated record keeping required improvement to ensure that residents receive the care they need from staff with sufficient skills and information to provide consistent and appropriate care, and to promote the safety and wellbeing of residents. In response to the inspection report the home developed an Improvement Plan, including timescales for the work they intended to carry out in order to effect the needed improvements. What the care home does well: The home is well designed, attractively decorated and suitably furnished, providing a comfortable living environment. Meal provision is of high standard. Residents are offered a choice of all meals and food is nutritious and well presented. The following is a summary of the improvements recently implemented to meet requirements and recommendations of the key inspection report. We examined the pre admission records of two recently admitted residents and found that thorough assessment had been recorded in advance of their admission, to ensure staff had available the necessary information upon their arrival in the home. We noted that for new residents the home is properly recording personal information including dietary preferences, clothing, behaviour, sight, hearing, taste, touch and smell, to ensure that although the changes associated with dementia may prevent the person from expressing their preferences, the home is nonetheless aware of their previous likes and dislikes and can thereby continue to respect the individuality of each person. The registered manager, Mrs Cockwell, told us that audits of medicine handling are now carried out each week, and showed us the related records which provided evidence that the home has implemented a useful and well documented system, designed to quickly identify any weaknesses in the ordering, administration and recording of prescribed medicine handling. Mrs Cockwell has attended training to further develop her knowledge and understanding of current good practice in the care of people with dementia and a care worker has been appointed Activity Champion, to promote good practise in the provision of recreational and social activities. The practise of using staff employed by the Assisted Living home (located on the ground and first floors of the premises, and comprising a separately registered care home) has ceased, with the outcome that Mrs Cockwell now has authority over all the care staff Care Homes for Older People Page 4 of 11 working in the home and has implemented processes for directing and formally supervising their work. The provider organisation carries out a visit of the home each month to monitor overall standards and a detailed record is kept of each visit. The policy and procedure for the management of complaints is being adhered to. A specialist company attends the home at least once each month to carry out thorough cleaning of any carpets which require this attention. 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 set out on page 2. Care Homes for Older People Page 5 of 11 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 2 5 The registered provider must 25/03/2010 include in the Service Users Guide details of the amounts of fees to be paid and in accordance with Schedule 4 must keep a record of the care homes charges to service users including any extra amounts payable for additional services not covered by those charges. To support these arrangements and ensure clarity of information to service users there should be available reliable evidence of the basis on which the fees have been calculated. At the random inspection on 10 May 2010 it was found that this requirement had not been met, so it is retained for compliance assessment at the next inspection. 2 7 15 The registered person shall prepare a written plan as to how the service users needs in respect of his health and welfare are to be met. This plan must include all relevant information and instruction to ensure that 30/04/2010 Care Homes for Older People Page 6 of 11 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action staff have available to them the information they need to provide consistent and appropriate care. At the random inspection on 10 May 2010 it was found that this requirement had not been met, so it is retained for compliance assessment at the next inspection. 3 8 3 The registered person shall 30/04/2010 so far as is practicable enable service users to make decision with respect to the care they are to receive and their health and welfare. This means that arrangements for end of life care, including considerations regarding resuscitation, shall be properly supported by a written policy and procedure which reflects and includes the associated legal aspects. At the random inspection on 10 May 2010 compliance with this requirement was not assessed, so it is retained for assessment at the next inspection. 4 9 13 The records for people who have to have their medicine administered covertly must be regularly reviewed and detail all the medicines that they take. This will ensure that the records accurately reflect the Care Homes for Older People Page 7 of 11 04/09/2009 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action current practice. At the random inspection on 10 May 2010 it was found that this requirement had not been met, so it is retained for compliance assessment at the next inspection. 5 30 18 The registered person shall 30/04/2010 ensure that persons working at the care home receive training appropriate to the work they are to perform. This means that to protect residents from harm all staff must be able to demonstrate their competency for the work they are employed to carry out and the registered person should periodically review and assess levels of competency. At the random inspection on 10 May 2010 compliance with this requirement was not asssessed, so it is retained for assessment at the next inspection. 6 38 13 Records of investigation, 30/04/2010 assessment and outcome should be promptly recorded with regard to all accidents involving residents of the home, to ensure that risks of recurrence are minimised. At the random inspection on 10 May 2010 compliance with this requirement was not assessed, so it is Care Homes for Older People Page 8 of 11 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action retained for assessment at the next inspection. Care Homes for Older People Page 9 of 11 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, 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 9 When directions for medication administration are handwritten the entry should be signed and dated by the writer, and countersigned by a competent person to confirm the accuracy of the directions. Risk assessment should be recorded in the event of a new employee being permitted to commence work in the home prior to receipt of the Criminal Records Bureau disclosure. 2 29 Care Homes for Older People Page 10 of 11 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got 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 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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