Care Home: Sussexdown

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What the care home does well People are assessed prior to admission. Care needs are assessed, kept under review and met. There is an excellent range of activities in the home. There is effective communication with residents, relatives and friends. There is weekly publication of the activities programme and menus. People confirmed that they have a choice of good food. Complaints are listened to and acted on. The home is well managed in the best interests of people whho use the service. What has improved since the last inspection? A bi monthly newsletter has been introduced. Staff supervision and a keyworker system have been introduced. Additional staff have been recruited reducing the reliance on agency staff. What the care home could do better: The newly appointed catering manager intends to further improve the menus and catering provision. She will also ensure that kitchen staff wear correct clothing and will implement a cleaning schedule. The home needs to work towards meeting all requirements from the last environmental health authority inspection Key inspection report Care homes for older people Name: Address: Sussexdown Washington Road Storrington Pulborough West Sussex RH20 4DA     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home 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 full review a ‘key’ inspection. Lead inspector: Sheila Gawley     Date: 1 0 0 8 2 0 0 9 This is a review of 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. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 25 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. 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 Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Sussexdown Washington Road Storrington Pulborough West Sussex RH20 4DA 01903744221 01903741555 sussexdown@care-south.co.uk www.care-south.co.uk Care South Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Susan Jane Bush Type of registration: Number of places registered: care home 77 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Additional conditions: The maximum number of service users to be accommodated is 77. The registered person may provide the following categories of service only: Care home with nursing (N) To service users of the following gender: Either Whose primary care needs on admission are within the following categories: Old Age not falling within any other category (OP) Dementia not falling within any other category (DE (20)) Date of last inspection Brief description of the care home Sussexdown was registered with the Commission as a care home with nursing on the 28th February 2007, having previously been operated by another provider. The service is registered to accommodate people in the category of old age, not falling Care Homes for Older People Page 4 of 25 20 0 77 Over 65 0 77 0 Brief description of the care home within any other category, and physical disability. The service is also registered to accommodate up to 20 people suffering from dementia, for which a unit separate from the main building is provided. The home is situated in extensive grounds near to the village of Storrington, which offers various community facilities and local transport links. The provider for the service is Care South, for whom the responsible individual is Mr RRichard Hawes. The registered manager is Mrs Susan Jane Bush and the fees range between £650 and £850 Care Homes for Older People Page 5 of 25 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This site visit as part of the inspection process was carried out on 10/08/09. It was undertaken by a lead inspector from the Care Quality Commission (CQC) and was facilitated by the registered manager Prior to the visit all files held by the commission, complaints and safeguarding issues were reviewed. The home had sent us their Annual Quality Assurance Assessment for the inspection, which gave us the information we needed on the home and any documents required on the day were made available. We were in receipt of ten surveys from people who use the service and ten from staff during our recent Annual Service review process. All expressed satisfaction with the care on offer in the home. People who use the service, a relative and staff were spoken Care Homes for Older People Page 6 of 25 with on the day. People who use the service spoken with stated that they are happy in the home and that they enjoy the food. All appeared happy were well dressed and the atmosphere in the home was relaxed. There is an extensive activities programme in the home and people expressed satisfaction with the activities on offer. Staff spoken with on the day stated that they were happy working in the home and that the management was supportive. Surveys received from staff stated that the manager was resolving the issue of using agency staff. Care Homes for Older People Page 7 of 25 What the care home does well: What has improved since the last inspection? 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. Care Homes for Older People Page 8 of 25 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 25 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care needs are assessed prior to admission and information is made available to people who wish to use the service. Evidence: People who use the service are fully assessed prior to admission to the home. They are given a self assessment to complete in the first instance and then outlining their needs and what they expect of the home. pre admission assessment is then undertaken by the lead clinical nurse. All medical and personal care need is assessed and recorded. This includes health needs, continence, mobility, and communication. Social need is recorded. Seven people who use the service were case tracked and their pre admission assessment was seen. People are invited to visit the home prior to admission, often for lunch. Some people Care Homes for Older People Page 10 of 25 Evidence: who come into the home for respite care often go on to be permanently accommodated. The AQAA stated that a number of referrals come from local Health Centres demonstrate professional confidence in the service. The statement of purpose and service user guide is being updated following consultation with people who use the service and stakeholders and the revised version will be available later in the month. The Commission is to be supplied with a copy of this. Care Homes for Older People Page 11 of 25 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service have their needs assessed, recorded and met. Evidence: The AQAA states that home is responsive to the changing needs of people who use the service and is flexible in their accommodation and care in order to deliver the highest attainable standards of care. During the visit it was observed that a person who uses the service with visual difficulties had been moved to a larger brighter room which enhanced her experience in the home. The organisation of the home into dedicated residential, nursing and dementia wings allows the specialist needs of people using the service to have these needs met. All people who use the service have a plan of care to meet assessed need. This includes mobility, continence, personal care needs, nursing needs and oral hygiene. Allergies are prominently recorded. Health professionals are consulted as needed including general practitioners, district nurses, social workers, occupational therapy, dental care, opticians, audiometry, vascular specialists and continence advisory services. There is liaison with the local hospice for palliative care advice as required on a case by case basis. Care Homes for Older People Page 12 of 25 Evidence: Seven people who use the service were case tracked, their care plans and medicine charts were inspected and those available and their relatives were spoken with. Staff were observed offering care in a respectful and dignified manned. People spoken with stated They take good care of us. A relative commented This is an excellent home The care plans had evidence of assessment of need and interventions required to meet that need. Risk assessment is in place covering issues such as leaving the premises, burns and scalds, tissue viability, moving and handling, and self medication. The care plans are currently being redeveloped to include all information in one folder and this makes the plans more accessible. Medicines are received, administered, and returned correctly. Medicine administration charts (MAR) inspected were up to date. There are policies and procedures in place for the management of medicines. Controlled drugs were correctly stored, recorded and were correct. The home had reported to us a drug error and actions taken. Care Homes for Older People Page 13 of 25 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The lifestyle experienced in the home meets the expectations and varied abilities of people who live there. Evidence: There is a full time activities coordinator in the home. The activity programme is varied and includes in house activities and external involvement and outings. All people who use the service and their relatives and visitors are encouraged to participate in the planning of and undertaking of activities. One relative commented There is a host of activities every day. The programme considers the abilities and disabilities of people who use the service in relation to equality and diversity and activities are offered to all parts of the home and are held in a variety of locations in the home. The activities coordinator is currently developing activities for the less able. Independence and choice are promoted. Some outings are supported by charities such as a recent visit to Buckingham Palace supported by the Not Forgotten Association. Thirty people who use the service attended a concert performed by a singer in the home recently. There is a drop in centre which people use in the mornings to chat and to read the newspapers. There are many books available. The home has one minibuse, a wheelchair people carrier and access to a thirty seven seat coach. Care Homes for Older People Page 14 of 25 Evidence: Day trips out include shopping trips and trips to local areas of interest such as Shoreham Airport, concerts at Worthing Pavilion and a song club. A shopping trip was planned for the afternoon of the visit and tickets were seen for upcoming Christmas concerts and shows. The home also had a recent themed week Fresh Air Week where there was an outdoor event every day. These included walks in the garden, a stroll along the seafront, Pimms in the garden and a garden concert. This activity has been entered into a competition with the National Association for Providers of Activities for Older People. A two monthly newsletter has been introduced to keep people who use the service and other interested stakeholders informed of activities and life in the home. There is a lending library in the home for people to borrow DVDs and videos to watch in their rooms if they wish. The home has its own chapel and a minister visits on Sundays, there is also a service on Thursday and songs of praise once a month The catering has been reviewed with an on-going programme of improvement to enhance the dining experience for people who use the service. There is a four week menu in place. People are offered a cooked breakfast and a choice at lunch and supper. There is a new catering manager who intends to consult with people on the choices of food available. The menus were discussed with the catering manager and it was agreed that there is some repetition on some weeks, she will address this. She also intends to address the equity of menu provision to all wings. People spoken with on the day expressed satisfaction with the meal on offer. Those requiring assistance were offered help in a respectful manner. Care Homes for Older People Page 15 of 25 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People know that complaints would be listened to and acted on. People who use the service are protected from abuse. Evidence: There is a complaints procedure in place and it is on display. The service user guide also contains a copy of the complaints procedure. Complaints and actions are recorded. People spoken with on the day stated that they could make concerns known to the staff and that things would be dealt with. They all stated that they did not have any reason to complain. A relative spoken with expressed satisfaction with all aspects of the home. There are policies and procedures in place in line with West Sussex Safeguarding Adults policies and procedures. All staff have had safeguarding adults training and future training is planned to ensure the procedures are embedded into practice and to ensure staff have confidence in managing alerts. Safeguarding alerts have been appropriately reported to West Sussex adults services. The registered manager to consider a referral to Protection of Vulnerable Adults list regarding an exemployee implicated in a recent alert. The AQAA states that there is a policy in place for equal opportunities, diversity, and anti-oppressive practice. Care Homes for Older People Page 16 of 25 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a homely well maintained and safe environment. Evidence: The home is well maintained and decorated to a high standard internally and externally. It is laid out in three units, has sitting rooms, dining room, sun lounge, library, a chapel, a bar and a hairdressing room. There are extensive well maintained accessible garden and grounds. People who use the service spoken with all expressed great satisfaction with their accommodation. There is a main kitchen with kitchenettes on the units to make drinks. There are plans to turn a large unused area in the nursing wing into additional sitting and dining facilities. Bedrooms are personalised and nine have en suite facilities. There are three lifts, hoists, track rails and grabrails are available. There is pictorial signage and brightly coloured grab rails in the dementia unit to address the needs of this group of people. There is a large laundry with machines offering the correct range of temperatures to meet the needs of people who use the service. The most recent environmental health authority report made several requirements which the home is working towards meeting. The catering manager is to ensure that caps and tunics are to be worn and also to address the cleanliness of one tunic seen Care Homes for Older People Page 17 of 25 Evidence: worn by one of the chefs on the visit. A regulation 26 report has highlighted that kitchen cleanliness should be addressed. That the home meets all the requirements of the recent environmental inspection will be a requirement of this inspection. There is a maintenance and refurbishment plan in place with a view to updating the older parts and facilities of the home such as furniture bathrooms, this is to be completed over the next two years. Care Homes for Older People Page 18 of 25 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples nursing and care needs are met by suitably recruited and trained staff. Evidence: Staff rota showed staffing levels were sufficient to meet the needs of people who use the service. Recruitment in the past year has reduced the reliance on agency staff. There is housekeeping and kitchen support. Staff spoken to stated that the home is a supportive place to work in as did staff surveys which we had received. Some 30 of care staff have the National Vocational Qualification (NVQ) Level 2 in Care and the home continues to work towards increasing this. People who use the service and a relative spoken with all expressed satisfaction with the nursing and care staff. Staff were observed offering care in a supporting and encouraging manner. One staff member was observed interrupting what she was doing to offer support to a person who uses the service who seemed upset saying she wanted to go home. There are robust recruitment procedures in place and staff files inspected contained all the documentation required to ensure the protection of people who use the service. There was evidence of application forms with employment history, Criminal Records Bureau Clearance and POVA check, two references, identity documentation, and photograph were all in place. There is some geographical constraint within the organisation in the provision of Care Homes for Older People Page 19 of 25 Evidence: trraining. Moving and handling training is provided by a local trainer. Staff files had evidence of up to date training. Care Homes for Older People Page 20 of 25 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed in the best interests of people who use the service. Evidence: The registered manager has many years experience in health care and management. She is a Registered Nurse and has a Masters in Business Administration and BA (Hons) Health Care Management. She continues to meet the educational requirements to maintain her registration with the Nursing and Midwifery Council. She is supported by a lead clinical nurse who deputises in her absence. She demonstrates a clear sense of direction for the home and has encouraged staff to update practice and has worked to integrate staff. She demonstrated a clear vision for the home and is aware of the organisations strategic planning. Quality assurance is well developed in the home. We received the AQAA when we requested it and it was comprehensive and demonstrated openness and transparency. Regulation 26 visits are carried out. There is monthly audit of various aspects of the Care Homes for Older People Page 21 of 25 Evidence: service, residents meetings are held every three months and relatives meetings are held twice yearly. There is a bi monthly newsletter for people who use the service, relatives and stakeholders. Head of department meetings are held weekly and issues are communicated to staff. The home holds monies for people who use the service. This recorded and receipted. The money at the time of the visit was held securely but not individually. The registered manager agreed to hold and record individuals money separately in line with current CQC guidance. Staff supervision has been a challenge to put in place and staff now undertake group supervision. The registered manager ensures the health and safety of people who use the service by the provision of a mandatory training system including safeguarding adults, fire safety, first aid, health and safety,infection control and food hygiene. Contracts are in place for equipment testing and utilities maintenance. Care Homes for Older People Page 22 of 25 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 23 of 25 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 19 3 The registered person must ensure that the home complies with the requiremments of the environmental health department. To prevent the spread of infection in the home. 09/10/2009 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 Care Homes for Older People Page 24 of 25 Helpline: 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. Care Homes for Older People Page 25 of 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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