Inspection on 29/08/07 for Sabre Court

This inspection was carried out on 29th August 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Sabre Court 13/09/06

Sabre Court 24/01/06

Sabre Court 21/04/05

Sabre Court 19/10/04

Sabre Court 29/04/04

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Sabre Court 4 Lonsdale Road Scarborough North Yorkshire YO11 2QY Lead Inspector Pauline O`Rourke Unannounced Inspection 29th August 2007 09:30 Sabre Court DS0000007730.V345519.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Sabre Court DS0000007730.V345519.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Sabre Court DS0000007730.V345519.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Sabre Court Address 4 Lonsdale Road Scarborough North Yorkshire YO11 2QY 01723 361256 01723 361256 Jantait@btconnect.com Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr Andrew Maurice Tait Mrs Janet Tait Care Home 12 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (12), Mental Disorder, excluding of places learning disability or dementia - over 65 years of age (12) Sabre Court DS0000007730.V345519.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. One Service User with a dementia and aged under 65 years of age may be accommodated. This condition will terminate when the named Service User ceases to be accommodated at Sabre Court. Service Users under 65 years of age whose primary need for care derives from a mental health disorder, but who have an associated dementia may be accommodated in the home. 13th September 2006 2. Date of last inspection Brief Description of the Service: Sabre Court is registered to provide care and accommodation for up to 12 younger adults who have or are recovering from a mental illness. The manager is Mrs Janet Tait and Mr Andrew Maurice Tait owns it. Sabre Court is a large semi-detached house situated in a residential area of the town. It is convenient for local amenities and facilities. Public transport to and from the town centre passes the door. Accommodation and facilities are provided on three of the floors. The ground floor houses the communal areas while the upper two floors provide the bedroom accommodation. The top floor is used for storage purposes and night staff accommodation. The property does not have a passenger lift and is consequently only considered suitable for people who are fully ambulant. Information about the home is provided in a Service User Guide on request, a copy of the last inspection report is also available on request. The current fees for the service users are £317 a week this does not include toiletries, newspapers, hairdressing or chiropody. Sabre Court DS0000007730.V345519.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The key inspection has used information from different sources to provide evidence for this report. These sources include: • • • • Reviewing information that has been received about the home since the last inspection. Information provided by the registered person on an Annual Quality Assurance Assessment Comment cards returned from a GP, two from relatives, two health care professionals and one social care professional. A visit to the home by one inspector that lasted for three and a half hours. During the visit to the home six people who live there, and two staff were spoken with. Care records relating to three people, three staff members and the management activities of the home were inspected. Care practices were observed, where appropriate, and time was also spent watching the general activity within the home. This enabled the inspector to gain an insight of what life is like at Sabre Court for the people living there. What the service does well: Sabre Court provides a balanced environment for the people who live there between a care home and a supported living environment. The people in the home are properly assessed before they are admitted and staff have a good understanding of individuals health and mental health needs. Staff said that they work in a sensitive manner with them and try not to put them under pressure, which could aggravate their mental health illness. Staff were seen to be patient and sensitive in their dealing with people in the home. Only one survey was returned and that came form a GP who said ‘the staff accompany patients to hospital and always have a grasp of the problem’ People in the home live in a relaxed and informal environment and whilst they said they are happy to live there they do not want to help maintain the environment in good order. People in the home said ‘you can go out when you like but they like you to tell them if you are going to be late back’ and ‘Jan and Andrew are ok you can talk to them’ ‘its alright here you can do as you like’ Feedback from a relative said ‘I think they are doing an excellent job’ and a healthcare professional said ‘they are a good contact who care about the group they work with. They see the greater picture-good contact for patient support’. Another healthcare professional said ‘very good manager who understands the residents and their needs-he constantly encourages his staff and offers guidance and support.’ Sabre Court DS0000007730.V345519.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Sabre Court DS0000007730.V345519.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Sabre Court DS0000007730.V345519.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 People who use 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 who want to be admitted to Sabre Court are fully assessed prior to their admission so that the manager can make a considered decision as to the appropriateness of the proposed placement. EVIDENCE: Three case files seen contained comprehensive assessments that had been carried out by the providers. Although all of the people concerned had been admitted through a placing agency the agency had not provided detailed and historical information for one of them. This has meant that whilst the support the person receives appears to meet his needs it does not allow for a holistic approach by the carers. One person spoken with said that they visited the home before they came in and that the manager had explained things to them during that visit. The assessment information not only looked at the level of support required by the individual but also provided risk assessments in relation to behaviours they may exhibit. This allows staff to be as fully informed as possible when someone is admitted. Staff said that they sufficient usually had sufficient information on someone coming in to the home to devise a care plan. Sabre Court DS0000007730.V345519.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, and 9 People who use 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. The people who use the service are able to make decisions on a day-to-day basis about their lives and this allows them to remain as independent as possible. EVIDENCE: The three case files seen contained a detailed care plan, covering the personal and social support required by the individual concerned. The plans identified what requirements were for rehabilitation and positive interventions regarding communication needs. There was also information on any restrictions there were on an individual’s choice and freedom in the plan. People spoken with were aware of their plans but were not interested in helping devise them or signing them. Each person has a key worker and they knew who they were. The plans are reviewed twice a year unless earlier intervention is required. The people they were about had signed the plans and people spoken with knew that records were kept about them. Sabre Court DS0000007730.V345519.R01.S.doc Version 5.2 Page 10 People spoken with were clear that they could follow their own routine when in the home. The daily diaries showed that people were allowed to make their decisions and the consequences of these decisions were also recorded. In one instance someone had agreed to be admitted so that they could get out of hospital. Once they were in the home they absconded. Once this person was readmitted staff worked with him to encourage him to stay allowing him to test boundaries with his behaviour until he settled down. Records show that the staff supported him through this time and have not interfered with his decision-making. The majority of people manage their own finances although there are several who have requested assistance with this purely so they do not run out of money between benefit cheques. These occasions are recorded and reviewed on a regular basis. Agreements are also recorded on the management of their medication. The case files were well organised and easy for staff and the people they were about to follow. Risk assessments are in place to minimise risk but allowing people to lead a full and independent life. These assessments are underpinned by the homes policies and procedures. Sabre Court DS0000007730.V345519.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17 People who use 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 enabled to follow a lifestyle best suited to their needs and wishes EVIDENCE: People who live at Sabre Court present a variety of needs, however in discussion with them it was clear that the staff are able to meet their needs. None of the people in the home currently attend college or are employed but they all access the local community some with and some without support. There is not a formal approach to activities but according to some of the more able people in the home it was not necessary. They liked the informal and relaxed approached taken by the staff when they were supporting them. Staff were seen interacting with people and this approach promotes independence and allows people to make their own choices. There is a visitor’s policy in place and this is included in the information available to people and their families. Each of the service files had important family contacts and where appropriate family contact is maintained with Sabre Court DS0000007730.V345519.R01.S.doc Version 5.2 Page 12 support of the staff. None of the relatives contacted responded to the survey. People are encouraged to maintain friendships and evidence that this happened was available in the daily diaries. During the inspection a visitor was present and they confirmed that they visit when they want to and are made welcome when they do visit. The daily routines within the home are flexible and promote individual choice. The case files seen contained information about the persons preferred name and whether they had a key to their room. This is provided following a risk assessment. One person spoken with said that staff always knock before they go in his room and this was witnessed throughout the visit. People chose where they wanted to be when they were in the house and one person choose to stay in the dining room because they did not like being alone and people were always passing through or having a drink. The meals are planned on a weekly basis and people can have a cooked breakfast, a snack lunch with their main meal on an evening. People spoken with said the food was nice and one person was encouraged to cook his own food as he is hoping to become independent again. The manager and/or staff choose the menus and people spoken said this was ‘ok’ as they weren’t really interested in planning meals. The meals appeared to be varied and offered alternatives if someone did not want the main choice. There are no special diets required at this time but staff are aware of peoples likes and dislikes and incorporate these in to the menus. Sabre Court DS0000007730.V345519.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19,and 20 People who use 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. Support is provided to people living in the home by staff and externally by healthcare professionals ensuring their health and personal care needs are met. EVIDENCE: The people at Sabre Court are primarily independent with their personal care. Staff provide prompts and support with regard to personal hygiene whilst respect the individuals privacy and dignity. The case files contained evidence that the people in the home access health services’ as they require them. They are all registered with their own GP from surgeries across the town. Some people have a care manager or community psychiatric nurse but the information and support provided to the person and the home has not always been positive. Other people in the home continue to have a ‘virtual care manger’. People can also access other service in the area to support them with their mental health issues. Sabre Court DS0000007730.V345519.R01.S.doc Version 5.2 Page 14 Medication is administered from either a monitored dosage system or directly from the original containers. It was stored securely and is only dispensed by staff that have received training in the safe handling on medicines. There are controlled drugs in use at this time, they were securely stored and the administration records were accurate and up to date. People manage their own medication only in line with their care plan and associated risk assessments. The stock is now audited on a regular basis by the manager and by the local pharmacist. Sabre Court DS0000007730.V345519.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 People who use 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 in the home are able to express their concerns through the complaints procedure and are protected from abuse, so their rights are protected. EVIDENCE: A complaints procedure was in place and was readily available to people in the home. People spoken with said that they would take any concerns or complaints to the manager or their key worker. Staff were aware of the complaints procedure and said that they usually dealt with any concerns raised by people in the home before they became a complaint. It was suggested that a concerns or grumbles book be maintained so that this information could be used in the quality assurance audit. There have been no concerns or complaints received by home or the Commission of Social Care Inspection since the last inspection An Adult Protection protocol is in place and staff were aware of their responsibilities under this procedure. Staff have received training in staff meetings to ensure they remain aware of this policy. Staff also understood the whistle blowing policy. Sabre Court DS0000007730.V345519.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 People who use 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 a good standard of accommodation that meets their needs and provides them with pleasant environment in which to live. EVIDENCE: The home remains well decorated and a regular maintenance is carried out to ensure the property remains sound. The lounge is especially well decorated. The new regulations about no smoking have been adhered to and people spoken with were aware of the changes in the law and subsequent changes in the house. People can access drink-making facilities in the dining room and lends its self to promoting independence. There is no passenger lift so only people who are fully ambulant can access the upper floors. The bedrooms were decorated to an acceptable level and the manager was clear about the rooms that were in line for redecoration. Several rooms had been personalised by the occupant. Whilst this shows some ownership in the property people in the home were reluctant or did not see the need for keeping the place tidy and clean. People spoken with during the inspection did Sabre Court DS0000007730.V345519.R01.S.doc Version 5.2 Page 17 not see their rooms as untidy or dirty. Staff kept the rooms clean and whilst they try to encourage people to look after their own rooms this is not working. There is a domestic style laundry to the rear of the kitchen and there were hand-washing facilities in the kitchen. People are encouraged to bring their own laundry down although in one room seen this did not appear to be happening as regularly as it should. The key workers are responsible for ensuring these jobs are complete and efforts should be made to encourage the people in the home to care for their own room more regularly. Sabre Court DS0000007730.V345519.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 People who use 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 supported by a stable staff team who have been thoroughly vetted prior to the commencement of their employment. EVIDENCE: The rota’s showed that there are usually two members of staff on duty throughout the day and one member of waking night staff plus a sleeping member of staff. The manager and proprietor who work every day supplement these figures. The current staff group have all worked at the home for longer than twelve months. The staff said that the level of staffing was adequate to meet the needs of the people in the home, whose primary needs are guidance, support and advice with only minimal physical care required. Staff records showed that they had all been thoroughly vetted before they commenced their employment. Training is available to the staff and 40 of them have completed or are completing their National Vocational Qualification in care level 2. People in the home said the ‘staff are alright’ and ‘you can talk to them’ the interactions observed were relaxed and appropriate. Staff said their greatest Sabre Court DS0000007730.V345519.R01.S.doc Version 5.2 Page 19 challenge was motivating the people in the home to be as independent as they are able. Sabre Court DS0000007730.V345519.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 People who use 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 live in a well managed home where the administration of the home is based on openness and respect. This allows them to retain their individuality. EVIDENCE: The registered manager and the registered provider are well qualified and have amassed considerable experience working with people who have a mental health problem. There is a basic quality assurance system in place that relies on surveys to people in the home, relatives, visitors and visiting professionals. Information from any completed surveys is used along with information from supervision, staff meetings, meetings for people in the home and reviews of the care plans. However people in the home are not motivated to take part in a productive way in either the surveys or meetings. The Sabre Court DS0000007730.V345519.R01.S.doc Version 5.2 Page 21 provider continues to find ways in which they will involve themselves mush more in the daily running of the home. All the working practices within the home are safe and staff keep accurate accident records, this information is used to inform the care plan and in requesting specialist input either through training or actual support. Staff have received training in the health and safety procedures and all the policies are read by the staff. The records relating to health and safety issues that were seen during the visit were up to date. Sabre Court DS0000007730.V345519.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Sabre Court DS0000007730.V345519.R01.S.doc Version 5.2 Page 23 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA35 Good Practice Recommendations The staff should be provided with training on mental health. Sabre Court DS0000007730.V345519.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Sabre Court DS0000007730.V345519.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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