Inspection on 27/09/06 for Salcasa

This inspection was carried out on 27th September 2006.

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 found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Salcasa 26/09/08

Salcasa 09/08/05

Salcasa 01/04/05

Salcasa 25/10/04

Salcasa 20/04/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Salcasa Coltishall Road Buxton Norfolk NR10 5HB Lead Inspector Mr Jerry Crehan Key Unannounced 27th September 2006 02:45 Salcasa DS0000027652.V314186.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 Salcasa DS0000027652.V314186.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. Salcasa DS0000027652.V314186.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Salcasa Address Coltishall Road Buxton Norfolk NR10 5HB 01603 278268 P/F01603 278268 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) Jeesal Residential Care Services Limited Position Vacant Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Salcasa DS0000027652.V314186.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 9th August 2005 Brief Description of the Service: Salcasa is a detached five-bedroom bungalow in the village of Buxton, near to Norwich. The Home is owned and managed by Jeesal Residential Care Services Ltd. Salcasa is situated a few doors away from Ashwood House which is a larger Care Home owned by the same organisation. Over the last two years the registration has increased so that accommodation is now provided for up to five service users with a learning disability. An extension has recently been completed at the home, which provides an annexe with its own ensuite bedroom, kitchen and lounge. The other four bedrooms are within the main bungalow. Salcasa DS0000027652.V314186.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection compromised an unannounced visit to the home that took place over 6 hours on 27th and 28th September. Opportunity was taken to tour the premises, look at care records and policies, and communicate with the home’s tenants in addition to its staff (‘support workers’) and the acting manager. The inspection report reflects evidence from inspection of Key Standards and other National Minimum Standards. Four comment cards were received from tenants prior to the inspection. These reflect the positive view tenants hold about their home. Salcasa is one of several homes in Norfolk owned by the proprietors. The range of weekly fees for the home is from £917 to £1,818. What the service does well: What has improved since the last inspection? Medication practices have improved following action taken to address previous requirements and recommendations, and are now good. Salcasa DS0000027652.V314186.R01.S.doc Version 5.2 Page 6 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. Salcasa DS0000027652.V314186.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 Salcasa DS0000027652.V314186.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2&5 The overall quality outcome for this standard is adequate. Individual contracts do not set out the full terms and conditions in respect of accommodation. The needs and aspirations of people thinking about moving into the home are assessed. EVIDENCE: The service has a ‘Statement of Purpose’ that sets out information required by Regulation. The service users guide sets out the information required to meet the Standard. A contract seen for the most recently accommodated tenant (October 2005) was not signed by the tenant or any other representative on their behalf, nor did the contract set out the fee’s payable or rooms to be occupied (see Requirement). Contracts list services not covered by fees; this includes the cost of holidays (see Standard 14). The home has an assessment pro-forma and ‘application form’ used by the manager or other senior staff when collecting information. These documents are well designed to ascertain the level of support required by, and aspirations of, any prospective tenant. There was evidence of good assessment of prospective tenants. A wide range of information had been collected prior to admission of the newest tenant. This included evidence of liaison with tenants, their relatives and relevant professionals. Salcasa DS0000027652.V314186.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 The overall quality outcome for these standards is good. Tenants assessed needs and goals are reflected in their individual plan, though these are unwieldy. Tenants make decisions about their lives with assistance as necessary and are supported to take risks as part of an independent lifestyle. EVIDENCE: A sample of individual care plans was reviewed. These evidently include tenant involvement, set out health and care needs, reflected goals or aspirations for tenants, and covered the following areas in detail – personal profile, health profile, assessments, action plans, day care, finance, progress reviews and correspondence. It is recommended that this information be refined in order that the individual care plan is more accessible as a working guide for support workers to access or add to (see recommendation). Additional day-to-day information regarding tenants is recorded in the home’s diary and in a ‘communication book’ (see recommendation). There was evidence of monthly summary/review by the allocated support worker, there is evidence of six monthly reviews (usually ‘in house’) and a Salcasa DS0000027652.V314186.R01.S.doc Version 5.2 Page 10 yearly review attended by external representatives, such as relatives and social workers. Risk management guidelines are also clearly set out for staff to follow. Those seen provided a clear analysis of risk and corresponding management guidelines. An example of the implementation of risk management guidelines was seen in an experienced support worker working one to one with a tenant. Tenants meetings take place on a weekly basis. Evidence of discussion seen includes a general discussion, what’s happening tomorrow, outings choice, food and packed lunches and staffing arrangements. Monthly summaries/reviews referred to above take place between the tenant and their key worker. Records were seen of a wider tenants forum involving tenants from other homes within the group owned by the proprietors, and including support workers and tenants from Salcasa. Salcasa DS0000027652.V314186.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16, 17 The overall quality outcome for these standards is good The home caters effectively for the lifestyle abilities and preferences of tenants. Links with the community are well maintained. EVIDENCE: At the time of the inspection visit there were two tenants at home. Others were attending a variety of formal day care facilities (returning later), though may stay at the home on other days. There is an emphasis on developing communication skills and personal care skills for tenants who do not attend day services on any given weekday, however daily routines are evidently flexible. Tenants from nearby Ashwood House had just arrived at the home to spend some time socialising with Salcasa tenants. The acting manager stated that there are currently no vocational, or adult education classes attended by tenants. Some tenants receive visits from relatives and others at the home, others return home on a regular basis, depending on their circumstances. The acting manager described the contact maintained with the local community. This includes access to the local hairdresser, use of the village chip Salcasa DS0000027652.V314186.R01.S.doc Version 5.2 Page 12 shop, the local pub and trips further afield to Aylsham to visit the library or to go bowling. Public transport is used on occasion, usually the train, but also the bus. The home has access to its own transport, which includes a Volkswagen bus and a car. The acting manager confirmed that tenants pay the full cost of their holiday(s) themselves. These have included trips to Center Parcs and to holiday sites such as Hopton. National Minimum Standard 14 requires that a seven-day annual holiday is provided as part of the basic contract price (see recommendation). There were no visits to the home by relatives of tenants during the inspection visit. Four out of the five comment cards from tenants received prior to the inspection indicate that they can have visitors; the other tenant indicated that this was sometimes possible. Support workers were observed talking to and interacting with tenants throughout the inspection visit. First names are used as the preferred form of address for support workers, and service users with verbal communication. Individual preferences and choices are supported by the home, and any restrictions agreed due to risk are set out clearly in the care plan. Support workers prepare all of the meals at the home, with the main meal taken in the evening. The evening meal on offer was sausage casserole, which looked and smelled appealing and was enjoyed by tenants. There was an alternative provided to a tenant who did not want this option. Salcasa DS0000027652.V314186.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 The overall quality outcome for these standards is good. Service users receive support in the way they require. Their personal and healthcare needs, including medication, are well attended to. EVIDENCE: Personal care is provided to tenants so as to ensure their privacy and dignity. Support workers are supported by the clarity of information available within individual care plans, and were observed to support and guide tenants according to their individual needs. Records reviewed indicate that service users health is carefully monitored and that access to GP’s and other community health professionals is supported where necessary. There was evidence of action taken to address a tenants hearing problem and a blood test for another tenant. The acting manager was observed to be sensitive to the need of a tenant who she expressed concern about on their return from their day care facility. She indicated that they may be leading up to a seizure, and subsequently spent time with them supporting them through the eventual seizure. There are no service users accommodated at the home who have responsibility for their own medication. On review of medication no discrepancies were identified, and records were good. Storage arrangements for medication are not ideal in a kitchen cabinet but were tidy and secure. Over stock of Salcasa DS0000027652.V314186.R01.S.doc Version 5.2 Page 14 medication was kept to a minimum and stored in a separate secure kitchen cabinet. Staff with responsibility for administering medication confirmed that they had received appropriate training, and training records seen. A requirement at the last inspection regarding quick removal of medication to be returned to the pharmacist had been acted upon, as was a recommendation that a record of medication handed to relatives of tenants. Salcasa DS0000027652.V314186.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 The overall quality outcome for these standards is good. Arrangements for protecting and responding to the concerns and complaints of tenants and staff are good. EVIDENCE: The home has a detailed complaints procedure and information on how to make complaints is set out in the service users guide, this is also made available in symbol format. Information in comment cards suggests that tenants have an awareness of how they may make a concern or complaint known; generally this is by telling a support worker. The home has relevant policies and procedures, which relate to the protection of the tenants from any form of abuse. A procedure for responding to allegations of abuse is in place that support workers are aware of. Support workers spoken to and records seen provided evidence of relevant training in recognising signs of abuse. Salcasa DS0000027652.V314186.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 The overall quality outcome for these standards is adequate. A homely and comfortable internal environment, and good gardens are provided for tenants. The shower room flooring and the patio area require improvement. EVIDENCE: The premises are suitable for the homes stated purpose. The interior accommodation is in a reasonable state of repair, with adequate furnishings and fittings. The home is accessible for any person using a wheelchair to mobilise. Bedroom doors are all lockable but with override devices. The shower/toilet favoured by tenants has a floor that is difficult to keep dry, as it appears moisture is underneath the hard floor covering. The proprietor is evidently aware of the problem with this room, as the issue has been highlighted in monthly Regulation 26 visit reports, copies of which are provided to the Commission (see recommendation). The gardens are well kept and accessible to tenants, and were in use at the time of the inspection visit by tenants. The recommendation made at the last inspection visit that the patio area is levelled out has not been acted upon. Salcasa DS0000027652.V314186.R01.S.doc Version 5.2 Page 17 Whilst this has not been the cause of any accident or injury since the last visit it still presents a possible hazard (see recommendation). Premises were clean and hygienic. Salcasa DS0000027652.V314186.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35, 36 The overall quality outcome for these standards is adequate. A competent staff team who have access to good induction and ongoing training supports tenants. For this outcome area to achieve a good standard a programme of regular supervision meetings should be established, and a greater proportion of NVQ 2 trained support workers. EVIDENCE: There were five tenants in residence at the time of the inspection visit cared for by three support workers. The acting manager stated that this is the usual ratio. There is one night waking carer and one carer sleeps in. There is a core group of eight staff that the acting manager stated would rise to nine. As a consequence of some recent staffing changes there are currently two staff with NVQ 2 (or above), five staff currently undertaking NVQ 2 and two new staff due to register for the training (see requirement). From discussion with support workers and a review of personnel files, it was evident that tenants are protected by good recruitment practices. Records for staff training indicate access to full induction training for staff. This was confirmed in discussion with support workers who described working in a supernumerary capacity, being supervised by senior staff, having access to care plans, to policies, and having training sessions. Their progress was recorded individual induction booklets. There was evidence of a good programme of ongoing mandatory and specialist training for staff. Salcasa DS0000027652.V314186.R01.S.doc Version 5.2 Page 19 Discussion with support workers and the manager provided evidence that regular recorded supervision is not taking place as specified in the Standard, however, there is ongoing supervision for staff throughout the day (see requirement). Salcasa DS0000027652.V314186.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42 The overall quality outcome for these standards is good. Tenants benefit from a well run home that they are able to make decisions about and influence. The acting manager is managing the home effectively, though will need to apply for registration. EVIDENCE: The registered manager has left the home to manage a nearby home with the same proprietor. The acting manager will be making an application for registration with the Commission in due course. The acting manager has two years management experience as deputy manager for Salcasa and another service owned by the proprietor. The acting manager demonstrated her experience and knowledge of tenants during the inspection visit, and was described in favourable terms by colleagues. Tenants clearly have confidence in her and find her approachable. There are several ways in which the quality of the service is monitored. These include monthly reviews of the service user plans, Tenants meetings, staff meetings, annual questionnaires to professionals and relatives, health and Salcasa DS0000027652.V314186.R01.S.doc Version 5.2 Page 21 safety monitoring, and the ‘Tenants Forum’ meeting that takes place with tenants from other of the proprietors homes. The home demonstrates good practices ensuring tenants health, safety and welfare. Relevant health and safety training for staff, including moving and handling, first aid, fire and food hygiene training, support practices. Salcasa DS0000027652.V314186.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 2 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 2 33 X 34 3 35 3 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 2 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 Salcasa DS0000027652.V314186.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. 1 Standard YA5 Regulation 5(1)(b) Requirement Timescale for action 12/10/06 2 YA32 18(1)(a) The registered person must ensure that terms and conditions in respect of accommodation be provided for service users, including the amount and method of payment of fees. The registered person must 30/11/06 ensure continued progress toward meeting a minimum ratio of 50 NVQ 2 (or above) trained staff. The registered person must ensure that care staff at the home are appropriately supervised. 31/10/06 3 YA36 18(2) 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 YA6 Good Practice Recommendations It is recommended that care plan information be refined in order that the individual care plan is more accessible as a working guide for support workers to access or add to. DS0000027652.V314186.R01.S.doc Version 5.2 Page 24 Salcasa 2. YA6 3. 4. 5. YA14 YA24 YA24 It is recommended that the use of the home’s ‘communication book’ for recording information about tenants cease, as this information may not meet the requirements of Data Protection Legislation. It is recommended that a seven-day annual holiday (or similar) be provided as part of the basic contract price. It is recommended that a solution be found to the faulty flooring in the communal shower/toilet area. It is recommended that the patio is levelled out so that it reduces the risk of trips/falls. Salcasa DS0000027652.V314186.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF National Enquiry Line: 0845 015 0120 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 Salcasa DS0000027652.V314186.R01.S.doc Version 5.2 Page 26 - 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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