Inspection on 03/11/05 for Salisbury House

This inspection was carried out on 3rd November 2005.

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

Salisbury House 25/06/09

Salisbury House 05/06/07

Salisbury House 25/10/06

Salisbury House 06/02/06

Salisbury House 20/09/04

Salisbury House 27/05/04

Salisbury House 09/02/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Salisbury House 83/85 Egerton Park Rock Ferry Wirral CH42 4RD Lead Inspector Karen Barry Unannounced Inspection 3rd November 2005 10:00 X10015.doc Version 1.40 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 Salisbury House DS0000018935.V264158.R01.S.doc Version 5.0 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 Older People. 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. Salisbury House DS0000018935.V264158.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Salisbury House Address 83/85 Egerton Park Rock Ferry Wirral CH42 4RD 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) 0151 645 6815 Salisbury Management Services Ltd Mr Russell Michael Canner, Mrs Marika Canner Mr Russell Michael Canner Care Home 37 Category(ies) of Old age, not falling within any other category registration, with number (37) of places Salisbury House DS0000018935.V264158.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. One (1) named adult with a learning disability may be accommodated. Only thirty four (34) elderly persons may be accommodated. Two (2) named elderly persons with a mental disorder (excluding learning disability) may be accommodated. 20th September 2004 Date of last inspection Brief Description of the Service: Salisbury House is a large detached house with well-maintained gardens. It is situated in a quiet area of Rock Ferry Birkenhead, close to local shops and other amenities. There are a number of communal areas where residents can spend time together chatting, reading, watching TV, listening to music or indeed just enjoying the relaxing character and views of a well-maintained property and gardens. The domestic furnishings and decoration are of a high standard throughout the home. The home has access to a minibus, which can be used to take residents out on various trips. Salisbury House DS0000018935.V264158.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The home had not been told that the inspector would be visiting. 2 requirements and 1 recommendation was made. This inspection took place over a period of five hours, commencing at 10:00am. A tour of the building took place, and with the permission of the residents, a number of bedrooms were seen. Residents were spoken with individually and privately, general group discussions also took place within the lounges with a number of other residents. Two visitors were spoken with during the day. The views of the staff on duty during the inspection were listened to. This included the owners, deputy manager, care and domestic assistants. What the service does well: What has improved since the last inspection? The deputy manager has been allocated two days a week to work “off rota” These days are being used to support the implementation of an improved person centred care plan system for the residents, staff induction and supervision programmes. Clearly the main focus here is to ensure all concerned gain a better quality of life and improved job satisfaction. Salisbury House DS0000018935.V264158.R01.S.doc Version 5.0 Page 6 In general there has been very little change to the staff team since the last inspection, this provides continuity of care for the residents. 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. Salisbury House DS0000018935.V264158.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Salisbury House DS0000018935.V264158.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4 & 5, The aims, objectives, and philosophy of the home are clearly reflected within the homes statement of purpose and service user guide. This helps prospective residents, families and professional to make an informed choice regarding the suitability of any possible move to Salisbury House. Residents are admitted to the home for a trial period only after their needs have been fully assessed. This helps the staff to make sure they have the knowledge, skills and if necessary equipment to maintain the residents safety independence and well-being. Individual contract and care plans are put into place, helping protect the residents’ rights and interest. EVIDENCE: The statement of purpose and service user guide provides information about what the home offers to residents living there and the range of facilities and lifestyle residents can expect. Salisbury House DS0000018935.V264158.R01.S.doc Version 5.0 Page 9 The managers and the deputies encourage prospective residents to visit the home before making a decision. However if this isn’t possible arrangements can be made for the senior staff to visit the resident and complete an assessment to ensure their needs can be met appropriately. Social worker and medical assessments are also used help gain a full picture of the residents needs. When the resident moves into the home, this information is used to develop a care plan. Individually signed contracts where seen upon residents files. These clearly showed the terms and conditions of all placements within Salisbury house. Salisbury House DS0000018935.V264158.R01.S.doc Version 5.0 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 & 10 There is a clear care planning system in place to provide staff with the information they need in order to meet the needs of the residents, however the staff are in the process of making further improvements to these systems. The medication system at the home is well managed. Personal support is provided in a way that ensures residents’ privacy, dignity and independence. EVIDENCE: Care plans used in the home are already to a good standard, however the management team are keen to improve their systems further by introducing a person centred system. Those already implemented clearly show that the resident views and wishes are at the heart of the plan which assist staff in offering the correct levels of support. Four residents care plans were seen and each clearly showed what staff need to do to meet the needs of the individual resident. The new format goes into more detail regarding the residents’ hobbies, interests and past and present life experiences. Using this information that staff will be able to support and assist the residents to focus upon their many strengths whilst setting achievable goals and plans for the future. Care plans are well written, up to Salisbury House DS0000018935.V264158.R01.S.doc Version 5.0 Page 11 date and reviewed on a regular basis. This ensured that staff are always aware of residents changing needs. It was noted that the home had found it necessary to serve notice to one resident a few months ago, as they no longer felt they were able to meet her needs appropriately. Records seen confirmed that other professionals had been contacted to assist in completing a new assessment and to assist the resident and her family to obtain information advice and guidance regarding other suitable options. The assessment process is now complete and although the outcome of the assessment has confirmed that the resident’s needs can be met within a residential home arrangements are still to be finalised regarding when and where this resident will be going to. The managerial staff within the home stated that although the term of notice given is over due they are prepared in the short term to continue providing this resident with support, as they are aware of the difficulties she and her family have encountered trying to finding an alternative home. Senior staff in the home that give out medication have all received training to undertake such tasks. The policies and procedures for dealing with medication are good. Storage facilities and records seen were found to be appropriate. Staff were seen communicating with residents in a sensitive and caring manner. Salisbury House DS0000018935.V264158.R01.S.doc Version 5.0 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 & 15 Residents have access to a range of social activities in and outside the home. Meals are nutritious and balanced and offer a varied diet for residents, meeting individual needs. EVIDENCE: A variety of in-house activities and outings are arranged by the staff group. The home also employs an activities co-ordinator to assist in these matters. Information relating to a proposed visit to the pantomime was seen on the notice board in the main hallway. During discussions with a number of residents, and staff it was evident that a number of the residents attend local day centres as they had developed and formed good relationships there prior to moving into Salisbury house and clearly wished to maintain these. In most case family members make arrangements to pay for these services. Residents gave a number of examples of the way in which they have choice and control over their lives. Some residents choose a relatively private lifestyle, living in their bedrooms for most of the time. Staff respect this. One resident said:“ I like staying in my room, I keep busy doing my crosswords and reading the daily paper”. Salisbury House DS0000018935.V264158.R01.S.doc Version 5.0 Page 13 Other residents said they have choices about food, what time they get up and go to bed and whether or not they join in any activities. In the afternoon the inspector joined the residents for a game of bingo in one of the larger lounges. Observations made showed that the staff had sufficient knowledge regarding various residents’ abilities and needs. One resident who has some hearing impairment was offered a chair close to the bingo caller so that she could hear the numbers clearly, other residents were offered assistance in marking off numbers called etc. Tea, coffee and snacks were brought through to the lounge towards the end of the session, by the afternoon staff. The staff appeared happy in their work as they enjoyed a bit of a song and a dance with a couple of the residents. It was pleasing to observe genuine interactions and conversations between residents and staff. During the tour of the building one resident was seen reading the paper and having breakfast in the dining room he stated:“ It’s lovely here, you’re never rushed - look at me just having breakfast at nearly 11 o’clock.” Residents said they liked the food and confirmed that they have a choice at each meal. The adjoining dining rooms are situated on the ground floor in the centre of the home, on the day of the inspection it was noted that they were clean and tidy and offered a pleasant environment for residents to have their meals in. Residents and staff confirmed that they can have their meals served in other areas of the home is they so wished. One resident said: “I would like more fruit to be offered and less jelly and we always have red cheese I’d like other types.” These comments were brought to the attention of the manager and deputy who stated that they had only recently started using red cheese on request from the same resident. Salisbury House DS0000018935.V264158.R01.S.doc Version 5.0 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 Arrangements for protecting residents and responding to their concerns are appropriate. Staff have knowledge of polices and procedures that are in place to protect residents from abuse. EVIDENCE: There is a clear comments and complaints procedure in place in the home. A copy is in the service users’ guide. Visitors spoken with said that communication in the home is good, and they feel comfortable talking to the staff about any concerns they may have. Records seen indicate that the management team respond to issues and concerns raised in a prompt and professional manner. Salisbury House DS0000018935.V264158.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,23,24,25 & 26 The home is homely and generally well maintained. A lift, and ramps allow residents to access all parts of the home. The homes gardens are well cared for and tidy, and accessible to all residents. EVIDENCE: Following two separate small fires within the home, the managers have invested in a new fire alarm system. The previous system did highlight these fires and appropriate actions were taken. However to ensure the safety of the residents and staff was maintained they felt a new updated system would be beneficial. There are eight communal lounges, two with conservatories and two communal dining rooms. The lounges are decorated to a high standard and contain televisions, music centres and a large number of reading books. The lounge nearest the office has been designated the only smoking area within the home. Salisbury House DS0000018935.V264158.R01.S.doc Version 5.0 Page 16 Lighting throughout the home is domestic in character. It is sufficiently bright and positioned to facilitate reading and other activities. Furnishing and fittings throughout are domestic, and of good quality. Bedrooms seen had been personalised by the residents and their families. The majority of the bedrooms have en suite facilities, which include, hand washbasin and toilet. All bedrooms are lockable; care staffs can over ride these lock in cases of emergency. Those service users who share bedrooms have written consent to do so, screens are available for shared rooms to provide privacy and dignity whenever needed. The home has seven communal toilets and three bathrooms, two of these have suitable bathing hoist to assist residents getting in and out of the bath. A walk in shower is also available, which accommodates a wheelchair. Grab rails are in place within the corridors and some bedrooms. Specialist equipment was seen to be used to aid residents with mobility problems. A Call alarm system is installed throughout the home, this ensures residents can call upon staff if in need of urgent attention. It was noted that the wallpaper is Room 7 on the second floor required attention. This was reported to the managers and deputy during our discussions. Salisbury House DS0000018935.V264158.R01.S.doc Version 5.0 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 & 30 Staff at the home are employed in sufficient numbers to meet the needs of the residents. The procedures for the recruitment of staff are robust providing safeguards to offer protection to people living in the home. More staff need to obtain NVQ to meet National Minimum Standards for Older People. EVIDENCE: Since the previous inspection, there have not been many changes to the staff group. There is still a core group of staff that have worked at the home for a number of years, providing continuity of care for the residents. Staff rotas showed that each day there is a mixture of managerial, or senior staff, care, catering and domestic staff on duty to undertake the various tasks within the home. The staff group at Salisbury House have been continuing with their NVQ training, and it is hoped that they will shortly have a minimum of 50 of the staff group holding NVQs at levels 2, 3 or 4. On the day of the inspection it was evidenced that staff in the home have undertaken both mandatory and specialist training to ensure their knowledge and understanding of residents needs is enhanced and kept up to date. The staff spoken with said they had good opportunities to attend training courses relevant to their jobs. They described the staff group as a ‘good team’. Salisbury House DS0000018935.V264158.R01.S.doc Version 5.0 Page 18 Staff files contained evidence of two references and the necessary POVA 1st and CRB checks being undertaken prior to them commencing duties within the home. The residents also praised the staff team, describing them as friendly and caring. Salisbury House DS0000018935.V264158.R01.S.doc Version 5.0 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33, 36 & 38 The home appears well run, ensuring the residents are safeguarded. The manager’s have a number of years experience within the caring environments. Extra attention must be undertaken to ensure all records are kept up to date to show that the welfare and safety of residents and staff is always considered. EVIDENCE: The managers have a number of years experience of working within caring environments, ensuring the home is run to meet the stated aims and objectives. Residents and staff confirmed that the home was managed in an open and positive way. The home has a large number of policies and procedures in place to safeguard both the residents and staff at Salisbury House. Salisbury House DS0000018935.V264158.R01.S.doc Version 5.0 Page 20 The deputy manager is in the process of implementing an improved staff induction and supervision programme, ensuring staff receive the appropriate knowledge, experience and guidance to undertake their jobs whilst receiving enhanced job satisfaction and recognition. Most service records and certificates relating to the safety of the building and equipment required where valid and well recorded, however testing of fire alarm bells and emergency lighting had not been filled in since 21/10/05. The inspector spoke with the handy person who undertakes these tests and stressed the importance of recording accurately when these tasks are undertaken. Accident books were seen and appear to be well maintained however during discussion with the managers and deputy it appeared that the home does not make use of Notification of death, illness and other events forms usually referred to as Reg 37 forms. These forms should be forwarded to CSCI without delay to highlight when a resident has encountered any serious injury, illness or if there has been an event occurring in the home which could affect the safety of the residents. Salisbury House DS0000018935.V264158.R01.S.doc Version 5.0 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 3 X HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X X 3 3 2 Salisbury House DS0000018935.V264158.R01.S.doc Version 5.0 Page 22 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 OP38 Regulation Reg 23 (4c) Reg 37(1c) Requirement Timescale for action 01/02/06 2 OP38 The register manager must ensure that equipment provided for the safety of residents is tested and recorded as required. The registered manager must 01/02/06 ensure that CSCI is notified in writing of any death, illness and other events that occur within the home that could adversely affect the residents safety or well being. 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 2 Refer to Standard OP19 OP28 Good Practice Recommendations In order to improve the décor in this room it is recommended that the torn wallpaper in room 7 on the second floor is replaced. In order to meet the National Minimum Standards for Older People it is recommended that the registered manager continues to provide opportunities for staff to achieve NVQ 2. DS0000018935.V264158.R01.S.doc Version 5.0 Page 23 Salisbury House Commission for Social Care Inspection Liverpool Satellite Office 3rd Floor Campbell Square 10 Duke Street Liverpool L1 5AS 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. 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