Inspection on 06/02/06 for Salisbury House

This inspection was carried out on 6th February 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 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 03/11/05

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 Announced Inspection 6th February 2006 09:30 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.V274872.R01.S.doc Version 5.1 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.V274872.R01.S.doc Version 5.1 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.V274872.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Only thirty four (34) elderly persons may be accommodated. Two (2) named elderly persons with a mental disorder (excluding learning disability) may be accommodated. One (1) named adult with a learning disability may be accommodated. Date of last inspection 3rd November 2005 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.V274872.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The manager, staff, residents and relatives where told that the inspector would be calling at the home. The manager completed a pre questionnaire and a number of the residents filled in comment cards. These where used to assist the inspector throughout the inspection, which took place over a 7 hour period. The inspector sampled the food served, toured the home, examined a variety of records and spoke individually and in groups to residents and staff members. What the service does well: What has improved since the last inspection? Person centred care plan systems have been fully implemented. Detailed risk assessments have been implemented to guide and direct staff when balancing residents’ rights to take risks whilst ensuring health and safety is maintained. Improvements have been made to staff induction and supervision programmes. Staff welcome packs have been produced to ensure staff themselves feel valued as individuals and that they have easy assess to essential information they require to undertake their roles and responsibilities whilst developing their professional competence within Salisbury House. Quality assurance questionnaires have been given out to residents, visitors and staff in order to gain their views regarding Salisbury House. The deputy manager is in the process of collating this information and aim to review outcome on a three monthly basis. Omissions noted within the maintenance records noted during the last inspection have ceased to occur. Therefore the inspector was able to confirm Salisbury House DS0000018935.V274872.R01.S.doc Version 5.1 Page 6 that equipment is routinely tested in order to highlight when any issues or concerns arise that could put the safety of residents and staff at risk. A number of areas within the home have been decorated in order to maintain a high standard of environment for the residents to live in. 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.V274872.R01.S.doc Version 5.1 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.V274872.R01.S.doc Version 5.1 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&3 Prospective residents are assessed prior to admission and are provided with the information they need to make a decision about whether or not Salisbury House will be able to met their needs effectively. EVIDENCE: The inspector was able to confirm that a Statement of Purpose and Service User’s Guide was available within the home. These contained clear relevant information prospective residents and their representatives require to make informed decision about the suitability of the services offered within the home. Residents and staff members confirmed that residents and their families are encouraged to visit the home before admission, so that they can actual see what’s available and to hear the views and experiences of others living there. Records kept within resident’s files confirmed that prospective residents were always assessed prior to admission by a senior member of staff, ensuring that the home could meet their needs effectively. The assessment forms used cover all aspects of the person’s health, personal and social care needs. Salisbury House DS0000018935.V274872.R01.S.doc Version 5.1 Page 9 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 & 11 Residents health and personal care needs are set out in person centred care plan and are fully met in a manner, which maintains their rights to privacy and dignity. Polices and procedures relating to the administration of medication within the home appeared to be followed correctly to aid good health and well being of residents within Salisbury House. EVIDENCE: A random selection of 4 residents care plans files, where examined. Each file contained a full range of assessment documentation, risk assessments, and care plans. Details relating to visits from GPs and other professionals where clearly recorded and written records completed by staff clearly indicated observations and interaction encountered on a daily basis. Records seen demonstrated that care plans are regularly reviewed and where necessary adapted to reflect changing needs / aims of the residents. It was noted that the new person centred care planning approach has been adopted to ensure staff members have an opportunity to taking into account residents life histories and past and present social interests. As this can have a Salisbury House DS0000018935.V274872.R01.S.doc Version 5.1 Page 10 profound affect upon how a resident may in fact be viewing their present situation. All residents are encouraged to sign their care plans in order to demonstrate that they have been consultation and that they are in agreement with the aims and objectives recorded. Evidence was gained from examining care plans records and from speaking with residents and staff that health needs were being met appropriate. Documentation seen confirmed that residents’ health needs are assessed in relation to nutrition, continence, mobility and risk of pressure sores. Equipment necessary to aid mobility and for the prevention and treatment of pressure sores was seen to be provided when necessary/ appropriate. Residents and staff members confirmed that when required they could access the services of other health care professionals, such as optician, dentist, chiropodist, GP, continence adviser etc. Care files examined confirmed such advice or treatment had been sought when necessary. The arrangements for storage and disposal of medications seen were good. The deputy manager and a member of the senior care team gave the inspector an insight into how the homes policies and procedures are put into practise and records relating to the booking in, storing, administrating and returning of unused medication records where seen. It was noted that although residents photo’s are already in place on individual Medication Administration Records (MAR) to reduce any possible errors when giving out medication that staff within the home have decided to add photos to the individual nomad boxes too these is seen to be extremely good practice in minimising risk. A small sample of residents medication stored in the home was checked against records held and these where found to be correct. All senior staff that administer medication have undertaken suitable training to ensure they understand their roles and responsibilities in these areas. Records seen by the inspector confirmed that on going training is planned to ensure awareness, knowledge and experience is regularly refreshed. Staff were observed speaking to residents in a courteous and helpful manner, and addressing them by their preferred name. They were seen knocking on residents’ doors and waiting for permission before entering the room. Throughout the inspection staff members were observed assisting / supporting residents discreetly as set out within their individual care plans. They where also observed as they entertained residents, served meals & drinks, cleaned & tided rooms as well as spending time in general conversation with residents and visitors to the home. At all times the inspector noted that staff were respectful and that a good rapport with the residents had developed. Salisbury House DS0000018935.V274872.R01.S.doc Version 5.1 Page 11 When asked about the staff, residents made comments such as “their the best I’ve met, I can always have a bit of laugh with the” ” and “they are very kind and helpful” Policy and procedures are in place within the home to assist staff in supporting residents and their families in dealing with the affects of failing health as well as expected and unexpected deaths. Observations of staff interactions seen throughout the day indicate that residents and their families can be assured that they can be assured that in such situations they will be treated with appropriate levels of sensitivity and respect. Salisbury House DS0000018935.V274872.R01.S.doc Version 5.1 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 Social activities are advertised and provided in and outside the home ensuring residents are provided with opportunities to maintain their chosen lifestyles and desires to socialise. Meals are nutritious and balanced and offer a varied diet for residents, meeting individual needs. EVIDENCE: Residents gave a number of examples of the way in which they have choice and control over their lives. Some residents stated that they had chosen a relatively private lifestyle, living in their bedrooms for most of the time. Other residents said they have choices about the time they get up and go to bed, the food they eat and whether or not they join in any activities. The home has recently registered with Care Aware services and a posters in the main hallway highlights how they can arrange advocacy services for any resident who does not have a representative. Residents are encouraged to personalise their rooms as they wished with small items of their own furniture, ornaments, pictures and any other mementoes. One resident stated “having my own things around me, helps me to really feel at home” Salisbury House DS0000018935.V274872.R01.S.doc Version 5.1 Page 13 An activity programme is displayed within the main hallway so that residents and visitors are aware of what is due to be taking place. Activities arranged by the home include old time music, bingo, outings to various places of interest. On the day of the inspection a regular outside entertainer came in and played a number of tunes upon the organ. Residents and visitors where seen enjoying singing and dancing to many of their “old time favourites” A number of the residents within Salisbury house attend local day centres on a regular basis as they have formed and developed relationships and interests that they wish to continue pursuing. Visitors where seen to be welcomed within the home and residents stated that they are encouraged and supported to maintain contact with their families at all times. Salisbury House staff strive to recognise and respect the rights of their residents by committing to their residents “charter” which centres around six basic areas which they believe aids a good quality care and life experiences CHOICE PRIVACY DIGNITY INDEPENDENCE FULFILMENT CITIZENS’ RIGHTS Menus cover a four week cycle, and appear to offer a varied and balanced diet. Residents confirmed that they are offer a choice from the menu the day before and that they could choose whether they ate in the dining room or their own room. Staff working in the kitchen confirm that they have regular supplies of fresh products and that they are kept up to date with any relevant changes in dietary or preference needs of the residents. The main meal of the day was served to the residents and inspector at lunchtime. Food served was hot and tasty and well presented. Fresh vegetables where served from suitable serving dishes by the staff ensuring that residents had a further opportunity to exercise choice not only regarding which vegetables they preferred but also with regard to the size of the portion they received. Salisbury House DS0000018935.V274872.R01.S.doc Version 5.1 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): 18 Staff have knowledge and understanding of adult protection issues, which protects residents from abuse. EVIDENCE: The home has satisfactory policies and procedures in place to meet this standard, including prevention of abuse, whistle blowing and protection of vulnerable adults. Staff receive training during the induction programme to ensure they have an awareness of the issues that can arise in such situations and the importance of recording and reports any issues or concerns as quickly as possible. The management team have recently had experience of working with Wirral’s Adult Protection Unit in order to report and clarify issues and concerns ensuring appropriate actions and advice was sort to protect residents in their care. Salisbury House DS0000018935.V274872.R01.S.doc Version 5.1 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 provides a safe, comfortable, well-equipped and clean environment for the residents. EVIDENCE: A number of areas have recently been decorated to ensure good standards remain in place throughout the home. 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. 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. Salisbury House DS0000018935.V274872.R01.S.doc Version 5.1 Page 16 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. Residents 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 Salisbury House DS0000018935.V274872.R01.S.doc Version 5.1 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 Robust recruitment practices are followed offering protection for residents, and the induction programme helps to equip staff in the early stages of their employment with all the skills they need to adequately care for residents. EVIDENCE: Rota’s seen confirm that Salisbury House ensures there are sufficient staff on duty throughout the 24 hr period to attend to residents needs and the maintaining of a clean and safe environment. An examination of staff personal files and discussion with the management team confirmed how robust recruitment practices are put into place and followed. The management team appears to have extensive knowledge of POVA and CRB legislation and procedures and may in the future consider applying to become an umbrella body for CRB applications as the owners of Salisbury Independent living is a growing organisation in its own right. An on going training programme was seen to be in place to ensure staff members have access to suitable areas of training to continue undertaking their roles effectively. Staff spoken to during the inspection confirmed that they are encouraged and supported to undertake relevant training to do their jobs and to pursue National Vocational Qualification training in order to enhance their personal career development whilst demonstrating the knowledge and skills these jobs Salisbury House DS0000018935.V274872.R01.S.doc Version 5.1 Page 18 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): 31,32,33,34,35,36,37 & 38 Quality assurance systems in place within Salisbury House, ensure the management and administration of the service is influenced by the views of the residents, visitors and staff and that as far as possible everyone is safeguarded. EVIDENCE: The home has recently implemented an updated quality assurance programme. Documentation relating to audits recently carried out with residents and staff where seen and discussed during the inspection. It is envisaged that these satisfaction survey results and actions taken will be reviewed on a 3 monthly basis. It is advisable that such results are published annually to show areas of achievement via such consultation process. It’s also recommended that a copy of such finding be sent to CSCI. Alongside regular monthly reports of the owners findings regarding conduct and service delivery within the home. Salisbury House DS0000018935.V274872.R01.S.doc Version 5.1 Page 19 It was agreed that the inspector would ensure that the relevant information and forms regarding the format used within regulatory 26 visits would be forwarded to the home to assist them with in implementing this recommendation. There are good policies and procedures in place to safeguard the resident’s financial interests. Records examined confirmed that any handling of monies on resident’s behalf is clearly and accurately recorded and that these could easily be cross-reference with accounts held. Improvements have been made to the recording of regular maintenance work undertaken within the home i.e. the weekly testing of fire alarm systems. Health and safety matters appear to be given good attention. There are a range of policies and procedures in place and evidence that staff work in ways to promote the well being of residents. Salisbury House DS0000018935.V274872.R01.S.doc Version 5.1 Page 20 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 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 4 4 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 4 3 3 3 3 3 3 Salisbury House DS0000018935.V274872.R01.S.doc Version 5.1 Page 21 Are there any outstanding requirements from the last inspection? no 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 OP28 Good Practice Recommendations 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 to at least level 2. The register persons are strongly recommended to produce and forward regular monthly reports to CSCI to demonstrate their own findings with regards to the conduct of the home. It is recommended that recently implemented Quality assurance survey results are published in an annual report and that a copy of this be sent to CSCI 2. OP33 3. 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