Inspection on 12/09/05 for Santosa

This inspection was carried out on 12th September 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

Santosa 08/01/09

Santosa 07/01/07

Santosa 21/12/05

Santosa 10/02/05

Santosa 23/09/04

Santosa 29/01/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Santosa Anvil Corner Holsworthy Devon EX22 6NR Lead Inspector Antonia Reynolds Unannounced 12 September 2005 th 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 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 Stationary 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. Santosa D54-D07 S22023 Santosa V239990 120905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Santosa Address Anvil Corner, Holsworthy, Devon, EX22 6NR Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01409 254434 01409 254434 Atlas Project Team Limited Mr Paul Hewitt Mr Timothy Peter Stevens Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Santosa D54-D07 S22023 Santosa V239990 120905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: New toilet and shower will be created prior to the permanent admission of a 5th service user Date of last inspection 10th February 2005 Brief Description of the Service: Santosa is a care home providing personal care and accommodation for five people, aged 18 – 65, with learning disabilities who may demonstrate behaviours that challenge services. It is owned by the Atlas Project Team Limited, which is a private sector organisation, owning several other care homes in Devon, Berkshire and Surrey. This home is located in a rural setting, therefore provides transport for service users to access shops, pubs, and other amenities. The home was opened in 2000 and is a detached bungalow. All the home’s bedrooms are single and oneof these has en suite toilet and shower facilities. There are separate lounge and dining rooms, as well as a large sunroom, which is designated as a smoking area. The home has a very large garden, with parking facilities. All areas are accessible to the service users. Santosa D54-D07 S22023 Santosa V239990 120905 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place between 3.30pm and 4.50pm on Monday, 12th September 2005 followed by an announced visit between 10am and 2.30pm on Wednesday, 5th October 2005. The Registered Provider, Paul Hewitt and the Area Manager, Tim Stevens were present during the first visit. The Manager, Michelle Fleming was present throughout the second visit and Tim Stevens was present for part of it. A tour of the premises took place and records relating to care, the staff and the home were inspected. All four of the service users, as well as three staff members on duty, were spoken with and observed during the visit. What the service does well: What has improved since the last inspection? The Manager has applied to be registered with the Commission for Social Care Inspection, although the process is not yet completed. All the care plans have been reviewed and updated. Some refurbishment has taken place including the creation of an en suite shower, toilet and sink for the 5th bedroom (presently vacant). There are plans to extend the house to include an office/sleeping in room for staff, another bathroom, and enlarge the present lounge room. Some redecoration has taken place and is ongoing. There are also plans to update/refurbish the kitchen and utility room. The organisation has purchased a large motor home to enable service users who are uncomfortable with unfamiliar environments to go on holidays and short trips away. Following consultation with the service users, the home has acquired a cat, and the service users have responded positively to this. Santosa D54-D07 S22023 Santosa V239990 120905 Stage 4.doc Version 1.40 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. Santosa D54-D07 S22023 Santosa V239990 120905 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Santosa D54-D07 S22023 Santosa V239990 120905 Stage 4.doc Version 1.40 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 standard(s) 1, 2, 3, 4 and 5 The home’s Statement of Purpose and Service User Guide provide service users and prospective service users with details of the services the home provides, enabling an informed decision about admission to the home. EVIDENCE: No new service users have been admitted to the home since the last inspection. However, the organisation had a detailed admissions procedure where all prospective service users are assessed prior to admission by the senior management team within the organisation. Whenever possible service users are provided with opportunities to visit the home and meet the other service users and staff prior to admission. Individual records were kept for each of the service users and these contained detailed assessments, care plans and risk assessments. Discussion with the management team confirmed that specialised services were accessed if required and staff were communicating effectively with service users. Contracts with purchasing authorities were kept in the organisation’s head office, but statements of terms and conditions were available for each service user. Santosa D54-D07 S22023 Santosa V239990 120905 Stage 4.doc Version 1.40 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 standard(s) 6, 7, 8 and 9 Service users are enabled to participate in, and make decisions about, all aspects of their lives. EVIDENCE: Discussion with service users, staff and the Manager, as well as observation, confirmed that service users were enabled as much as possible to make decisions about their lives and participate in all aspects of life in the home. Service users’ plans were detailed and had recently been reviewed and updated. Staff were fully aware of the needs of each person. Any restrictions on choice or freedom were documented and agreed with the service user and other relatives/professionals involved in the person’s care. Detailed risk assessments were carried out relating to various aspects of the service users’ lives to ensure that they were able to participate in anything they chose to do, with the least risk. Service users confirmed that they have accounts with a local Building Society and, when they need to withdraw money, they are supported to do this by the staff. Service users were expected to pay for personal items, haircuts and toiletries, as well as make a contribution to some activities and the occasional takeaway meal. Where they have chosen to do so, service users have also Santosa D54-D07 S22023 Santosa V239990 120905 Stage 4.doc Version 1.40 Page 10 purchased some of their own furniture. Other costs, such as transport and holidays, were met by the organisation. Santosa D54-D07 S22023 Santosa V239990 120905 Stage 4.doc Version 1.40 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 standard(s) 11, 12, 13, 14, 15, 16 and 17 Service users can learn life skills, attend college, participate in any community and leisure activities, choose their own daily routines and enjoy a healthy diet of their choice. EVIDENCE: Discussions with service users, staff and the Manager, as well as observation and information in care plans, showed that personal development opportunities and independent living skills were actively encouraged and developed. One of the methods of encouragement was a development incentive programme where service users were paid for tasks achieved. Service users were able to describe how this system worked and clearly understood what was expected of them. Service users were enabled to attend various courses of their choice at local further education colleges and participate in various activities both inside and outside the home. Service users were able to go shopping or take part in various leisure activities of their choice when they chose to, unless the risk assessment indicated otherwise. It was evident, through observation during Santosa D54-D07 S22023 Santosa V239990 120905 Stage 4.doc Version 1.40 Page 12 the inspection, that service users considered this to be their home and were empowered to make decisions, in negotiation with the staff team. The home provided two cars for use by the service users which enabled different activities to take place at the same time. Staff were not expected to use their own cars to transport service users. Service users confirmed that they have a choice of meals, chose the menu and participated in shopping and meal preparation. Alternatives and snacks were always available and records were kept of meals provided. Service users had access to the kitchen and were involved in all the domestic activities in the home. The Manager was aware of specific dietary needs and service users were involved in understanding their own condition and how it affected them. Service users were encouraged and facilitated to keep in touch with, and see, family and friends, and the home ensured this happened by providing staff support and transport, at no cost to the service users or their families. Service users go on holiday, usually in the United Kingdom, and this was being funded by the organisation. If service users did not wish to go on holiday, day trips were arranged. The organisation has recently purchased a large motor home that may facilitate holidays for those service users who do not like being in unfamiliar environments. Service users were able to keep small animals or fish and were encouraged to take responsibility for them. Following consultation with the service users, the home had acquired a cat, and it was evident that the service users were very fond of her. Santosa D54-D07 S22023 Santosa V239990 120905 Stage 4.doc Version 1.40 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 standard(s) 18, 19 and 20 Service users can be confident that personal support is provided in the way, and at the time, that service users want and need. Health care needs are addressed as soon as they are identified. EVIDENCE: Service user plans provided detailed information about personal and health care needs. Through observation it was clear that timings were flexible and the choice of the service user. Information contained within the files, as well as discussion with the management team, confirmed that external professional advice and guidance was sought when necessary from local health care professionals or social services. Visits to and from health care professionals took place in private although staff were always present to facilitate communication and because of the needs of the service users. Individual risk assessments were carried out regarding whether or not service users were able to keep their own medication, the result being that no-one self administered medication. The organisation has its own system for the administration of medication which they have tried and tested over many years, and believe that it is the most appropriate system for them. Medication was locked away safely and records pertaining to its administration were clear, Santosa D54-D07 S22023 Santosa V239990 120905 Stage 4.doc Version 1.40 Page 14 well kept and accurate. Medication prescribed to be taken ‘as required’ was only administered by staff following consultation with a senior manager. Santosa D54-D07 S22023 Santosa V239990 120905 Stage 4.doc Version 1.40 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 standard(s) 22 and 23 Service users are protected from abuse, neglect and self-harm. Service users can be confident that complaints are always dealt with seriously and any concerns from service users will be listened to and acted upon immediately EVIDENCE: The home had a complaints procedure and staff and management always responded immediately to any issues raised by service users or their relatives. Neither the home nor the Commission for Social Care Inspection have received any complaints regarding the service since the last inspection. Regular house meetings were held where any issues or concerns were raised and dealt with immediately, although service users can raise any issue at any time. The Manager was well aware of adult protection issues and procedures and training has been undertaken, or is planned, for all staff members. The organisation is considering producing their own adult protection training for staff, specifically designed for their service user group. All incidents were documented and carefully monitored by the management team. Santosa D54-D07 S22023 Santosa V239990 120905 Stage 4.doc Version 1.40 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 standard(s) 24, 25, 26, 27, 28 and 30 The standard of the environment is very good, providing service users with an attractive and homely place to live. EVIDENCE: The home was comfortable, safe and clean and was well maintained. The home’s lounge and dining rooms were comfortably furnished and there were plans to extend the lounge room. Decoration is ongoing and all the rooms were decorated to a good standard. The home is in a rural setting and two vehicles were provided to enable service users to access local amenities with staff support. It was evident that service users felt ‘at home’ in the environment and each service user had a single bedroom, two of which had en suite toilets, showers and sinks. One of the en suite facilities was new and was awaiting decoration and that bedroom was vacant on the day of inspection. The other bedrooms did not contain wash hand basins due to the needs of the service users. The bedrooms were all decorated individually and contained many personal possessions. Service users confirmed that they were able to choose the furnishings and décor of their bedrooms. Some of them had purchased their Santosa D54-D07 S22023 Santosa V239990 120905 Stage 4.doc Version 1.40 Page 17 own furniture and inventories were kept of these items. Bedrooms did not have private telephones, but service users had access to the home’s portable ‘phone. Bedroom doors were not fitted with locks, however previous inspections have noted that service users have agreed that they do not wish to have locks on their bedroom doors and discussion with service users confirmed this. The home had one bathroom containing a bath with over bath shower, toilet and wash hand basin, which was shared by three service users. The bathroom door was fitted with a suitable lock that could be opened from the outside in an emergency. There are plans to provide an additional bathroom. The home had lounge and dining rooms, which were comfortably furnished, as well as a sunroom, that was the designated smoking area. There are plans to install heating in the sunroom to make it more comfortable in the winter months. There was plenty of outdoor space in the garden, which was well maintained. Kitchen and laundry facilities were satisfactory. The washing machine was sited beside the kitchen but the Manager confirmed that soiled laundry was taken there via the conservatory and that there are plans to update and refurbish these areas, including moving the laundry equipment. Infection control procedures described by the Manager were satisfactory. The home had an office where staff could store belongings when on duty and there are plans to build another office/staff sleeping in room. The home did not have a call alarm system or any specific aids and adaptations, apart from hand rails, as these were not required for the service users. Santosa D54-D07 S22023 Santosa V239990 120905 Stage 4.doc Version 1.40 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 34, 35 and 36 Recruitment procedures are robust and service users’ needs are met by high staffing levels. Service users benefit from well supported and supervised staff, creating a calm, relaxed and pleasant atmosphere in the home. EVIDENCE: Staff files inspected show that the organisation had a robust recruitment procedure and all the required information was available. A file for a recently employed staff member showed that only one written and one verbal reference had been received but the Manager confirmed that this was being addressed. Criminal Record Bureau checks had been carried out and recent checks were available for inspection. Where these checks had been destroyed, confirmation that they had been carried out was available in staff files. Discussions with the service users and staff, as well as observation, indicated that staff understood their roles and responsibilities and the advice, guidance and support of other professionals was sought when necessary. Regular staff meetings were held which service users could also attend. Discussions with the Manager and staff, as well as records, confirmed that regular individual supervision sessions took place. The organisation had a training officer who maintained an overview of what the organisation requires, as well as ensuring that individual staff members received the training they need, and training records had been sent to the Santosa D54-D07 S22023 Santosa V239990 120905 Stage 4.doc Version 1.40 Page 19 Commission for Social Care Inspection. These records confirmed that all staff received training on various subjects and were enrolled on various courses including National Vocational Qualifications. Training included induction, emergency first aid, health and safety, food hygiene and adult protection as well as training specifically related to the service users, such as behavioural management courses and strategies for crisis intervention including defusion/distraction techniques as well as physical restraint. Staffing rotas were available in the home showing that there were usually three or four staff on duty from 8am to 9pm, including the Manager; two staff between 9pm and 1030pm, and one waking night staff. If an additional member of staff is required at night, the Manager confirmed this would be arranged and, to ensure adequate facilities are available, there are plans to extend the home which will include another office/sleeping in room. The organisation operates an ‘on call’ system whereby members of the management team are available both in and out of office hours and the staff team confirmed that this worked well. Unannounced inspections have also shown that the Registered Provider and senior Managers within the organisation respond promptly to crises when needed. Santosa D54-D07 S22023 Santosa V239990 120905 Stage 4.doc Version 1.40 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 38, 39 and 42 The management approach of the home is open and positive and provides clear leadership, with the management team believing in leading by example. Providing quality care is the focus of the organisation. Service users’ rights, health, safety and welfare are protected and promoted. EVIDENCE: The Manager of the home has been in post since October 2004 and has applied to be registered with the Commission for Social Care Inspection. The Manager was competent and experienced to run the home, had already achieved the Advanced Management in Care award and was in the process of completing the Registered Manager’s Award. Lines of accountability were clear and the organisation has a management structure that enables it to cover absences when required, and provide an effective ‘on call’ system to support staff. The organisation has introduced a ‘trainee management’ scheme over the last two years and this has worked well. Santosa D54-D07 S22023 Santosa V239990 120905 Stage 4.doc Version 1.40 Page 21 The members of management and staff who were spoken with confirmed that they are consulted and included in any decisions regarding the running of the home. The organisation has devised its own quality assurance system, specifically designed around the service user group for whom the home is intended. The system included an internal audit and consultation with service users, relatives/representatives and other stakeholders. Discussion with the management team showed that the quality of care is constantly under review and any poor practice issues were addressed immediately. Service users were consulted informally through discussion and observation and any action taken relating to an individual was recorded. All documentation relating to service users was detailed, up to date and accurate. All incidents were recorded and monitored by the management team. Records relating to health and safety issues, such as risk assessments, the accident book, fire log book, and employers liability insurance certificate were available and up to date. The Manager confirmed that all staff members had received training in emergency first aid, health and safety, food hygiene and fire safety training and service users were included in fire drills. Records showed that fire safety equipment was checked and tested as required. The Manager has confirmed at previous inspections that a valve to control the temperature of hot water is fitted to the bath but not to the showers and wash hand basins, therefore risk assessments have been carried out. All substances hazardous to health were kept securely. Pre inspection documentation confirmed that the Environmental Health Officer had inspected the home on 30th November 2004, portable electrical appliances had been checked on 18th February 2005 and the home had an electrical wiring certificate valid until January 2008. The home had an annual insurance plan for the servicing of gas appliances. Monthly provider visit reports were being carried out and copies of the reports sent to the Commission for Social Care Inspection. Santosa D54-D07 S22023 Santosa V239990 120905 Stage 4.doc Version 1.40 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 3 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 N/A 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Santosa Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 3 3 x x 3 x D54-D07 S22023 Santosa V239990 120905 Stage 4.doc Version 1.40 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 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 Good Practice Recommendations Santosa D54-D07 S22023 Santosa V239990 120905 Stage 4.doc Version 1.40 Page 24 Commission for Social Care Inspection Unit D1 Linhay Business Park Ashburton TQ13 7UP 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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