Inspection on 07/01/07 for Santosa

This inspection was carried out on 7th January 2007.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Santosa 08/01/09

Santosa 21/12/05

Santosa 12/09/05

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 Anita Sutcliffe Unannounced Inspection 7th January 2007 05:30 Santosa DS0000022023.V315930.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 Santosa DS0000022023.V315930.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. Santosa DS0000022023.V315930.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Santosa Address Anvil Corner Holsworthy Devon EX22 6NR 01409 254434 F/P 01409 254434 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) Atlas Project Team Limited Mr Paul Hewitt Vacancy Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Santosa DS0000022023.V315930.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Five service users with a learning disability aged 18 - 65 Date of last inspection 21st December 2005 Brief Description of the Service: Santosa is a care home registered to provide personal care and accommodation for up to five people, aged 18 - 65, with learning disabilities who may demonstrate behaviours that challenge services. Atlas Project Team Limited owns the care home. The home was opened in 2000 and is a detached bungalow. It is located in a rural setting. Transport is provided for service users to access shops, pubs, and other amenities. All the homes bedrooms are single and one of these has en suite toilet and shower facility. 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. Current fee levels are: £1,817 - £3,054. Additional charges are made for personal items. The most recent report is available on request. Copies are also kept in the dining room of the home. There have been no new service users at Santosa for more than two years. It has been decided by the providers to limit the number of admissions to four. Santosa DS0000022023.V315930.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Information toward this key inspection has been gathered since January 2006. The home provided current information about its service. Each staff member had the opportunity to complete an anonymous survey and comment about the home. None chose to do so. Comments about the home were received from health and social care professionals. The visit to the home was unannounced on a Sunday evening. Each service user was met. Staff were spoken with and observed working. Each part of the premises was visited. Care and medication records were examined. The manager, staff and a representatives from the organisation, were present. What the service does well: The staff are kind and caring. They know what they are doing. You can feel safe at Santosa. You can have a good life. It is a very good home. Management and staff take every opportunity to support service users toward a fulfilled and meaningful life. They have knowledge, skills and expertise in their work. The environment is of a high standard. Food provision is good. Risk is well managed and the safety and well being of service users is a high priority of the organisation. What has improved since the last inspection? The home has a better kitchen, a new shower and some new carpets. This makes it an even nicer place to live. There were no previous requirements or recommendations. What they could do better: The registration of a manager must be undertaken at the earliest opportunity for the organisation to meet its legal obligations. Santosa DS0000022023.V315930.R01.S.doc Version 5.2 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Santosa DS0000022023.V315930.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 Santosa DS0000022023.V315930.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The needs of service users are the priority of the home and organisation. EVIDENCE: No new service users have been admitted to the home for over two years. A senior member of the management team would assess any new admission and each current service user has their needs regularly and fully reviewed. Santosa DS0000022023.V315930.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users are listened to, understood, and supported to enjoy a varied and fulfilling life. EVIDENCE: Service users appeared relaxed and comfortable in the presence of staff. Two of them were particularly keen to talk about activities they enjoy and things they have achieved. They are encouraged to be involved in all aspects of their life and supported towards achieving their full potential. Examples include the use of computer/technical equipment and household tasks. There are daily ‘house’ meetings and a ‘key’ member of staff identified to provide support. Where risk is involved this is understood and managed in service users’ best interest and with their involvement; there is consultation with other experts as appropriate. Health and social care professionals are very satisfied with the way the home meets service users’ needs. Santosa DS0000022023.V315930.R01.S.doc Version 5.2 Page 10 Staff understand how to reduce behaviour that adversely affects a service user’s life, enhance positive behaviours that enrich their lives and teach new skills. Discussion with one service user confirmed their involvement in how this is achieved. Santosa DS0000022023.V315930.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16 & 17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents enjoy a quality lifestyle and are supported to reach their full potential. EVIDENCE: One service user said: “Lovely meals, three times a day. Staff are very kind and helpful. The manager organises monthly trips for me. I have fruit morning and afternoon. We get taken out in cars quite often, sometimes to Bude, sometimes for lunch. I buy videos and DVD’s”. Service users are supported with hobbies and interests. Their individual computer, video and entertainment equipment was demonstrated with confidence. One spoke of the support that had been received through a difficult family situation. Family connections are very well supported. Santosa DS0000022023.V315930.R01.S.doc Version 5.2 Page 12 Local education provision has been cut and is therefore not available to service users as previously. However, the organisation is taking steps to meet this shortfall and skills are developed none-the-less. Although the home is rural there are frequent trips to the city and local towns. In addition, social events are shared with another Atlas home in the vicinity, an example being an autumn bonfire party. Service users also have a holiday each year. In 2006 these included trips to Amsterdam and Cornwall. Hobbies and interests are very well promoted. Service users say they like the food at the home; they are able to influence the menu, which was very varied. One described in detail the Christmas lunch and how they all shared in its preparation. Two service users helped themselves to food and drink during the inspection visit. Santosa DS0000022023.V315930.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Personal and health care needs are understood and met. Medication is handled diligently, with strict controls in place to ensure service user well being. EVIDENCE: Service users rely completely on staff to ensure their health care needs are met, but are able, and supported, to make choices. One talked of current treatment being received by a local health care professional. Records showed the involvement of health care professionals, including doctor, psychologist and chiropodist. Each service user is encouraged to be responsible for their personal care. No specialist health care equipment is required in the home. No current service user has the ability to safely handle their medicines, so this is done for them. Medicines are securely stored. The registered manager dispenses medication into a monitored dosage box, it was said: “to reduce the Santosa DS0000022023.V315930.R01.S.doc Version 5.2 Page 14 likelihood of mistakes”. However, this practice does not comply with the Royal Pharmaceutical Society guidelines for care home, which states that ‘Medication should never be secondarily dispensed for someone else to administer to the service user at a later time or date’. This practice should be reconsidered. Medication records are orderly and each medicine can be fully accounted for. When a variable or little needed medicine is used this can only be given with permission from a senior member of the organisation. Information about each prescribed medicine is available within the care records, should it be needed as a reference. Santosa DS0000022023.V315930.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can be assured that complaints would be taken seriously and dealt with properly. They are protected from abuse through strong leadership and the culture of the home. EVIDENCE: Neither the home, nor the Commission, has received complaints about Santosa. Service users would be unlikely to use a formal complaints procedure but staff have the skills to communicate well with them and are aware when something is wrong. Therefore problems not communicated would be recognised and dealt with promptly. There is strong management within the organisation with a passion for the protection of service users, who were relaxed and appeared confident in the presence of staff. A staff member said: “The organisation are very keen on whistle blowing”, implying that staff are expected to speak out if they see anything that gives them concern. Protection of abuse is a standard part of staff training. The home has effective policies and procedures in complaints and the prevention of abuse. Santosa DS0000022023.V315930.R01.S.doc Version 5.2 Page 16 Santosa DS0000022023.V315930.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users live in a home, which is clean, well furnished, warm, safe, comfortable and meets their individual needs and desires. EVIDENCE: All parts of the home were visited. It was clean, warm and comfortable and provides a variety of shared and private space. Furnishings and décor are modern and in a good state of repair. Where there might be a danger, such as cleaning chemicals and medication, the risk is reduced or removed. The laundry facility is adequate to meet the needs of current residents. Service users do their laundry individually. Each service user has an individual bedroom. They are very well equipped and age appropriate. Service users confirmed that they have chosen their furniture and décor and were very keen to demonstrate their computer and technical equipment. Santosa DS0000022023.V315930.R01.S.doc Version 5.2 Page 18 The gardens include a patio area and swing and are used for social occasions in warm weather. There has been a recent upgrade to the kitchen, which is now larger. Staff felt the space was now better managed, and service users were seen preparing food. Washing and toilet facilities have also been extended, providing better choice. Santosa DS0000022023.V315930.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 & 36 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users benefit from staff that are skilled, experienced and well supervised. They are protected through robust recruitment practice. EVIDENCE: A service user spoke of how hard staff work to help him visit places of importance to him. One was showing her photographs to staff. Another described how a member of staff is allocated as a ‘key’ person to support them. Service users are confident and well supported by staff and the way the home is organised. Health and social care professionals felt that staff demonstrate a clear understanding of the care needs of serviced users and said there is always a senior member of staff to speak with. The manager, day and night staff were met during the inspection visit. One staff member was interviewed. He described his recruitment and the support he received when new to the work and organisation, saying: “support is very Santosa DS0000022023.V315930.R01.S.doc Version 5.2 Page 20 good”. A night support worker also confirmed that support and advice is always available. The home’s recruitment policy is strictly followed. Staff do not work unsupervised until it is assured they are safe to work with vulnerable adults, and have sufficient skills to work safely and effectively. The registered provider ensures staff are in no doubt as to what is expected of them and takes appropriate steps if their appointment is deemed unsuitable. Staff training provides them with the knowledge necessary to deliver a high standard of care to the service users, and it helps keep staff safe. It includes fire safety, food hygiene, behaviour management and prevention of abuse. Training is of good quality. Santosa DS0000022023.V315930.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, 40 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The organisation runs the home in the best interest of residents. Interests will be further met once the manager is registered with the Commission. Health and safety are properly attended to. Providing quality care is the focus of the organisation. EVIDENCE: Following the resignation of the registered manager in January 2006 a new manager was employed by the organisation. She has provided consistency for the service users who knew her previous to the appointment. She has been well supported by the organisation, whilst deciding whether to accept the statutory responsibilities of being registered as a manager. She has now taken Santosa DS0000022023.V315930.R01.S.doc Version 5.2 Page 22 steps towards registering with the Commission. However, as yet the application has not been received; the Commission is aware of the reasons for this. If the manager were registered the home would be operating in line with its legal obligations. There is an effective management structure within the organisation with strong leadership and support for staff. Service users appear comfortable, relaxed and happy. Staff are clear what is expected of them. One member of staff said: “The management is very good”. Health and social care professionals indicate that management and staff communicate clearly and run the home in the best interest of service users. The health, safety and welfare of service users are met through effective care planning and support, competent staff, good management and administration and investment in the building. Santosa DS0000022023.V315930.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 4 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 4 32 4 33 4 34 3 35 3 36 4 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 X 4 X LIFESTYLES Standard No Score 11 4 12 3 13 4 14 4 15 3 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 4 3 3 X 3 X Santosa DS0000022023.V315930.R01.S.doc Version 5.2 Page 24 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 YA37 Regulation Care Standards Act 2000 Part 2, 11, (1) Requirement Any person who carries on or manages an establishment must be registered under Part 2 of the Care Standards Act 2000. (In this case the person employed as manager of the home must apply to registered). Timescale for action 28/02/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Santosa DS0000022023.V315930.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Santosa DS0000022023.V315930.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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!