Inspection on 08/01/09 for Santosa

This inspection was carried out on 8th January 2009.

CSCI found this care home to be providing an Excellent service.

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 07/01/07

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 19/06/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Santosa Anvil Corner Holsworthy Devon EX22 6NR The quality rating for this care home is: three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Anita Sutcliffe Date: 0 8 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area Outcome area (for example: Choice of home) These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Reader Information Document Purpose Author Inspection report CSCI Page 2 of 30 Care Homes for Adults (18-65 years) Audience Further copies from Copyright General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 30 Information about the care home Name of care home: Address: Santosa Anvil Corner Holsworthy Devon EX22 6NR 01409254434 01409254434 dawn.bond@apt-ltd.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Atlas Project Team Ltd Name of registered manager (if applicable) Mrs Dawn Elizabeth Bond Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 5 0 care home 5 learning disability Additional conditions: The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: Learning disability (Code LD) - and who are aged 18 years or over on admission. The maximum number of service users who can be accommodated is 5. Date of last inspection 0 7 0 1 2 0 0 7 Care Homes for Adults (18-65 years) Page 4 of 30 A bit about the care home Up to five people can live at the home but four are living there now. They need help and support which is what the home provides. The home is in the country and so people need to be driven to towns and places of interest. Everyone at the home has their own room. One room has its own bathroom but the others share a bathroom. People share the lounge and dining room space. There is a big sunroom and a very big garden. Current fee levels are: £1,956 to £2,232 per week. General information about fees and fair terms of contracts can be accessed from the Office of Fair Trading web site at /www.oft.gov.uk . Additional charges are made for personal items only. Care Homes for Adults (18-65 years) Page 5 of 30 Care Homes for Adults (18-65 years) Page 6 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home Care Homes for Adults (18-65 years) Page 7 of 30 How we did our inspection: This is what the inspector did when they were at the care home They visited the home and met the people who live there. They had a long talk with one person. He told us how he spends his time. They talked to staff and the manager Mrs. Dawn Bond. They looked at how the home is run. This includes records of how people are supported and cared for. Care Homes for Adults (18-65 years) Page 8 of 30 They looked at some policies and procedures. They tell staff what they must do and how they must do it. What the care home does well Staff know what they are doing. They have been well trained and want to do a good job. The people who live at Santosa are listened too. They are helped to get what they want and need. Care Homes for Adults (18-65 years) Page 9 of 30 People are able to learn new things. They have an interesting life. The home is warm, clean, safe, and has all that people need in it. What has got better from the last inspection What the care home could do better There are two ways the home could be even safer. The list of people who should not work at a care home must always be checked before staff Care Homes for Adults (18-65 years) Page 10 of 30 start working there. Staff need the contact number of the local team who protect people from abuse. If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Anita Sutcliffe Colston 33 33, Colston Avenue, Bristol. BS1 4UA 0117 930 7110 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. Care Homes for Adults (18-65 years) Page 11 of 30 You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line - 0870 240 7535 Care Homes for Adults (18-65 years) Page 12 of 30 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 13 of 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People thinking of moving into the home can be assured that their care needs will be asessed and can be met. Evidence: There has been one admission to the home since the previous key inspection January 2007. That person moved from another home run by Atlas Project Team Ltd. We saw that as much information as possible was gathered on the person before admission. This included visits to see them, assessment from their Care Manager and speaking with people who know them well. The manager and organisation representatives make a full assessment of a person so they can be sure Santosa can meet their needs. The person recently admitted had visited Santosa a few times before moving in and they had the option to stop over night but chose not to. Their Care Manager said of the home Very satisfied. The person themselves was unable to tell us what they thought of the home, but she looked well cared for and was receiving much attention. Staff had a good knowledge of how to care for her. Care Homes for Adults (18-65 years) Page 14 of 30 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People are consulted, listened to, and supported to enjoy a varied and fulfilling life within their capabilities. Support is well planned and risk well managed. Evidence: We met two people using the service, and asked staff about those peoples needs. We also looked at the care plans, medical records and daily notes for the two people and had a long conversation with one of them. The care plans are based around the assessments of identified risks for each person and goals are planned with the individual and clear boundaries are set if this is necessary. Where risks are identified, for example, travelling away from the home, ways are looked at to ensure that risk is reduced or removed. This helps the person move toward independence. Staff confirmed that they refer to the plans when things crop up and every time a review of the care is necessary. Each person at the home has different abilities, but are encouraged and helped to make decisions about how they wish to live their lives. They are involved in all aspects Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: of their life and supported towards achieving their full potential. 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 peoples best interest and with their involvement; there is consultation with other experts as appropriate. A health and social care professional said: Care is very person centred. It was Santosa that initiated my client getting out and about more. We are always invited to the twice yearly reviews and kept well informed. One person explained how they are encouraged to take part in the homes Development Initiative, where they are paid for completing household tasks. A member of staff said that through this initiative people are often unaware they are learning new skills. Daily recordings are well maintained and appropriate. Staff use these recordings to ensure they are up to date with the current needs of the person. All incidents within the home are recorded and staff are well informed about changes in behaviour that might indicate a problem arising. Care Homes for Adults (18-65 years) Page 16 of 30 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People who use the service are supported to reach their full potential and enjoy a good quality of life. Evidence: People who use the service were relaxed and comfortable in the presence of staff. One of them was keen to talk about their daily work at the home, known as Developmental Incentives, for which they are paid. The tasks required a responsible person to do them, such as checking the gas tank, recycling and doing their laundry. With their earnings they were saving up for some new technical equipment. They told us they liked the system saying: Very happy with it. The organisation tells us that people are expected to take an active role in the development of their home, thus enabling them to feel empowered and take ownership, teaching them to be responsible for their actions and reaping the rewards of a valued role within the home and community. Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: Although the home is rural there are frequent trips to the city and local towns. In addition, social events are sometimes shared with another Atlas home close by. People have a holiday each year, or if they are not suited to stopping away from the home, special day trips. People go shopping, to the beach, aquarium, stay in a cottage or at Centre Parc. Holidays for 2009 are not yet planned. People were taken out individually during our visit. We are told that a training centre will soon be opening at another Atlas home, close to Santosa. This will give people the opportunity to try new skills, such as computer work and crafts. The organisation are currently arranging a tutor to run it. People are encouraged and helped to keep in touch with, and see, family and friends. Family connections are well supported. People told us they are involved in choosing what meals to have and like the food available. The menu was quite varied. People had access to fresh fruit and good quality foods. Care Homes for Adults (18-65 years) Page 18 of 30 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of 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 peoples well being. Evidence: People rely completely on staff to ensure their health care needs are met, but are able, and supported, to make decisions about this. Peoples plan of care describes how they are to be helped with their personal care needs where this is necessary. Records showed the involvement of health care professionals, including doctor, psychologist and dentist. The Care Manager of the last person admitted said: Very satisfied, in particular with how xxx now attends health care appointments. Very, very, very well done Santosa. No specialist health care equipment is required in the home. No person who uses the service has the ability to safely handle their own 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 likelihood of mistakes. Although not practise in line with the Royal Pharmaceutical Society Care Homes for Adults (18-65 years) Page 19 of 30 Evidence: guidelines for care homes there has never been a medication error at the home. 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. Peoples need for medicines is regularly reviewed. Care Homes for Adults (18-65 years) Page 20 of 30 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People 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 any complaints about Santosa. The home has a complaints procedure in a pictorial format to help people with reading difficulties. Each person has a copy for their use. People who use the service would be unlikely to use a formal complaints procedure but staff have the skills to communicate with them and are aware when something is wrong. We believe that problems not voiced by people would be recognised and dealt with promptly. People at the home appeared relaxed in staff company. The owner and manager said that they would respond to and deal with any concerns raised immediately and people who we spoke with said that they would tell the staff if they were unhappy about anything. Everyone living at the home has their own bank account and people there are helped to learn to budget. The home keeps good records on their behalf. Staff that were spoken with had received some training in how to safeguard the Care Homes for Adults (18-65 years) Page 21 of 30 Evidence: vulnerable people in their care and were able to describe several differing types of abuse. They were clear about their duty to report any suspicion of abuse, and knew who to report it to, including outside agencies. They knew where to find the homes policy on Whistle Blowing (how to take concerns to appropriate outside agencies when necessary). However, management looked for some time and concluded it did not contain the Local Authority Safeguarding team contact details, although there were many other agencies listed. It is the Safeguarding team which would coordinate any safeguarding alert and so this information should be included in the policy at the first opportunity. Care Homes for Adults (18-65 years) Page 22 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People live in a home, which is clean, well furnished, warm, safe, comfortable and meets their individual needs and desires. Evidence: Shared spaces and two bedrooms at the home were visited. The home is clean, warm, appears to be comfortable and provides a variety of shared and private space for people. Furnishings and decor 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. Each person has an individual bedroom. They are very well equipped and age appropriate. People told us that they had chosen their furniture and decor. The laundry arrangements are adequate to meet the needs of the home. People are encouraged to do their laundry themselves if they are able. The gardens include a patio area and swing and are used for social occasions in warm weather. The front car park area has been adapted specifically for one person so they are more likely to be able to use their own vehicle. Care Homes for Adults (18-65 years) Page 23 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People benefit from staff that are skilled, experienced and well supervised. They are protected through robust recruitment practice but this could be further improved. Evidence: Staff told us that there are always enough staff to meet peoples needs which includes lots of one to one time with them and is flexible. Three of the people who use the service went out with staff individually while we were there. The homes recruitment policy is strictly followed. We looked at the records of the only staff employed since the last inspection. We found that they were working at the home before the organisation had checked to see if they are listed as people unsuitable to work with vulnerable adults (POVA list). Although staff do not work unsupervised they should not start at the home until the organisation confirms through that list if they have been excluded from working in the care profession. Staff training provides them with the knowledge necessary to deliver a high standard of care to people and it helps keep staff safe. It includes fire safety, food hygiene and prevention of abuse. Training is of good quality although much of it takes place at the home, on-the-job. Staff are continually learning about the people living there. They also receive SCIP (Strategies for Crisis Intervention and Prevention) training that teaches them how to diffuse situations or as a last resort how to safely restrain Care Homes for Adults (18-65 years) Page 24 of 30 Evidence: individuals. Following all incidents at the home, there is a thorough de-brief for all staff when they discuss what could have been done better. All staff are encouraged to take formal qualifications in care. The organisation reports: The senior managers are trained to diploma/degree level in behavioural support. This means that there is at least one behavioural specialist between two homes this provides consistency and reduces the need to drain on already stretched external resources. High staff ratios ensure that resources are available to meet the changing needs of the people who live here. The staff team are trained in behavioural approaches and we do not use agency staff, this means the staff team are experienced and consistent. We demand a high level commitment from all staff and repay this with high levels of support. This enables us to deliver a service that is of a very high standard and is valued by those who use it and work within it. We have found this to be the case. Care Homes for Adults (18-65 years) Page 25 of 30 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The home is run in the best interest of people who use the service. Evidence: The manager, Mrs. Dawn Bond, has worked at Santosa since the year 2000. She has both the Registered Managers Award and the National Vocational Qualification (NVQ) level 4 in care, indicators of her competence. She was registered with the Commission as manager in April 2007. Staff told us that she provides clear leadership at the home. There is an effective management structure within the organisation with strong leadership and support for staff. People at the home appear comfortable, relaxed and happy. One said: Im happy. I like it here. One staff said: Very happy. Absolutely fantastic team here. They help each other. Staff told us that they receive regular formal supervision of their work and a yearly appraisal. A person from the organisation does a monthly, unannounced visit to talk to people and staff and check some records. We saw and discussed a six monthly quality checking system the home uses, for example, to check the standard of personal care and peoples diet. The home does not give staff or professionals associated with the Care Homes for Adults (18-65 years) Page 26 of 30 Evidence: home the opportunity to give their opinion anonymously through survey. However, people associated with the home told us that they are encouraged to speak openly about the way the home operates and it is always well received. 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. We believe the organisation will take steps to ensure recruitment procedures are made more robust (see section called Staffing), which will further improve peoples safety. Care Homes for Adults (18-65 years) Page 27 of 30 Are there any outstanding requirements from the last inspection? Yes  No  Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 28 of 30 Requirements and recommendations from this inspection Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No Standard Regulation Description Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set No Standard Regulation Description Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 29 of 30 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 30 of 30 - 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!