Inspection on 12/10/05 for Saresta and Serenade

This inspection was carried out on 12th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Saresta and Serenade 22/05/07

Saresta and Serenade 24/05/06

Saresta and Serenade 04/05/05

Saresta and Serenade 30/11/04

Saresta and Serenade 19/05/04

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Claremont House

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Sun Court Nursing Home

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Paradise Lodge

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Upaya Ananda

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

CARE HOME ADULTS 18-65 Saresta and Serenade Bromley Road Elmstead Market Colchester Essex CO7 7BX Lead Inspector Ray Finney Final Unannounced Inspection 12th October 2005 09:15 Saresta and Serenade DS0000017927.V258544.R01.S.doc Version 5.0 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 Saresta and Serenade DS0000017927.V258544.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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. Saresta and Serenade DS0000017927.V258544.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Saresta and Serenade Address Bromley Road Elmstead Market Colchester Essex CO7 7BX 01206 827034/825779 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) Mr Rohan Vasantha Kumara Dias Mrs Velamba Dias Ms Karon Bosher Care Home 10 Category(ies) of Learning disability (10), Physical disability (10) registration, with number of places Saresta and Serenade DS0000017927.V258544.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home accommodates 10 people with learning disabilities who may also have physical disabilities 4th May 2005 Date of last inspection Brief Description of the Service: Saresta and Serenade is a home providing care and accommodation for ten individuals with learning disabilities between the ages of 18 and 65, some of whom may have a physical disability. The home is owned by Mr and Mrs Dias and is one of a small consortium of homes in the area. The manager of the home is Ms Karon Bosher. Accommodation is provided in two separate bungalows, each offering single bedrooms for five individuals. Each bungalow has living accommodation, kitchen and its own laundry facilities. There is a small patio area situated between the two bungalows and a large garden area to the rear. Saresta and Serenade is situated in a small village close to local facilities. There are adequate parking facilities at the front of the bungalows for staff and visitors. Saresta and Serenade DS0000017927.V258544.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This routine unannounced inspection took place on 12th October 2005, for a total of 6 hours. The inspection process included discussions with the manager and members of staff and the parent of a service user. The inspection also included a tour of the home, observations of interactions between service users and members of staff, evidence gathered from samples of records and a completed survey form from a relative. The atmosphere in the home during the day of the inspection was relaxed and welcoming and the inspector was given every co-operation from support staff and the registered manager, Ms Karon Bosher. What the service does well: What has improved since the last inspection? 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. Saresta and Serenade DS0000017927.V258544.R01.S.doc Version 5.0 Page 6 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 Saresta and Serenade DS0000017927.V258544.R01.S.doc Version 5.0 Page 7 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 the following standard(s): 2 and 5 The needs and aspirations of service users were identified through a process of assessment. Service users had individual written contracts of terms and conditions with the home. However, these contracts remained unsigned by service users or their representatives. EVIDENCE: Three service users’ files were examined and found to contain assessments that enabled comprehensive plans of care to be developed. Healthcare needs in particular were thoroughly assessed. The manager confirmed that there had been discussions with relatives and most had agreed that they were willing to sign the contracts on behalf of the service users. At the time of the inspection this had not been done. Saresta and Serenade DS0000017927.V258544.R01.S.doc Version 5.0 Page 8 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 the following standard(s): 6, 7 and 9 The assessed needs of service users were reflected in their individual plans of care. Service users were given the assistance to make decisions about their lives. Service users were supported to take risks within the limitations of their capacity to understand. EVIDENCE: Service user records examined showed that there were individual care plans in place that were comprehensive and ensured that there was clear guidance for support staff to meet individual needs. The plans showed evidence of input from other professionals such as community nurse specialists. Care plans were reviewed monthly by keyworkers. No service users at Saresta and Serenade had the capacity to manage their own finances. Information given to the inspector by the registered manager and the area manager confirmed that all service users had an appointee. Staff spoken with said that the service users’ complex learning disabilities and, for some, limited verbal communication meant that sometimes choices were limited. Records examined showed that if there were limits to a service user’s ability to make choices it was documented in the care plan. Staff spoken with Saresta and Serenade DS0000017927.V258544.R01.S.doc Version 5.0 Page 9 explained how they encouraged service users to make choices in their daily lives, such as what to wear. Records examined showed evidence of comprehensive risk assessments in place. The manager informed the inspector that because of the service users complex learning disabilities, difficulties with communication and competency, relatives were consulted and involved in care planning and assessing risks. Saresta and Serenade DS0000017927.V258544.R01.S.doc Version 5.0 Page 10 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 the following standard(s): 13, 15 and 16 Service users were supported to be part of the local community. Service users were supported to have personal and family relationships. The home ensures the rights and responsibilities of service users are respected and recognised. EVIDENCE: Service users were supported to access activities in the local community. Staff spoken with said that service users were supported to go bowling or have meals out. They also said that going to the local pub was popular. The manager informed the inspector that the home had worked with one service user around encouraging good eating habits and the parents felt more able to take the service user into restaurants to enjoy a meal. The manager and staff spoken with said that service users accessed activities such as trampolining, the Hydro pool at a local school in Clacton, or Aqua Springs at Colchester. The manager informed the inspector that family links were encouraged by the home and relatives visited regularly. Records examined showed copies of letters sent to relatives. Staff spoken with said service users were supported to buy Christmas and birthday presents for relatives and flowers were sent on Mothering Sunday. One parent made a brief visit on the day of the inspection Saresta and Serenade DS0000017927.V258544.R01.S.doc Version 5.0 Page 11 and was given a comment card, which was completed and returned to CSCI. The comments received indicated an overall satisfaction with the home. Staff spoken with explained how they tried to promote choice and independence through the daily routines. Bedrooms had locks and keys, but the manager explained that none of the service users at Saresta or Serenade had the capacity to lock doors and use keys. The inspector observed appropriate interactions between members of staff and service users. Staff spoken with said that service users were able to express preferences about whether to take part in an activity by their body language or behaviour. Some service users participated in minor housekeeping tasks; one service user sometimes ‘hoovered’ a little and one put personal laundry in the washing machine. Saresta and Serenade DS0000017927.V258544.R01.S.doc Version 5.0 Page 12 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 the following standard(s): 18 and 20 Service users’ preferences and requirements were taken into account when having personal support. Overall service users were protected by the home’s policies and procedures for dealing with medicines, although printed information from the pharmacy should be checked to ensure that all instructions are clearly documented. EVIDENCE: Records of care plans, policies and procedures examined indicated that service users were treated with dignity and their privacy was protected. Staff spoken with said that times for getting up and going to bed were flexible and mealtimes varied according to what service users were doing. One member of staff explained the methods used to try to encourage choice of what to wear for service users whose communication was limited. Records examined showed that service users received specialist support according to their needs. The home operated a key worker system to ensure service users have continuity of support. At the time of the inspection, no service users were self-medicating. The home operated a monitored dose system and the manager informed the inspector that they had a very good relationship with the pharmacy, whose staff were helpful and co-operative. One senior carer took responsibility for ordering medication and liaising with GPs and the pharmacy. Saresta and Serenade DS0000017927.V258544.R01.S.doc Version 5.0 Page 13 Records were examined and found to be completed accurately. However, one PRN or ‘as required’ medication was not marked as such on the printed Medicine Administration Record sheet supplied by the pharmacy. The manager said she would contact the GP to ensure that the prescription was clearly marked as PRN as the pharmacy would not print it if not clearly marked as such on the prescription. Saresta and Serenade DS0000017927.V258544.R01.S.doc Version 5.0 Page 14 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 the following standard(s): 22 Overall the views of service users and their representatives were listened to, although the home would benefit from more detailed records being kept of issues raised. EVIDENCE: Records examined showed that the home had a complaints policy in place. The manager informed the inspector that there were forms to complete if a complaint was made, but there had not been any complaints. Further discussion indicated that a number of concerns had been raised by relatives, which had been perceived as minor and had been dealt with. Records of these ‘minor concerns’ had not been kept. A comment card received from a relative said that complaints were normally dealt with promptly. Saresta and Serenade DS0000017927.V258544.R01.S.doc Version 5.0 Page 15 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 the following standard(s): 24 The home provided a homely, comfortable and safe environment for the service users who lived there. EVIDENCE: A tour of the premises showed that the home was bright and cheerful and the décor and furnishings were homely. There were no offensive odours in either service users rooms or in communal areas. There was evidence of new furniture in some of the rooms. There was ample evidence of personal items in service users rooms and the manager said that they had been decorated in accordance with service users individual likes. Fire extinguishers examined had been serviced in March 2005. Saresta and Serenade DS0000017927.V258544.R01.S.doc Version 5.0 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not inspected on this occasion. EVIDENCE: No evidence was looked at for these standards at this inspection. Saresta and Serenade DS0000017927.V258544.R01.S.doc Version 5.0 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 40 Service users’ rights and best interests were safeguarded by the home’s policies and procedures. EVIDENCE: Records inspected showed that the home had a range of policies and procedures in place to ensure the best interests of service users were protected. The manager informed the inspector that it was part of the general manager’s role to update policies and procedures. Saresta and Serenade DS0000017927.V258544.R01.S.doc Version 5.0 Page 18 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 X 3 X X 2 Standard No 22 23 Score 2 X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 X 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X X X X X LIFESTYLES Standard No Score 11 X 12 X 13 3 14 X 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X X X X X X CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Saresta and Serenade Score 3 X 3 x Standard No 37 38 39 40 41 42 43 Score X X X 3 X X X DS0000017927.V258544.R01.S.doc Version 5.0 Page 19 Are there any outstanding requirements from the last inspection? yes 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 YA5 Regulation 5 Requirement The registered person must ensure that the service users or their representatives sign their contracts. This requirement is repeated for the third time. Timescale for action 31/12/05 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 YA22 Good Practice Recommendations The registered person should ensure that all minor concerns are documented, even if the issues have been dealt with, before they develop into problems and formal complaints. Saresta and Serenade DS0000017927.V258544.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ 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. Extracts may not be used or reproduced without the express permission of CSCI Saresta and Serenade DS0000017927.V258544.R01.S.doc Version 5.0 Page 21 - 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. 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