Inspection on 22/06/05 for Sarum House

This inspection was carried out on 22nd June 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 but made no statutory requirements on the home.

Other inspections for this house

Sarum House 24/02/09

Sarum House 31/01/08

Sarum House 18/09/07

Sarum House 06/03/07

Sarum House 07/02/06

Sarum House 13/12/04

Sarum House 19/05/04

Sarum House 16/01/03

Similar services:

2 Perhaver Park

The Vicarage

7 Hyde Road

St George`s

5 Seafield Road

Credence House

Radfords

Trevaylor Manor

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

CARE HOME ADULTS 18-65 Sarum House Beehive Corner Old Sarum Salisbury Wiltshire, SP4 6BL Lead Inspector Alyson Fairweather Unannounced 22nd June 2005 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. Sarum House D51_D01_S32418_SARUMHOUSE_V207196_220605_Stage4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Sarum House Address Beehive Corner Old Sarum Salisbury Wiltshire SP4 6BL 01722 335283 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) Wiltshire County Council Mr Malcolm Wilson Care Home 11 Category(ies) of LD Learning Disability (11) registration, with number LD(E) Learning Disability - over 65 (7) of places PD Physical Disability (1) Sarum House D51_D01_S32418_SARUMHOUSE_V207196_220605_Stage4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. The total number of service users accommodated at the care home shall not exceed 14. 2. Only one named service user with a physical disability to be accommodated at the home at any one time as agreed with the National Care Standards Commission. Date of last inspection 13 December 2004 Brief Description of the Service: Sarum House provides personal care and accommodation for people with learning disability. At present, the home has some service users for whom this is their permanent home and some who use the service for respite care. A new purpose built respite unit is due to open for these service users in the very near future. The home is operated by Wiltshire County Council, and is on the outskirts of Salisbury. A nearby park and ride scheme offers regular bus journeys into the city, and Sarum House also has its own transport. The home is an older property, although good efforts have been made to maintain and enhance it. There are two floors for service user accommodation, and all residents have single bedrooms. The home has no lift, making the upper floors unsuitable for anyone with a physical disability. Baths, showers and toilets for general use are on both floors. Communal areas include a ground floor games room. Day care facilities, which several service users attend, are adjacent to Sarum House. Sarum House D51_D01_S32418_SARUMHOUSE_V207196_220605_Stage4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on 22nd June. 2005 There were several residents at home, four of whom were spoken to. The manager conducted the inspection and three staff members were spoken to. The inspector walked round the premises and examined several records, including care plans, medication records, staff files and assessment information. 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. Sarum House D51_D01_S32418_SARUMHOUSE_V207196_220605_Stage4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Sarum House D51_D01_S32418_SARUMHOUSE_V207196_220605_Stage4.doc Version 1.30 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 standard(s) 1 and 2 Prospective guests have enough information to make a choice about whether they would like to stay in the home. Their needs, hopes and goals are assessed and recorded before they move in to the home for respite care so that staff know how best to support them. EVIDENCE: The home has a statement of purpose and a service user guide, which give details of the service offered, the staffing and management arrangements and the scale of fees. The type of service is due to be changed, and these documents should be amended to reflect the fact that no respite care is to be offered in the home. Although there have been no permanent residents admitted recently, an up to date community care assessment would be requested from the referring community care team, as currently happens when a new client is planning to have respite care. Information is also kept on file for longer standing respite guests. Family members are a source of much of the information gathered, and staff visit the family prior to respite care being offered and collect information relating to mobility, domestic skills, accessing the community, personal care needs, communication and daytime and recreational activities. Sarum House D51_D01_S32418_SARUMHOUSE_V207196_220605_Stage4.doc Version 1.30 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 standard(s) 6 and 9 Care plans reflect the needs and personal goals of respite guests, which means that staff are able to support them in the way they wish. They are supported to take risks where appropriate, and encouraged to be as independent as possible. EVIDENCE: Care plans were in place for all residents. Each person has a support plan which is drawn up with the help of their families if possible. These plans include details of any personal care needs, medical and physical health, mobility and communication skills. The support plans also highlight people’s likes and dislikes, and what activities they like to pursue. However, one care plan had not been reviewed for some time, and some of the reviews had not been signed and dated by staff. The manager has been asked to ensure that this is done in future. Care plans were laid out in such a way as to show residents’ goals and how they would be reached. Staff spoken to said that it was often difficult to show this and that perhaps a new format could be devised that would show a more realistic target for individuals. Sarum House D51_D01_S32418_SARUMHOUSE_V207196_220605_Stage4.doc Version 1.30 Page 9 Risk assessments were on file for people when in the home, during trips out and when travelling, and ways of minimising risks were identified. Risk assessments covered areas such as bathing, eating, smoking, financial arrangements and using electrical appliances. There was a risk assessment for one resident who likes to travel alone by taxi and another for one vulnerable resident who likes to travel alone into Salisbury. Residents are, however, supported to take acceptable risks as part of their independent lifestyle, and these are reviewed on a regular basis. Sarum House D51_D01_S32418_SARUMHOUSE_V207196_220605_Stage4.doc Version 1.30 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 standard(s) 12, 13, 15 and 16 Social and leisure activities are varied and tailored to individual need, with residents choosing what they wish to do. Residents take part in community activities, and are encouraged to take responsibility for their own lives. Residents can have as much or as little contact with family and friends as they wish, and are supported to do so by staff. EVIDENCE: Service users at Sarum House take part in a variety of activities. Most of them attend an adjacent day centre, and enjoy such activities as gardening, crafts, jigsaws, reading, dominos and watching videos. One resident helps out in a Mencap shop, and when spoken to was arranging to run the residents’ house meeting. Another resident is the Mencap national representative, and when spoken to, was preparing for a weekend away as a delegate. The same resident was also planning a short period away as a helper of people with disabilities. Some residents go into town on a regular basis, and day trips and holidays are arranged, according to what people want. Sarum House D51_D01_S32418_SARUMHOUSE_V207196_220605_Stage4.doc Version 1.30 Page 11 Some residents have holidays with their families and some go to visit on a regular basis. Friendships both inside and outside the home are encouraged, and befrienders have been engaged for those people with little family contact. One resident wanted to talk about personal relationships with the manager, and was able to do so in privacy. Sarum House D51_D01_S32418_SARUMHOUSE_V207196_220605_Stage4.doc Version 1.30 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 standard(s) 20 The home’s medication policies and procedures ensure that service users are safe when their medication needs are being met, and people are encouraged and supported to control and administer their own medication. EVIDENCE: The home has a policy in place for all medication, and all staff have medication training when they first start work. A pharmacist comes in to do this and staff have a workbook which must be completed, with staff being tested before they start to administer medication. Staff administer medication to most service users but one person self medicates and is supported to do so by staff. There is a comprehensive book-in system and medication administration records are used. These are signed whenever medication is given to a resident, although there was one occasion where this was missed. medication for respite residents is also carefully managed, with the person on duty at the time recording all the medication brought in by the person. One resident had a very complicated prescription, with several planned increases over a period of time. This was seen to be very well managed by staff. Sarum House D51_D01_S32418_SARUMHOUSE_V207196_220605_Stage4.doc Version 1.30 Page 13 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 Each service user has a copy of the home’s complaints procedure, and have their views listened to and acted on. The policies and procedures the home has in place try to ensure that residents are safeguarded from abuse and harm. EVIDENCE: There is a complaints procedure which outlines the steps to take if there are any complaints. This also gives details of how service users and families can contact the Commission for Social Care Inspection (CSCI). Residents are also given a postcard with these details on them, as well as how to contact their care manager. Two service users spoken to were aware of who talk to if they had any complaints, and were sure that the manager would listen to them and take any action necessary. The home has copies of the “No Secrets” document, as well as the organisational policies and procedures on responding to allegations of abuse. A “Whistle Blowing” procedure is also available for all staff. All staff have had training in the Vulnerable Adults Procedure. Sarum House D51_D01_S32418_SARUMHOUSE_V207196_220605_Stage4.doc Version 1.30 Page 14 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 and 30 Overall service users live in a homely and comfortable environment, although changes in the bedroom door locks would make it safer for them. The home is clean and hygienic. EVIDENCE: The home is an older property, although good efforts have been made to maintain and enhance it. Several areas of the home had been improved since the last inspection. All radiators have now been covered and the laundry room is having the cracked seal between the floor and the wall repaired. The building has had several windows replaced, and would certainly benefit from having this work completed for all windows. The work which was meant to have been done replacing the locks on residents’ bedroom doors had not been done, and the manager reported that this was because of the cost implication. There has been some discussion with the providers about a new building replacing the current Sarum House, and if this is to be done in the foreseeable future, the Commission for Social Care (CSCI) will be flexible about any internal work which is deemed to be necessary. However, any risk to residents must be assessed and recorded, and details of any future plans must be forwarded to the CSCI. Sarum House D51_D01_S32418_SARUMHOUSE_V207196_220605_Stage4.doc Version 1.30 Page 15 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) 34, 35 and 36 Service users are safeguarded by the current recruitment practices of the home, and benefit from a stable staff team. Their needs are met by appropriately trained staff, and they benefit from having staff who are well supported and supervised. EVIDENCE: Staff recruitment is assisted by Wiltshire County Council’s human resources department, and employment checks include Criminal Records Bureau (CRB) checks, two written references and a medical declaration. All the staff files looked at contained the appropriate documentation. Staff training included medication, environmental hygiene, food handling, emergency first aid, manual handling, HIV and basic health and safety. Fire training is mandatory for all staff, and the home has been used as a placement for the Fire Department training. The home has many training videos for staff, including Personal Safety for people with Learning Disabilities, the Needs of the Service User, Challenging Behaviours and Sexuality for people with Learning Disabilities. Training opportunities for staff are wide ranging, and are not limited to NVQ, although several staff are doing this. One staff member is undertaking an Open University course, “Care in the Community” and another has a certificate of Advanced Management in Care and is keen to do a supervisory management course. Staff also benefit from having a manual Sarum House D51_D01_S32418_SARUMHOUSE_V207196_220605_Stage4.doc Version 1.30 Page 16 handling trainer on-site, as well as several work place assessors in the NVQ system. Staff supervision takes place monthly to six weekly and is recorded. The manager and supervisors are all permanent staff members and are available to help support and encourage the staff team. All staff have an annual appraisal. Sarum House D51_D01_S32418_SARUMHOUSE_V207196_220605_Stage4.doc Version 1.30 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 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 and 39 Service users benefit from a well run home. They can be confident that their views underpin the monitoring and review of care practice and any developments which might take place. EVIDENCE: The manager of Sarum House has many years experience of working with people with learning disabilities, and has a long standing knowledge of most of the residents. He has an NVQ level 5 in Management and has almost completed his Registered Manager’s Award. There were several examples during the inspection of both staff and service users seeking him out for advice, and he was seen to be extremely patient and encouraged independent decision making. A series of external quality network meetings have been held, where a group of people with no connection to the home met with the residents to find out if they were happy living there and if they had any worries which they would like to share. This will be an on-going process and it is hoped that this will help Sarum House D51_D01_S32418_SARUMHOUSE_V207196_220605_Stage4.doc Version 1.30 Page 18 service users to express concerns over any proposed move to a new building. A questionnaire is sent out annually to relatives. There is a focus group for respite residents, and carers and social workers are invited to these meetings, which have been used as a forum to consult over the new respite care unit which is due to open in the very near future. Regular monthly visits by a senior manager of Wiltshire County Council take place, and a report of these visits is sent to the CSCI. Sarum House D51_D01_S32418_SARUMHOUSE_V207196_220605_Stage4.doc Version 1.30 Page 19 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 x x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 x x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x x x x 3 Standard No 11 12 13 14 15 16 17 x 3 3 x 3 3 x Standard No 31 32 33 34 35 36 Score x x x 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Sarum House Score x x 2 x Standard No 37 38 39 40 41 42 43 Score 3 x 3 x x x x D51_D01_S32418_SARUMHOUSE_V207196_220605_Stage4.doc Version 1.30 Page 20 YES 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. 2. 3. Standard 6 20 24 Regulation 15 (2) (b) 13 (2) 13(4) (c) Requirement Timescale for action 22/07/05 Care plans must be reviewed on a regular basis, and must be signed and dated. All medication must be signed 22/06/05 for when dispensed. 22/07/05 Bedroom door locks must be easily openable from the inside without the use of a key and of a type that cannot prevent the door from being opened from the outside. Where locks are of a cylinder type the snib should be removed. Comment: This requirement has been carried over from the last inspection. There are tentative plans to build a purpose built home on a new site, and the cost of the above requirement may not be merited. The manager must inform the CSCI of current plans and conduct a risk assessment for all residents’ rooms used with no privacy lock. Sarum House D51_D01_S32418_SARUMHOUSE_V207196_220605_Stage4.doc Version 1.30 Page 21 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. 2. 3. Refer to Standard 1 6 6 Good Practice Recommendations The statement of purpose and the service user guide should be amended when the home no longer offers respite care. Consideration should be given to developing care plans which show realistic goal setting and which can easily be reviewed with residents. Staff should receive further training in care planning. Sarum House D51_D01_S32418_SARUMHOUSE_V207196_220605_Stage4.doc Version 1.30 Page 22 Commission for Social Care Inspection Avonbridge House Bath Road Chippenham Wiltshire, SN15 2BB 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 Sarum House D51_D01_S32418_SARUMHOUSE_V207196_220605_Stage4.doc Version 1.30 Page 23 - 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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