Inspection on 25/11/08 for Serenita

This inspection was carried out on 25th November 2008.

CSCI found this care home to be providing an Good 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

Serenita 19/07/07

Serenita 04/07/06

Serenita 21/02/06

Serenita 22/08/05

Serenita 05/08/04

Serenita 22/05/04

Serenita 16/04/04

Similar services:

Clouds House

Closereach

Westcliffe House

Hilldales

Longreach

Chandos House

Cherry Orchards Camphill Community Ltd

Broadreach

Extracts from inspection reports are licensed from CQC, this page was updated on 13/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Serenita 15 - 19 Clevedon Road Weston Super Mare North Somerset BS23 1DA     The quality rating for this care home is:   two star good 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: Juanita Glass     Date: 2 5 1 1 2 0 0 8 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. the things that people have said are important to them: They reflect 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 Older People 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. Care Homes for Older People Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI 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 Older People Page 3 of 28 Information about the care home Name of care home: Address: Serenita 15 - 19 Clevedon Road Weston Super Mare North Somerset BS23 1DA 01934620195 01934622670 traceyngreen@yahoo.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: N Notaro Homes Limited care home 34 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 past or present alcohol dependence Additional conditions: The maximum number of service users who can be accommodated is 34. 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: Past or present alcohol dependency (Code A) Date of last inspection Brief description of the care home Serenita is a specialist unit providing medium to long term residential care and rehabilitation for sufferers of alcohol related problems such as Korsakoffs Syndrome. They do not provide detoxification or therapies related to rehab units. They do provide a programme to aid recovery and rehabilitaion in areas such as personal care and life skills. They are registered to take up to 34 people over the age of 45 years. They cannot take people with nursing needs, however if the situation should arise they do have access to the Local Community Nursing Team and Weston Hospice. Serenitas Statement of Purpose states that through providing a safe secure and supportive environment they aim to help people living in the home to achieve personal aspirations and abilities in all aspects of their lives. Serenita is situated within walking distance of the seafront, shops and local amenities. People benefit from large communal areas Care Homes for Older People Page 4 of 28 Over 65 0 34 Brief description of the care home equipped with a full size pool table, a conservatory and safe garden areas all of which are accessible by wheelchair. Current fees are 675 per week Care Homes for Older People Page 5 of 28 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: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This inspection took place over one day and a total of 6 hours were spent in the home. To gather enough evidence to support our judgments for this inspection, we The Commission asked the service provider to complete an Annual Quality Assurance Assessment (AQAA). The AQAA is a self-assessment that focuses on how well outcomes are being met for people living in the home. It also gives us some numerical information about the service, and how they intend to maintain or improve outcomes for people using their service. We also looked at surveys returned to us by people living in the home and people with an interest such as relatives, social workers and GPs. We received 10 surveys, 3 from Care Homes for Older People Page 6 of 28 people living in the home, 6 from staff who work there and one from a relative who wished to comment. Once we had received this information we carried out a visit to the home and spoke to people living there and staff. Whilst in the home we also looked at documents maintained for the day-to-day running of the service. These included care plans, staff recruitment, training and supervision. Also records relevant to the administration of medication, service records and health and safety. What the care home does well: What has improved since the last inspection? What they could do better: 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. You can get Care Homes for Older People Page 8 of 28 printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 28 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 28 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 and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. 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 them 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective residents benefit from adequate written information, a chance to visit the home and a full assessment of their needs. This means they can make an informed decision before moving in and their personal, cultural and religious needs can be met Evidence: We discussed the admission procedure with both staff and people living in the home, we also looked at records kept by the home to show that information had been provided and assessments carried out. People we spoke to said they had plenty of information about Serenita and that staff were always helpful by answering questions and explaining things they may have forgotten or did not understand. One person said that the information they had been given was indepth and backed up by staff explaining the finer details. Another person indicated that the choice of home had been made by their social worker, however they had been assured by staff that they could choose to stay or not. They then said they Care Homes for Older People Page 11 of 28 Evidence: were happy that they had decided to stay following the trial period. We asked for a copy of the Statement of Purpose, which was made available immediately. The Statement of Purpose gives very concise information about the home and states very clearly the admission criteria and age range accepted at Serenita. The Statement of Purpose also contained a copy of the contract issued between the person and the home. Signed copies were also seen in peoples files. The records we looked at showed that a full assessment of peoples needs was carried out on each occassion. The manager and staff assessed whether the home could meet the specific needs of the person as an individual. The assessments included peoples physical and mental health, emotional wellbeing and medication needs. The Statement of Purpose clearly states that Serenita can meet the diverse needs of people with different cultural and religious backgrounds as well as supporting people to develope and maintain personal relationships. Care Homes for Older People Page 12 of 28 Health and personal care 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 health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they 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. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home benefit from personal and specialist care and support that is provided in a person centred way, respecting their diversity, privacy and dignity. People are supported in making end of life decisons which are respected and followed with compassion and professionalism. They benefit from and are protected by the homes policies and procedures for the administration of medication. Evidence: We looked at the care plans for three people living in the home, we also looked at all 8 service user agreements to ensure people were being consulted about the care plans written up on their behalf. We noted that of the eight care plans only two had been agreed with the person living in the home. We discussed this with the manager who said some people did not wish to be involved, we advised that service user agreements need to be completed and if the person was not interested they needed to indicate this. People we spoke to said they knew about the records kept by staff but indicated that they were not really interested in the written plans, however they felt they could talk about their care plans and future aims with a member of staff or the manager. Care Homes for Older People Page 13 of 28 Evidence: All the care plans we looked at were written in a personal and individual way identifying needs specific to that person. They not only reflected the persons current needs but also their future aspirations. One care plan showed clearly that the longterm aim was to assist the person to move forward in life and attain the daily living skills needed to live in Supported Housing. The care plan showed physiotherapy input to improve mobility, shopping trips to build up budgetting skills and structured household chores including cooking and cleaning. Another care plan clearly stated triggers that may instigate a challenging outburst needed to be indentified, staff were aware of the triggers but these needed to be written in full. People spoken to said they felt well cared for by staff who knew their personal needs, likes and dislikes. One person said they know me better than I know myself somethimes and they always remind me when I forget something. One survey from a relative stated, the service providers show a great deal of patience and concern. They seem genuinely caring and kind. People were observed to have a freindly and easy rapport with staff. Staff indicated that they had a good knowledge of peoples diverse needs on an individual basis, recognising their personal likes and dislikes as well as physical and emotional needs. Care plans also included agreements with residents about staff managing cigarettes and lighters when necessary. The agreements were also very clear about the homes alcohol policy. People said they understood some of the restrictions in place and agreed to them. Records maintained by the home showed that people living there were enabled to attend healthcare services such as out patients appointments, health check screening, dentists, opticians, physiotherapists and other specialist support they needed. We looked at the homes medication policy and procedure; they provide staff with very clear guidance on the receipt, storage and administration. We observed staff and saw that they followed the policies and procedures well, protecting people from possible errors. An audit of medication in the home and records kept showed that there were no errors and medication was stored properly. One person living at Serenita had indicated that they wished to remain in the home whilst receiving palliative care. The manager and staff respected their end of life decision and liaised with Weston Hospice and the Community Nursing Team to ensure the person received all the support and care they required. Staffing was reveiwed so that one to one support could be provided 24/7. They indicated that they would like to receive support from a minister of religion and regular contact with a local priest was arranged. The care package put in place showed a high standard of care and a compassionate respect for the individual physical, emotional and spritual needs of the person in their care and their family and should be highly commended. Care Homes for Older People Page 14 of 28 Care Homes for Older People Page 15 of 28 Daily life and social activities 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 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. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. 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 living in the home benefit from the development of meaningful activities which, recognises their diverse needs, likes and dislkies enabling them to maintain some control over their lifestyle. They benefit from continued contact with family, friends and the community. A well balanced menu means people benefit from a healthy and nutritional diet. Evidence: Activities at Serenita are organised on a daily basis and people confirmed that they had plenty to do. One person said that they could take part in any activity, and an impromptu game of pool was taking place between a resident and member of staff. One member of staff organises activities and trips for people to take part in, whilst other members of staff support the work they are doing. people were occupied in games, quizzes, reading or watching TV, after lunch most of the residents went out on an organised trip. Everybody spoken to had joined in some activity through the day. People said they could go and do their own thing if they wished and staff respected their choice. As well as organised activities in the home people can access the local community and college following an interest or educational course. Records also showed that people were being supported to maintain their choosen religion within the Care Homes for Older People Page 16 of 28 Evidence: community. When we spoke to people about maintaining some choice and control over their lives, they confirmed that they felt they did have choice and control and were supported to develope their ability to have a say in the way they lived. They felt they were being supported in expressing and obtaining their dreams and hopes for the future. The service user guide states that family and friends are always welcome. People spoken to said they could see their family or friends whenever they wanted to and that staff helped them to maintain contact, meet new friends and develope relationships. We observed lunch at Serenita and spoke to people about the meals they ate in the home. They said they always had very good meals and praised the standard of cooking in the home. The manager recognises the importance of nutrition for people with Korsakoffs, this is supported by the cook who showed an enthusiasm in providing people with a varied menu that was healthy, nutritional and interesting. Menus included fresh fruit, vegatables and home made cakes. A choice of meals is offered and people indicated that staff knew their likes and dislikes and an alternative could be provided if necessary. Care Homes for Older People Page 17 of 28 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. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. 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 and are protected by the complaints and safeguarding policies and procedures in the home. Staff are fully aware through appropriate training, of the procedures to follow to protect people from harm or abuse. Evidence: Serenita has a very clear complaints policy and procedure, which is easy to read. It shows a clear timeline and action to be taken if some one wishes to raise a concern or complaint. A copy is readily available in the hall and includes a large print version. We noted that the policy contains all the information a person would need including the contact details for CSCI. Any complaint received would be recorded in the complaints log, which would also include the persons level of satisfaction when an issue had been dealt with. No complaints had been received. People we spoke to said they knew who to approach and felt they could raise any issue with the manager if they wished. One person said they could talk to anybody and knew it would be dealt with appropriately. We saw a copy of the North Somerset policy and procedure for Safeguarding Adults under No Secrets, which was available for staff to read. Staff spoken to said they knew Care Homes for Older People Page 18 of 28 Evidence: who to inform if they suspected abuse and they all knew about the homes whistle blowing policy. Staff records showed they had all received appropriate training in safeguarding adults with regular up dates arranged for them to attend. Care Homes for Older People Page 19 of 28 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, 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. 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 living in Serenita benefit from a comfortable, well equipped and homely environment, however the provider was aware of and dealing with heating and hotwater problems to part of the home. People have access to well laid out garden areas and local parks. They are protected by staff awareness of approriate infection control guidelines. Evidence: Serenita is arranged over three floors, with a passenger lift to provide people with mobility problems access to all areas of the home. Communal areas are on the ground floor with a large lounge that was well furnished and arranged so that people could sit in small groups to take part in activities or sit quietly, there was also a full sized Pool Table. A large dining area was seen to be pleasantly laid up for dinner. Peoples rooms were personalised and they said they liked the rooms they had choosen. We noted that the heating and hot water to part of the home was not working adequately. We discussed this with the manager who confirmed that the problem had been identified and the provider was arranging for repairs to take place. Staff were observed to use personal protective clothing approriately and Infection Control training was up to date. All areas of the home were clean and tidy with no offensive odours. Care Homes for Older People Page 20 of 28 Care Homes for Older People Page 21 of 28 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 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 to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. 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 benefit from and are protected by the staffing levels and skill mix of staff in the home. The home recruitment procedures and staff training further protect them from the possibility of abuse. People spoken to confirmed that there were always enough staff to meet their needs. Evidence: We looked at the personnel files held by the home for some of the staff. We looked at the employment records for two recently employed members of staff. We also looked at the staffing rota and the training records for people working in the home. The staffing rota showed that there is always enough staff in the home with the right skill mix to support the diverse needs of the people living there. They also showed that staffing is flexible so extra staff could be bought in to cover extra busy times and to ensure that the one person in the home needing one to one care received the staffing care required. The group of homes benefits from a dedicated training officer who ensures that all staff maintain their annual updates of all mandatory training. All records reveiwed showed that as well as their mandatory training staff had attended training specific to their roles and the needs of the people in the home. Staff spoken to were aware of Care Homes for Older People Page 22 of 28 Evidence: Alcohol related Dementia and how to enable people to take control of their lives. They were also up to date on specific needs such as diabetes and palliative care. The manger confirmed that staff were also being encouraged to attend NVQ In Health and Social Care training. Staff surveys indicated that they felt supported to attend training necessary to their role in the home. We looked at the recruitment records for two new members of staff recruited since the last time we spoke to peple in the home. The records showed that people living in the home were protected from possible harm or abuse, they showed that all the required checks had been carried out, such as CRB, POVA 1st checks and supporting references. Care Homes for Older People Page 23 of 28 Management and administration 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 led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate 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. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. 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 living in a well run home with an appropriately qualified manager and supervised staff. They are protected from financial abuse through safe and stringent policies for managing residents money. Both people working and living in the home are protected by robust health and safty policies and procedures, however risk assesments needed up dating. Evidence: The manager Mr Oldridge has a number of years experience in providing care in a residential setting. He has attained the NVQ Level 4 Management in Health Care. He has also attended training relevant to the specific diverse needs of the people living in the home. These include an understanding of the needs of people with an Alcohol related Dementia and Palliative Care. An annual customer satisfaction survey is carried out however it was too early for one to have been done since the change of category for the home. The survey is also sent Care Homes for Older People Page 24 of 28 Evidence: to visitors, relatives, social workers and health care professionals to ascertain their view and how they would like the home to be run in the best interests of the people living there. Facilities exist for the safe handling of money on behalf of the people living in the home. It was stated that individuals have cash in safekeeping and nominal amounts of cash are withdrawn from individauls personal bank accounts on their request for safekeeping at the home. Staff comments and records kept by the home showed that all staff had received regualr supervision identifying training needs and good practice. We looked at the records relating to the servicing of equipment used in the home. All the records were up to date and available for inspection, these included the COSHH records, which are guidelines for staff to follow if they spill, drink or are splashed by chemicals used in the home. The implementation of health and safety within the home was satisfactory. Two minor details were discussed with the manager. One fire door did not close completely and risk assessments still referred to Russel Haven rather than Serenita. A review of the firelog showed all tests, training and drills were being carried out to the Avon Fire Brigade guidelines. Care Homes for Older People Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R 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 Older People Page 26 of 28 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 Requirement 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 Requirement 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 1 7 The manager needs to ensure that care plans include signed service user involvement, or indicate why a person has decided not to sign. The manager needs to ensure that staff include possible triggers and coping strategies for challenging behaviours in care plans. The provider needs to ensure that the heating and hot water problems are dealt with to provide approriate heating and hot water for peolpe living in the home. The identified fire door needs to be maintained to ensure full closure. The generic risk assessments need to reflect the new name of the home. 2 7 3 19 4 5 38 38 Care Homes for Older People Page 27 of 28 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 Older People Page 28 of 28 - 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!