Inspection on 23/05/07 for Shula`s

This inspection was carried out on 23rd May 2007.

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

The inspector 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

Shula`s 03/10/05

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

CARE HOME ADULTS 18-65 Shula`s 9 Cadogan Road Cromer Norfolk NR27 9HT Lead Inspector Mr Jerry Crehan Unannounced Inspection 23rd May 2007 01:30 Shula`s DS0000064211.V341337.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Shula`s DS0000064211.V341337.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Shula`s DS0000064211.V341337.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Shula`s Address 9 Cadogan Road Cromer Norfolk NR27 9HT 01603 279222 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) www.jeesal.org Jeesal Residential Care Services Limited Position Vacant Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Shula`s DS0000064211.V341337.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. An ensuite shower and handbasin to be provided for the bedroom on the first floor within three months from the date of the registration certificate. 3rd October 2005 Date of last inspection Brief Description of the Service: Shulas is a Care Home for three adults with a learning disability. The accommodation is a flat within a large house owned by the Jeesal Residential Care Services Ltd. The flat has its own front door. There are three single bedrooms, one of which is on the first floor. There is a shared lounge, kitchen/diner, bathroom and additional toilet. There is no garden but a small paved area to the rear of the flat. The aim of the Home is to promote independent living and so staffing is provided to meet the service users needs but not necessarily on a 24 hour basis. The Home is managed by the Manager of Lilas House, which is a Care Home owned by the same organisation and is three doors away. Shula`s DS0000064211.V341337.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection compromised an unannounced visit to the home that took place over 3 hours on 23rd May 2007. Opportunity was taken to tour the premises, talk to service users, care staff, the manager, deputy and training managers, and to look at care records and policies. The inspection report reflects evidence from inspection of Key Standards and other National Minimum Standards. Four comment cards were received from visiting health and care professionals before the inspection visit. These reflected generally positive views about the new manager and the difference they have made to aspects of healthcare. Three comment cards were received from tenants. These also reflected very positive views about the home, its manager and care staff. The proprietor is in the process of making application to extend the registration of the home. This process has involved seeking the views and wishes of the tenants currently living there, who evidently feel positive about the potential changes at the home. The range of weekly fees for the home is £356 to £635. What the service does well: • • • • • • People who use the service are involved in decisions about their lives, and play the leading role in planning their care and support. Skilled and well trained staff provide excellent physical and emotional healthcare support to people who use the service. People who use the service are protected from abuse through very good care guidance for staff and through good training for staff. The service and its staff are very effective at ensuring tenants are able to make choices about their lifestyle, and supported to achieve aspirations. The tenants take part in a wide variety of educational, leisure and work activities within the local community. People who use the service speak positively about their home and their carers. Shula`s DS0000064211.V341337.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? • The new manager has managed to establish both herself and several new staff members in a relatively short space of time, in such a way as to provide continuity and stability for tenants. The new manager has established good relationships with community health and social care professionals and acted on some of their recommendations. There were no requirements made at the previous inspection and recommendations have been acted upon. • • 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. The summary of this inspection report can be made available in other formats on request. Shula`s DS0000064211.V341337.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Shula`s DS0000064211.V341337.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 2 People who use the 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 people to use the service have their needs assessed, and access to all of the information they need about the service they may choose. EVIDENCE: There have been no new admissions to the home since the last inspection. The home has an assessment pro-forma and ‘application form’ used by the manager or other senior staff when collecting information. These documents are well designed to ascertain the level of support required by, and aspirations of, any prospective tenant. The admission procedure is supported by the home providing suitable information to prospective tenants in formats appropriate to the needs of the individual. Shula`s DS0000064211.V341337.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6, 7 & 9 People who use the 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 who use the service are involved in decisions about their lives, and play the leading role in planning the care and support they receive. EVIDENCE: Several care files were looked at during the site visit. Each contained detailed care plans and risk assessments. There was evidence in care files of tenant participation in their care planning and reviews. Care plans contained comprehensive summaries of care needs and what level of support the tenant requires. This includes diabetic care, which includes blood sugar monitoring, mobile eye screening annually, foot care that sets out precisely what care is required by care staff and what the tenant can do for themselves e.g. wearing slippers to reduce risks of damage to feet. Daily living schedules are incorporated into care plans for each day, indicating what activities the tenant has chosen to participate in. Shula`s DS0000064211.V341337.R01.S.doc Version 5.2 Page 10 The tenants all have their own bank accounts and deal with their own money. There are good financial care plans in place to support the safety of these arrangements. The tenants meet with a member of staff on a monthly basis to review the previous month and to make any plans for the forthcoming month. Records are kept of these meetings and the tenants sign the record. Care files contained clear risk management guidelines, for tenants and care staff to be aware of. The ethos of the home is to enable the tenants to live a more independent lifestyle and this is clearly being put into practice. The staff respect that this is the tenants home and that they are visitors there. The staff refer to the tenants in all choices and encourage them to discuss issues amongst themselves before coming to any decisions that affects them all. There was concern and criticism from some visiting health professionals that the home had not achieved the right balance between providing tenants with freedom of choice about how much and what foods to eat, and the health impact this presented for a tenant. They indicate that the tenant is ‘unable to engage in many of the meaningful activities they previously enjoyed’. Health professionals note in their comments that the new manager is working hard with care staff and tenants to raise awareness of the difficulties they face and to provide other health and diet choices. They also indicate that recommendations are being listened to and acted upon by the manager and care staff. Tenants views of the care staff supporting them are exclusively positive such as ‘staff are lovely’ and ‘we’ve got good staff who are kind and helpful’. Shula`s DS0000064211.V341337.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 15, 16 & 17 People who use the 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 make choices about their preferred lifestyle, and supported to develop and maintain their life skills. Social, recreational and educational activities meet individual’s expectations. EVIDENCE: The care plans set out the schedule of weekly activities preferred by tenants. These include social and educational activities that take place both at the home and in the community. Educational activities undertaken include literacy groups and food and health groups run by adult education. Vocational work based activities are also undertaken by tenants including horticulture and working at a local restaurant. Home based activity includes cooking, laundry and other general domestic type tasks. At the time of the visit a tenant was preparing the evening meal for each of the tenants, with some assistance from staff. Tenants were preparing for an evening in with visitors on the day of the inspection visit. One tenant said that they were a regular cinemagoer having Shula`s DS0000064211.V341337.R01.S.doc Version 5.2 Page 12 seen most of the new film releases. Another tenant indicated that they like to go the their local pub in the early evenings for a meal or drink. These comments reaffirmed the positive views expressed in comment cards received from tenants prior to the inspection visit that they are able to lead a lifestyle they prefer with people they like to live with. Tenants were asked how they felt about the proposal that some new tenants move into recently developed accommodation in the upper floor of their home. Their responses were very positive indicating that they know the tenants who will be moving in, that they are looking forward to this. It was evident that tenants wishes and feelings had been taken into account about the accommodation of new tenants at the home, and that they have been consulted and been given choice about these proposals. The home is within easy walking access to the town and seafront of Cromer and near to the railway station. The home has access to a vehicle, which it shares with a nearby service that is owned by the proprietor. Public transport is used, including the train and local bus service. Some tenants spoke about their arrangements for maintaining contact with their relatives. These arrangements vary for individuals. Some contact takes place at the home, or from the home. Other tenants are supported by the home in contact at the tenant’s relatives home. Menus for the home are planned ahead by tenants and care staff. These are monitored by care staff who may re-direct to healthy eating options. Tenants buy fresh fruit and vegetables independently through the week; care staff provide support for the main supermarket shop of the week. Shula`s DS0000064211.V341337.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 18, 19 & 20 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and personal care that people receive is based on their individual needs. Well-trained staff provide good healthcare support to people who use the service. EVIDENCE: Care plans indicate the tenants individual support needs, and care staff are clear about the most appropriate ways to provide support, including supporting the physical and emotional health needs. Tenants can attend health appointments on their own or with staff depending on their preference. The care plans contain records of appointments with health professionals. Tenants are supported to attend for routine appointments, such as dental and opticians. There is evidence of good practice to support the management of a tenant’s diabetes, which involves a range of community health and social care professionals. There is evidence from comments from community professionals that the new manager and home are acting on the advice and recommendations they make, particularly in relation to healthcare. Shula`s DS0000064211.V341337.R01.S.doc Version 5.2 Page 14 There are procedures in place for the safe storage and administration of medication. The tenants are responsible for their own medication and pick this up from the chemists and then look after it in a suitable locked container. The staff keep a record of the medication that has been picked up by the tenants and then verbally check that the medication has been taken. A visual check is carried out weekly. Appropriate risk assessments have been carried out supporting and monitoring safe health care. Shula`s DS0000064211.V341337.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 22 & 23 People who use the 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 who use the service are able to express their concerns, have access to an appropriate complaints procedure, and are protected from abuse. EVIDENCE: Tenants are provided with the opportunity to raise concerns or complaints with care staff or with the manager. This can be done at any time on a less formal basis as issues arise, or more formally through the home’s procedure. The home’s detailed complaints procedure and information on how to make complaints is detailed in the service users guide. The complaints procedure can also be made available in other formats to suit the needs of individual tenants. All three comment cards received from tenants indicate that they feel safe at the home. From information provided by the manager there have been no complaints received by the home in the past 12 months. The Commission has not received complaints about the home either. The care staff are clear about the home’s policies and procedures to protect tenants from abuse, and were clear about the action they would take if concerned about the possibility of abuse taking place. Staff have received training in the protection of vulnerable adults. Evidence of this was seen in training records. Shula`s DS0000064211.V341337.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 24 & 30 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The environment at the home is safe, well maintained and equipped to support the needs of people who use the service. EVIDENCE: The premises are suitable for the homes stated purpose, and in keeping with the local community. The interior accommodation is in a good state of repair, with very good quality furnishings and fittings. There was evidence of redecoration and improvements to the accommodation to suit the needs of tenants. The bathroom at the home has been turned in to a wet room to enable better access for a tenant with restricted mobility. Another tenant has had a new en suite shower installed in their bedroom. There are other helpful additions to the equipment and fixtures at the home. The bedrooms belonging to tenants are furnished and decorated to a very good standard, these are clearly personalised and decorated in a way that reflects the tenants choice and interests. Shula`s DS0000064211.V341337.R01.S.doc Version 5.2 Page 17 The tenants work hard to keep the home clean and hygienic throughout, as they each take part in household chores. Shula`s DS0000064211.V341337.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 32, 34 & 35 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff at the home are trained, skilled and in sufficient numbers to support the care and independence of people who use the service. EVIDENCE: There were three tenants supported by a staff member at the time of the inspection visit. Staffing support to the tenants at the home is provided mainly from its neighbouring home Lilas House. The staff have a good understanding of their role and of how this is different to their work at Lilas House. The staff are required to have a good understanding of the ethos of the home and to provide a supportive and guiding role rather than assisting the tenants to do tasks that they are able to do themselves. One member of staff provides support at the home for a part of the early morning, and is then available from 10am till 6pm. Lilas House waking night staff provides support for tenants during the night. This support is via the telephone at the home, which each tenant is able to use independently. From information provided at the inspection there are currently three carers with a qualification at NVQ level 2 & 3, and a further 2 carers signed up to undertake NVQ 2. Their successful completion of this training will provide five Shula`s DS0000064211.V341337.R01.S.doc Version 5.2 Page 19 out of the eight care staff who work at the home with at least an NVQ 2 qualification. Care staff are enthusiastic about the work they do and demonstrated good communication and interaction with tenants throughout the inspection visit. From observation and their comments it was evident that tenants they have confidence in their carers. From discussion with staff and a review of personnel files, it was evident that tenants are protected by good recruitment practices. Training records seen at the visit provide evidence that staff receive good induction and ongoing training from the proprietor’s own training department, which is relevant and appropriate to their roles. Staff see their role as facilitators to enable tenants to maintain their independence and achieve their aspirations. Shula`s DS0000064211.V341337.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 37, 39, 42 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management and administration of the home promotes the care, independence and aspirations of people who use the service, has effective quality assurance systems developed by the proprietors. EVIDENCE: The manager of the home has been in her current post for 5 months. She has worked in care for over 10 years, including experience as deputy manager. The manager stated that she has begun the process of applying for registration with the Commission. The manager is also responsible for managing another home owned by the proprietors in the same road where a further six tenants live. This situation evidently works well and the manager is aware of the need to monitor this on a regular basis to ensure that she is able to carry out both roles effectively. Shula`s DS0000064211.V341337.R01.S.doc Version 5.2 Page 21 Both staff and tenants at the home are complementary about the manager and her approach to them. She has also developed good relationships with community social and health professionals in carrying forward a number of their recommendations. The home produces an Annual Development plan. The home sends out questionnaires to relatives and care/health professionals on an annual basis and these are included in the Annual Development plan. There are several ways in which the quality of the service is monitored. These include monthly audit visits to the home by the proprietors representative, monthly reviews of tenants care plans, staff meetings, annual questionnaires to professionals and relatives, health and safety monitoring, and the ‘Tenants Forum’ meeting that takes place with tenants from other of the proprietors homes. Maintenance records for the fire safety equipment and records were seen. These provided evidence of regular fire alarm tests and drills are carried out, including the names of the staff taking part so that the Manager can ensure that all staff take part at least twice per year. Health and safety issues are given a particular importance due to the fact that there are times when there are no staff on duty within the home. The tenants have clear guidance about how to deal with common situations e.g. domestic repairs, power cuts and dealing with visitors. Shula`s DS0000064211.V341337.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 3 12 4 13 4 14 X 15 3 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Shula`s DS0000064211.V341337.R01.S.doc Version 5.2 Page 23 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Shula`s DS0000064211.V341337.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Shula`s DS0000064211.V341337.R01.S.doc Version 5.2 Page 25 - 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!