Inspection on 03/10/05 for Shula`s

This inspection was carried out on 3rd October 2005.

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 23/05/07

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

CARE HOME ADULTS 18-65 Shulas 9 Cadogan Road Cromer Norfolk NR27 9HT Lead Inspector Lella Andrews Announced 3 October 2005, 10:00am rd 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. Shulas I55 s64211 Shulas v245265 AN 031005 (4).doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Shulas Address 9 Cadogan Road, Cromer, Norfolk. NR27 9HT. 01603 279222 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) Jeesal Residential Care Services Limited Mrs Sam Wiseman Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Shulas I55 s64211 Shulas v245265 AN 031005 (4).doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. An ensuite shower and handbasin is to be provided for the bedroom on the first floor within three months from the date of the registration certificate. Date of last inspection n/a Brief Description of the Service: Shulas is a Care Home for three adults with a learning disability. The accomodation is a flat within a large house owned by the Jeesal Residential Care Services Ltd organisation. 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. Shulas I55 s64211 Shulas v245265 AN 031005 (4).doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first Inspection for this Home as it was only registered a few months ago. Three tenants moved into the Home from Lilas House which is a Care Home owned by the same organisation and is three doors away from Shulas. The aim of the Home is to promote more independent living for the tenants and the staffing is provided according to the needs of the tenants but is not provided on a 24 hour basis. The three tenants provided the majority of the information during the Inspection with the Manager providing some additional information about recruitment and training of staff. The Inspector also spoke to a member of staff on an individual basis and looked at a selection of records. What the service does well: What has improved since the last inspection? This was the first Inspection of this service Shulas I55 s64211 Shulas v245265 AN 031005 (4).doc Version 1.40 Page 6 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. Shulas I55 s64211 Shulas v245265 AN 031005 (4).doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Shulas I55 s64211 Shulas v245265 AN 031005 (4).doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2, 3 and 4 The tenants needs were assessed prior to them moving to Shulas and this forms the basis for the staffing provided The tenants already knew the staff prior to moving to Shulas and were very involved in the process of Shulas being opened and so are confident that their needs will be met EVIDENCE: The Inspector had previously inspected Lilas House which is where the tenants moved from and so is aware of the work that staff had undertaken with the three tenants to develop skills to enable them to live more independently. A formal assessment with regard to independent living was undertaken by the Manager also. This information was used to work out the most suitable staffing support arrangements. The tenants told the Inspector that they have been involved since the plan to develop Shulas was started and visited at various stages of the development. They advised that they were responsible for the choosing of the decoration of their own bedrooms and that they had jointly agreed on the decoration of the communal areas and the purchase of new furniture and equipment. Some of the staff from Lilas House provide the staffing support to the tenants and so they are well known to the tenants. Shulas I55 s64211 Shulas v245265 AN 031005 (4).doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7, 8 and 9 The care plans contain detailed information about how to meet the individual tenants needs The ethos of Shulas is that it is the tenants home and this is clearly demonstrated in all aspects of the tenants lives. The staff support the tenants to make their own decisions and respect these Risks are assessed and guidelines put in place to enable tenants to live more independently Shulas I55 s64211 Shulas v245265 AN 031005 (4).doc Version 1.40 Page 10 EVIDENCE: The Inspector saw one of the care plans. This is very detailed and provides clear guidance to staff about how to meet the tenants needs. The tenants know what is contained within their care plans and have signed the individual risk assessments to confirm their involvement. The staff are aware of the information within the care plans and the steps in place to reduce individual risks. 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. The tenants also keep an individual diary which staff assist them to keep if needed. This is a record of what they have done during the day as well as to plan future events. 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. Tenants meetings take place on a weekly basis which are facilitated by the Manager or Deputy Manager. The records of these show that the tenants have consistently said that they are enjoying living at Shulas. The records also show that as issues or differences of opinion have arisen these have been discussed by all three tenants and a decision made to deal with the situation. The tenants all have their own bank accounts and deal with their own money. The Manager only has an oversight of the accounts to ensure that the tenants benefits are being paid appropriately and that the tenants are able to manage their money. The nature of the service is that there are inherent risks attached to enabling the tenants to live a more independent life. However, the Manager and staff are very keen to ensure that the tenants do not miss out on experiences and so these situations are discussed with the tenants and detailed risk assessments are carried out and regularly reviewed. The tenants are aware of and happy with any guidance that is in place to manage possible risks. For example one of the tenants told the Inspector that they ring the staff at Lilas House to confirm that they are home safely after an evening out. Shulas I55 s64211 Shulas v245265 AN 031005 (4).doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11, 12, 13, 14, 15, 16 and 17 The tenants are living a much more independent life since they moved to Shulas The tenants are very much part of the local community and take part in a range of educational and leisure activities The tenants are encouraged to maintain and develop relationships with friends and family The tenants rights are respected and their responsibilities recognised in their daily lives The tenants are responsible for the planning and preparation of all meals, with minimal staff support as needed Shulas I55 s64211 Shulas v245265 AN 031005 (4).doc Version 1.40 Page 12 EVIDENCE: AS previously mentioned in this report the focus is to enable the tenants to live more independently and this is already being achieved despite the tenants only having lived at Shulas for a short time. The tenants have agreed with staff a routine for the various household tasks that need to be done each day. Whilst this is flexible it does provide the tenants with a clear understanding of the tasks that need to be done. The tenants have agreed amongst themselves which tasks they will take each take responsibility for and the tenants meeting records show that these have been renegotiated as necessary. The staff provide minimal support as required with these tasks. The tenants have a file of important information such as phone numbers, what to do when someone comes to the door, how to change a lightbulb, what to do if the fire alarm goes off. This information is in simple language with colour symbols and the tenants said that they refer to it regularly as it is helpful. The tenants have lived in the Cromer area for many years and have developed links within the community. Each of the tenants has a busy lifestyle comprising of educational, work and leisure activities. For example, one of the tenants works in a children’s nursery, one works in a pub, one undertakes horticultural work. They also access adult education classes, go swimming, go to the pub, out for meals, to the library and to the local church. Staff support is not needed for the majority of these activities but is provided if necessary. The tenants are currently planning their holiday which takes place shortly. They are discussing the options with the member of staff who will be going away with them and planning what they will do whilst away. The care plans contain information about how each of the tenants maintains contact with family and friends and whether any staff support is needed to do this. One of the tenants regularly has a friend to visit and stay for meals. The tenants still visit the tenants who live at the Home where they moved from and have invited friends to visit them at Shulas. One of the tenants is currently taking part in a sponsored knitting competition and has taken part in other local fundraising events in the community. Two of the tenants told the Inspector about a recent “fun day” which had been held at the organisations head office and was a fundraiser for people affected by the Tsunami. The tenants really enjoyed meeting up with staff and other tenants who they have not met for a long time and particularly enjoyed putting the General Manager in the stocks! Shulas I55 s64211 Shulas v245265 AN 031005 (4).doc Version 1.40 Page 13 The tenants agree the menus for the forthcoming week and prepare shopping lists accordingly. Staff assist with the weekly larger shop but the tenants go shopping on a daily basis without staff support. The tenants have developed their own ways of preparing the shopping lists which suits them and they all find easy to use. The menus are planned with the preferences of all the tenants in mind. One of the tenants is vegetarian and one follows a low fat diet. The tenants carry out the daily temperature recordings for the fridge, freezer and cooked meat. The tenants prepare their own breakfasts and lunch whilst staff provide minimal assistance to prepare the evening meal. The tenants help themselves to drinks and snacks whenever they want them. The dietary needs of one of the tenants is particularly important and the staff work hard with the tenant to ensure that their needs are met whilst enabling her to make her own choices. Risk assessments are carried out with regard to this issue. Shulas I55 s64211 Shulas v245265 AN 031005 (4).doc Version 1.40 Page 14 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) 18, 19 and 20 The tenants receive personal support in the way that they prefer The tenants physical and emotional health needs are met The tenants are responsible for their own medication with suitable safeguards in place EVIDENCE: The care plans contain detailed information about the physical and emotional health needs of the tenants. The tenants can go to 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 also, such as dental and opticians. The staff are aware of the importance of maintaining the emotional health needs of the tenants as well as their physical health needs. Other professionals such as psychologists are involved in the tenants care as appropriate. Although the tenants are being supported to be independent the staff maintain a monitoring role and are sensitive in the way that they discuss issues with the tenants. Shulas I55 s64211 Shulas v245265 AN 031005 (4).doc Version 1.40 Page 15 One of the tenants requires some assistance with personal care and this is always provided by a female member of staff. The tenant said that staff come to assist her when she needs them and that this is flexible rather than her having to receive support when she is not ready to do so. 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. Shulas I55 s64211 Shulas v245265 AN 031005 (4).doc Version 1.40 Page 16 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 The tenants feel that their views are listened to and acted on The staff receive training with regard to the protection of the tenants from abuse EVIDENCE: The tenants are all clear that they know how to contact the Manager, General Manager or Proprietors if they needed to with regard to a complaint. They all said that the Manager sorts out day to day issues or concerns for them. The tenants said that the staff all support them in a respectful and kind manner. The staff have all received appropriate training with regard to the Protection of Vulnerable Adults and are aware of the whistleblowing procedure. The organisation has a range of policies and procedures which aim to protect the tenants from any form of abuse. Shulas I55 s64211 Shulas v245265 AN 031005 (4).doc Version 1.40 Page 17 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 The tenants live in a homely, comfortable and safe environment Shulas is clean and hygienic EVIDENCE: The living accommodation is very homely and comfortable. The tenants are still in the process of adding homely touches such as pictures and ornaments. The tenants have been involved in the purchase of all of the furniture, kitchen appliances, crockery, cutlery etc. The tenants are proud of their home and work hard to keep it clean and hygienic. As previously mentioned the tenants all take part in the household chores. The home has recently received approval from the Fire Officer and Environmental Health Officer as part of the registration process. The organisation employs maintenance staff who are able to deal with problems with the environment or will contact other professionals if needed. Shulas I55 s64211 Shulas v245265 AN 031005 (4).doc Version 1.40 Page 18 One of the tenants is waiting for a new armchair following an assessment by the physiotherapist. A condition of the registration is that an ensuite shower room be added to the bedroom on the first floor. The Manager advised that this work is due to commence shortly. Shulas I55 s64211 Shulas v245265 AN 031005 (4).doc Version 1.40 Page 19 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) 31, 32, 33, 34 and 35 The tenants benefit from the staff having a clear understanding of what their roles are The tenants are supported by competent staff who receive appropriate training and support EVIDENCE: Some of the staff based at Lilas House provide the staffing support to the tenants at Shulas. 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. The tenants speak highly of the Manager and all the staff who support them. There is a pictorial chart on the wall in the kitchen which shows which staff will be on duty. During the Inspection the Manager asked the tenants if they minded if the staff swapped shifts that afternoon so that the member of staff could undertake some one to one work with a tenant. Shulas I55 s64211 Shulas v245265 AN 031005 (4).doc Version 1.40 Page 20 The hours of support that are provided have been reviewed and slightly altered since the tenants moved in. This is to be expected and shows that the staffing is being provided to meet the needs of the tenants. Currently one member of staff provides support for two hours in the morning and then for six hours during the afternoon/evening. At weekends eight hours support is provided across the day. The upstairs flat in the same building as Shulas provides accommodation for staff working for the organisation and they are able to provide support during the night to the tenants if required. Shulas I55 s64211 Shulas v245265 AN 031005 (4).doc Version 1.40 Page 21 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, 38, 39. 41 and 42 The tenants benefit from living in a home which is well managed with an open and enthusiastic leadership style The tenants are confident that their views underpin all reviews and developments Record keeping is of a high standard The health, safety and welfare of the tenants are promoted and protected EVIDENCE: The Manager has worked with the tenants for several years and also manages Lilas House where the tenants used to live. She has almost completed the Registered Managers Award and has undertaken other relevant training to keep her knowledge and skills up to date. The tenants and staff speak highly of the support provided by the Manager and are confident in her style of Shulas I55 s64211 Shulas v245265 AN 031005 (4).doc Version 1.40 Page 22 management. The Manager is aware of the records required by regulation and maintains these to a high standard. It is recommended that the records relating to Shulas are kept there although it is recognised that the recruitment records will continue to be stored securely at Lilas House. This situation with the Manager being responsible for both homes seems to be working well at the moment 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. The Manager also provides some training with regard to communication for staff throughout the organisation. To continue to undertake all these roles effectively the Manager needs to be able to work supernumerary to the basic staffing rota at both homes. One of the personnel files was seen during the Inspection and this contained the necessary recruitment checks and records of training. Staff receive mandatory training such as induction, fire safety, food hygiene, moving and handling, first aid. They also receive additional training in subjects such as epilepsy, autism, care planning. The majority of the staff have either completed NVQ Level 2 or are working towards Level 2 or 3. Health and safety issues are given a particular importance due to the fact that there are times when there are no staff on duty. The tenants have clear guidance in words and symbols about how to deal with common situations eg. Changing a light bulb, power cuts, visitors etc. The tenants also know how to contact a member of staff at all times of night and day if they need to. The Inspector saw the maintenance records for the fire safety equipment and records show that regular fire alarm tests and drills are carried out. It is recommended that the record states the names of the staff taking part so that the Manager can ensure that all staff take part at least twice per year. Other health and safety monitoring checks are carried out on a regular basis with records kept of these. A formal quality assurance process has not taken place as the home has only recently opened. However, the views of the tenants are obtained on a daily basis and about every aspect of life in the home and the individual tenants life. The tenants feel that this is their home and that they make the decisions about what happens. Shulas I55 s64211 Shulas v245265 AN 031005 (4).doc Version 1.40 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 3 x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 4 4 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 3 Standard No 11 12 13 14 15 16 17 3 4 4 4 3 4 3 Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Shulas Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 3 3 x 3 3 x I55 s64211 Shulas v245265 AN 031005 (4).doc Version 1.40 Page 24 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. 1. Standard Regulation Requirement There are no requirements as a result of this Inspection 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. 1. 2. Refer to Standard 41 42 Good Practice Recommendations It is recommended that records relating to Shulas are kept in the home It is recommended that a record is kept of staff taking part in fire drills Shulas I55 s64211 Shulas v245265 AN 031005 (4).doc Version 1.40 Page 25 Commission for Social Care Inspection 3rd Floor Cavell House St Crispins Road Norwich NR3 1YF 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 Shulas I55 s64211 Shulas v245265 AN 031005 (4).doc Version 1.40 Page 26 - 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. 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