Inspection on 20/06/07 for Syrian House

This inspection was carried out on 20th June 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

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

CARE HOME ADULTS 18-65 Syrian House Syrian House Sandiway Road Ashton-on-Mersey Sale Manchester M33 5AL Lead Inspector Rukhsana Yates Unannounced Inspection 20th June 2007 10:00 Syrian House DS0000068357.V340225.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 Syrian House DS0000068357.V340225.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. Syrian House DS0000068357.V340225.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Syrian House Address 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) Syrian House Sandiway Road Ashton-on-Mersey Sale Manchester M33 5AL 01925 571680 Making Space Carol Ann Godfrey Care Home 17 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (17) of places Syrian House DS0000068357.V340225.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 17 service users to include:*Up to 17 service users in the category of MD (Mental Disorder excluding learning disability or dementia) Not applicable. Date of last inspection Brief Description of the Service: Syrian House is a care home that provides support and accommodation for 17 adults with mental health needs. The home s situated in a residential area of Sale, close to a wide range of amenities. Syrian House is a large detached property set in extensive, well-maintained grounds in a quiet suburban area of Ashton on Mersey, Sale. The towns of Altrincham and Sale are within easy reach, as the home is situated on a main bus route. The village of Ashton on Mersey is within walking distance of the home. Syrian House is a Registered Care Home owned by Making Space. Syrian House provides accommodation with personal care for up to 17 residents who have enduring mental ill health problems. The home aims to encourage and develop residents’ independence and living skills and to enable integration within the wider community. The weekly fees are £410.90. Residents pay for their holidays and for taxis. Syrian House DS0000068357.V340225.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. To find out about the experiences of people living at Syrian House, a visit was carried out, with a total of six hours spent at the home. No-one was told that the inspector would be visiting. The time was spent talking with people living and working at the home and watching the ways in which staff provided support to people living there. The findings of the inspection take account of comments made by seven of the residents consulted during the visit, and written information received from the manager as well as what was seen at the site visit. The service was inspected against key standards that cover the support provided, daily routines and lifestyle, choices, complaints, comfort, how staff are employed and trained, and how the service is managed. The term preferred by people consulted during the visit was “residents”. This term is, therefore, used throughout the report when referring to those living at the home. What the service does well: What has improved since the last inspection? This is the visit to the service under new ownership. Syrian House DS0000068357.V340225.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Syrian House DS0000068357.V340225.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 Syrian House DS0000068357.V340225.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): 1 & 2: Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents have their needs assessed, are provided with information and assured that the service is able to meet their needs. EVIDENCE: The prospectus, service users’ guide and statement of purpose are displayed in the home and contain the range of information people need regarding the facilities and services. The guide contains photographs of areas inside the home, and information about lifestyle plans, activities, entertainment, provision to meet spiritual needs, and access to specialist services. Admissions are planned and arranged at a pace to suit the individual. The plan of one person recently admitted showed that the decision to consider a move to Syrian House had been made following a multi-disciplinary assessment involving the prospective resident. Admission took place following a threeweek introductory period. During this time the person visited for lunch, spent an afternoon at the home, had overnight stays and a full week stay. Visits involved the person in trips and outings with other residents and getting to know the running and layout of the home, enabling them to be able to make an informed decision about living there. Following admission, each resident is involved in developing their Essential Lifestyle Plan detailing their needs, preferences and aspirations. Syrian House DS0000068357.V340225.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): 6, 7 & 9: Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Individuals are involved in decisions about their lives and in planning the care and support they receive. EVIDENCE: All of the residents consulted were satisfied with the support they receive and described benefits in terms of improved wellbeing or confidence as a result of living at Syrian House. One said, “The staff are very professional; they understand me. I’ve been much better since I came here”. Another resident said, “Syrian House has helped me deal with each day as well as the illness”. It was apparent in discussions and observations that support staff have a good awareness of the individual needs of each person, and the approach to use depending on the preferences and personalities of each person. Independence and increased life skills are promoted within a risk management framework that is recorded, implemented and reviewed. The service is responsive to each person’s changing mental and physical needs and ability to self-care, which helps residents to maximise their choices and independence. Syrian House DS0000068357.V340225.R01.S.doc Version 5.2 Page 10 Essential Lifestyle Plans are written in the first person, and detailed to the extent that a support worker reading it would get to know the personal, physical and emotional needs of the person, their likes and dislikes, background, routines, attitude to risk taking, religious and cultural needs, hobbies and interests and other relevant information. For each area of need, the resident is involved in deciding the level and type of support they require from staff. Regular reviews take place but the plans seen had not been dated and signed to show that residents agreed the contents. Syrian House DS0000068357.V340225.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): 12, 13, 15, 16 & 17: Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents feel their lifestyle choices, expectations, and preferences in daily routines are respected and met. EVIDENCE: Residents have access to a range of information about their local community, including details about facilities to meet cultural needs, interest groups and religious centres. Residents’ plans reflect a respect for individual identity that was in evidence in discussions with staff and in observations of practice throughout the visit. Knowledge of preferences is used as a basis for varied activity provision that includes board games, bingo, darts, pool, draughts, chess, meals out, cooking, gardening, trips into the village, courses and holidays. Consideration is given to peer groups and friendships that have developed. For example, a group of male residents enjoy playing pool, and also work on an allotment, supported by a male support worker. One staff member said, “We know that each person here is different and we help them to get involved in what they want to do”, and gave examples of ways in which Syrian House DS0000068357.V340225.R01.S.doc Version 5.2 Page 12 cultural and lifestyle preferences are addressed. A resident said, “They ask us what we like. They don’t talk down to you”. Some residents benefit from having a structured weekly routine, and the weekly programmes seen were varied and in line with the person’s hobbies, interests and aspirations. For example one person was developing their cooking skills with support from an occupational therapist. Domestic scale laundry and kitchen facilities are available for residents to use and develop their independent living skills. Residents have ownership of their rooms and take responsibility for keeping them clean and tidy with support from staff when needed. Those who wish to have a key to their room are provided with one. Residents participate in housekeeping tasks in a way that benefits them in terms of having structure, roles and responsibilities. All of the residents consulted said, “The food is very good”. Menus are varied and based on the known and recorded preferences and suggestions of residents. Syrian House DS0000068357.V340225.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): 18, 19 & 20: Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ receive support and have their physical and emotional health care needs met in the way they prefer and require. EVIDENCE: The Essential Lifestyle Plan for each person clearly describes the ways in which residents perceive their needs and the expectations they have of the people supporting them. For example the plan details preferred routines, personal care needs and emotional support requirements. There is also a recognition that the type of support may need to change depending on the mental health and vulnerability of each person at any particular time. Staff members were observed to be reassuring and respectful towards residents, and to take the time to explain their actions resulting in reduced anxiety for residents. One person said, “The carers here are fantastic. They get to the root of any problems and diffuse any trouble”. Syrian House DS0000068357.V340225.R01.S.doc Version 5.2 Page 14 Medication is managed in a safe and consistent manner, with clear systems in place for recording, auditing, administering and storing medication. Self medication is enabled for people if this is considered appropriate within well devised risk management guidelines. Syrian House DS0000068357.V340225.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): 22 & 23: Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are listened to, taken seriously, and feel safe. EVIDENCE: Residents spoken with all confirmed that they could speak to staff if they had any concerns and that action would be taken in response to their worries. There have been no complaints since registration. Residents were clearly comfortable approaching staff to ask questions or seek reassurance and the open door policy was appreciated by those consulted. Discussions and training records confirmed that staff receive a wide range of training, including adult protection, and understand their role in protecting residents. Lifestyle plans include guidelines and responsibilities agreed with individuals designed to promote choice and freedom while reducing risks to personal safety. For example one person had agreed a directive with the staff and the Community Psychiatric Nurse, to be implemented in the event of the person not returning home at a specified time. Syrian House DS0000068357.V340225.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): 24 & 30: Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents are satisfied that they live in a clean and comfortable environment. EVIDENCE: The home was generally clean and tidy, and residents consulted were happy with the environment. Each person has a single room and is offered a key to their room if they want one. Many residents had personalised their rooms and were involved in decisions about redecoration. Residents are encouraged to keep their rooms clean and tidy with support from staff in order to maintain their independence and sense of ownership. Some areas of the home would benefit from refurbishment and redecoration in order to create a brighter and more homely environment. For example, several carpets are worn, and lighting in some areas is dim. This has been recognised and a schedule for refurbishment has been produced and is being implemented. Syrian House DS0000068357.V340225.R01.S.doc Version 5.2 Page 17 The environment is safe and provides areas for residents where they can socialise, watch television, meet with visitors or spend time on their own. A number of adaptations have been made to the environment to assist residents with reduced physical mobility, such as handrails being fitted in corridors. This approach demonstrates that the service addressing the diversity of the resident group and enables residents to remain at their chosen home as their needs change. Syrian House DS0000068357.V340225.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): 32, 34 & 35: Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ needs are met by competent and suitably trained staff. EVIDENCE: Staff members said that they receive a great deal of training relevant to their roles including health and safety, medication, mental health, first aid, equality and diversity and adult protection. Many of the staff have achieved NVQ qualifications. It was evident that staff have a good knowledge of the needs and personalities of individual residents. Communication between staff is good. The information about residents provided to the senior person at the start of her shift was detailed and helped to ensure good continuity of support for those concerned. Staff members consulted also confirmed that relevant background checks were carried out before they were recruited, and induction training was provided. The full range of recruitment records are maintained at head office. Evidence of recruitment checks should be kept on site to provide supporting evidence that employment processes are robust and protect people. Syrian House DS0000068357.V340225.R01.S.doc Version 5.2 Page 19 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): 37, 39 & 42: Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Effective management ensures that residents’ rights and best interests are promoted. EVIDENCE: The Deputy Manager was in charge during this visit and demonstrated, along with the senior staff, a high level of competence and knowledge. Residents, visitors and staff described an open and friendly atmosphere in which people’s views are listened to and acted on. A quality assurance system is in place that seeks and acts upon the opinions of residents in terms of their day to day experiences and improvements that could be made. Health and safety checks promote residents’ welfare. Syrian House DS0000068357.V340225.R01.S.doc Version 5.2 Page 20 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 3 2 4 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 4 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 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 3 3 X 3 X 3 X X 3 X Syrian House DS0000068357.V340225.R01.S.doc Version 5.2 Page 21 N/A 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. 1 Refer to Standard YA6 Good Practice Recommendations Care plans should be dated and signed by the resident where possible to show that the resident has agreed the contents of the plan. Evidence of recruitment checks should be kept at the home to demonstrate that employment practices protect residents. 2 YA34 Syrian House DS0000068357.V340225.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Manchester Local Office 11th Floor West Point 501 Chester Road Manchester M16 9HU 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 Syrian House DS0000068357.V340225.R01.S.doc Version 5.2 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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