Care Home: Sailaway Residential Home

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What the care home does well People feel well cared for, and the staff are kind and considerate. The premises and the garden are being well maintained. People enjoy the meals provided. "Plenty of food, cooked lovely. Something different every day" one person told us. There are good arrangements in place for staff training. People`s concerns and suggestions are being acted upon, such as menu suggestions, films to watch, and a mobile shop. What has improved since the last inspection? Care plans are being changed to include more guidance to staff on how the person`s needs are to be met, and more information on the person`s wishes and preferences. Requirements made at our previous visit concerning risk assessments, care plans, medication, and staff recruitment were found to have been met. Improvements to the premises since our previous visit have included providing a chairlift and refurbishing the dining area and sitting area and bathrooms. Improvements have also included installing a new kitchen, developing garden features, introducing more outside seats, and redecorating the exterior of the building. What the care home could do better: The safety of medication being administered in the home would be improved by clearer guidance for staff on the circumstances when medication written up as when required should be administered. This would better ensure consistency on when this medication is to be administered. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Sailaway Residential Home Main Road Bosham Chichester West Sussex PO18 8PH     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: Edward McLeod     Date: 1 5 0 7 2 0 0 9 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. that people have said are important to them: They reflect the things 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 27 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.cqc.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Sailaway Residential Home Main Road Bosham Chichester West Sussex PO18 8PH 01243572556 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mrs Saroj Dahiya care home 18 Number of places (if applicable): Under 65 Over 65 18 old age, not falling within any other category Additional conditions: 0 The maximum number of service users to be accommodated is 18. The registered person may provide the following category/ies of service only: Care home only (PC) to service users of the following gender: Either Whose primary care needson admission to the home are within the following categories: Old age, not falling within any other category (OP) Date of last inspection Brief description of the care home Sailaway is a care establishment registered to provide accommodation for up to 18 people, in the category OP (old age not falling in any other category). The establishment is situated near to the main road near the village of Bosham. Local bus routes to Chichester are near by. Accommodation is provided on ground and first floor level. There is a chair lift to the first floor. All rooms are generally for single occupancy however there are two rooms that can be used as doubles providing the occupancy levels do not exceed 18. The service is privately owned. The proprietor is Mrs Saroj Dahiya. The current fees range from 400 to 500 pounds per week. Care Homes for Older People Page 4 of 27 Care Homes for Older People Page 5 of 27 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: The inspection was arranged to assess compliance with the requirements made at our previous visit and to assess compliance with the key national minimum standards for care homes for older people. The inspection visit took place on the 15th July 2009 from 9.35 a.m. to 2.40 p.m. In preparing for the visit we asked the home for their annual quality assurance assessment (the AQAA). The AQAA tells us about how they are meeting the needs of the people accommodated and provides us with some numerical information about the service. The AQAA was completed by the manager Mrs Dahiya and provided the information we asked for. Care Homes for Older People Page 6 of 27 Before our visit we sent out Care Quality Commission (CQC) surveys to a number of staff and people living in the home. We received responses from three members of staff and six people living in the home, and some of the information received has been included in this report. During our visit we sampled pre admission assessments and care plans for three people living in the home to assist our assessment of the quality of care planning in the home. We also talked with five people living in the home, three members of staff, and the manager. Other records we sampled during our visit included records relating to health and safety issues, two sets of medication records, and staff rotas. To assist our assessment of the homes recruitment procedures and staff training we sampled recruitment, training and supervision records for two members of staff. 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.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 27 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 9 of 27 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. People are confident the 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. Evidence: The six people living in the home who responded to our CQC survey told us that they received enough information to help them decide if the home was the right place for them before they moved in. The AQAA tells us that all people who are self-funding have a copy of their contract of terms and conditions, and that all people who are funded by a local authority have a copy of the agreement with the local authority. Care Homes for Older People Page 10 of 27 Evidence: During our visit we sampled the pre-admission assessments for three people admitted to the home, and found that their needs were being assessed before admission was agreed. The service does not have arrangements to provide intermediate care. Care Homes for Older People Page 11 of 27 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. Peoples 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. Clearer guidance for staff on when and if as required medicines are to be administered need to be provided to better ensure the person is being supported with their medication in a safe way. Peoples right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. Evidence: A requirement was made at our previous visit that each person must have a clear individual care plan which describes the support that staff will give to meet the Care Homes for Older People Page 12 of 27 Evidence: persons needs. We sampled the care plans for three people living in the home and found that their wishes and preferences were now being included in the care plan, and that the action staff are to take to meet the assessed needs is now recorded. The requirement concerning this was assessed as met. The six people living in the home who responded to our CQC survey told us that they receive the care and support they need, and that staff listen to them and act on what they say. One person told us in their survey that the home provides genuine care and kindness with laughter. The survey responses we received from people living in the home told us that their dignity is respected. For example, one person wrote that staff do not make them feel embarassed about delicate care issues. Care staff we spoke to during our visit gave examples of how they ensure peoples privacy and dignity is respected when personal care is being provided. A member of care staff told us that the routines for getting up in the morning and breakfast are always flexible according to the persons wishes, and that the persons independence is encouraged. One person wrote in their survey form that they have built me up physically and mentally to a stage where I am able to return home. A member of staff wrote in their survey form that peoples needs and rights were being respected. People responding to our survey told us the home makes sure they get the medical support they need, and the care records we looked at indicated that staff were supporting people to access medical support such as visits to hospital and visits from district nurses, for example. One person wrote that the home was good at helping me with monitoring my health, having health professionals visit as required. A requirement was made at our previous visit that the service must ensure that risks are considered on an individual basis. Care Homes for Older People Page 13 of 27 Evidence: At this visit we sampled risk assessments for three people and found that these were assessing the persons risk issues which were then being addressed in their care plan. The requirement concerning this was assessed as met. A requirement was made at our previous visit that medicines are not placed into any secondary container for administration by another carer. At this visit we found that the arrangements for medication administration had changed to better ensure that the right person is receiving the right medication. The requirement concerning this was assessed as met. A requirement was made at the previous visit that individuals must be assessed to ensure safety for self-administration of medication. At this visit we found that arrangements are now in place for risk asssessments to be carried out where a person is holding their own medicines. On the day of our visit Mrs Dahiya told us that none of the people accomodated were holding their own medicines. The requirement concerning this was assessed as met. During this visit we sampled medication records for two people. We found that no gaps in the records we looked at. We found that where people had been prescribed medication to be taken as required clear written guidance to staff on the circumstances under which the medication should be given to the individual was not in place. A relative of a person living in the home has written to us to say when my mother arrived her weight was down to about 6 and a half stone, it is now back to what it was. Care Homes for Older People Page 14 of 27 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. Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability 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. Evidence: We found that regular activities provided in the home include Tai Chi and musical therapy. Weather permitting short walks in the afternoon are popular and were mentioned by people we talked to, and staff regularly take people in wheelchairs for a walk who wish this. Care Homes for Older People Page 15 of 27 Evidence: There are also visits from entertainers, and people we spoke to said they enjoyed the entertainers. Ideas for other activities are discussed in the regular relatives and residents meeting. Contact with the local community is maintained by local groups such as the Brownies visiting and doing things such as planting sunflowers in the garden. Staff we talked to said that a mini bus which can accomodate wheel chairs will mean that outings into the local community can be arranged. Staff we talked to and care records we sampled indicated that people are supported to maintain contact with their family and friends. The relative of a person living in the home has written to us that the food is excellent and a very good choice is available. A member of staff wrote in their survey form that the food is well cooked and that there is good variety and choice. The people living in the home who responded to our CQC survey told us that they liked the meals. One person we spoke to said that there was plenty of food, cooked lovely. Something different every day. We observed that lunch was relaxed and unhurried, and everyone looked to be enjoying the food. Food was well-presented and there was a choice of desserts including fresh fruit which had been prepared. Care Homes for Older People Page 16 of 27 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. If people have concerns about their care they or other 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. Evidence: The AQAA tells us that a copy of the complaints procedure is given to people, and a copy of it is displayed in the entrance hall. The service undertakes in their complaints policy to investigate and provide an outcome for the complaint within 28 days. The six people living in the home who responded to our CQC survey told us that there was someone they could speak to if they were unhappy. Five of the six people told us that they knew how to make a formal complaint. No complaints have been recorded since our previous visit. Staff continue to receive training in safeguarding vulnerable adults from abuse. A copy of the local guidelines for reporting safeguarding concerns was prominently displayed for the attention of all staff. Care Homes for Older People Page 17 of 27 Care Homes for Older People Page 18 of 27 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 stay in a 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. Their rooms feel like their own, it is comfortable and they feel safe when they use it. Evidence: We found that the premises are being maintained to a good standard, and that significant improvements to decoration and furnishing have taken place. In the AQAA Mrs Dahiya tells us that improvements have included providing a chair-lift and refurbishing the dining area and sitting area and bathrooms. Improvements have also included installing a new kitchen, developing garden features, introducing more outside seats, and redecorating the exterior of the building. The communal areas of the house include a dining room, sitting room, sun lounge and patio, and the gardens are being well maintained. Mrs Dahiya told us that improvements planned included new furniture for the sun Care Homes for Older People Page 19 of 27 Evidence: lounge, and refurbishment of the bathrooms. We visited six bedrooms and found that residents are encouraged to personalise their rooms with photographs, pictures, ornaments and small pieces of furniture to create a familiar environment. One person we spoke to described their bedroom as a nice big room, good view. Mrs Dahiya said that some people had mentioned in the residents meeting that they would like their bedrooms changed around, and that this was arranged. People we talked to said they were happy with their bedrooms Recently a stair-lift has been installed to make it easier for some people to get up and down the stairs as there is not a passenger lift. Mrs Dahiya tells us in the AQAA that improvements were carried out around the schedule of the people living in the home, and that there were discussions with people about the planned work and agreeing a plan together. In their CQC survey forms people living in the home told us that the home is kept clean and fresh. One person wrote that the home is always fresh and clean, well presented with fresh flowers etc. During our visit we found all areas of the home to be tidy, clean and fresh. Care Homes for Older People Page 20 of 27 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 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. Evidence: Two care staff we spoke to said they had been working in the home for four years and that the staff team was settled and well established. They told us that staff live locally so can come in to cover a shift if needed. In our CQC survey form we asked people living in the home if staff were available when they needed them. Three people responded that staff were always available and three responded that staff were usually available when they needed them. One person wrote to us in their CQC survey form that staff are always available to talk to. One member of staff said in their CQC survey form that low staff turnover means that Care Homes for Older People Page 21 of 27 Evidence: staff know residents well and can meet individual needs. Discussion with staff and a sampling of training records indicated that staff are being provided with the training they need to update them on current good practice and improve the care they give. The AQAA tells us that new staff are only appointed following completion of satisfactory checks and that each shift consists of staff with different skills in order to ensure that service users are in safe hands at all times. The three members of staff who responded to our CQC survey told us that their employer carried out checks, such as their criminal records bureau (CRB) check and references before they started work. We sampled recruitment records for two staff which indicated that checks and references are being carried out before a member of staff commences work. The previous requirement concerning recruitment was found to have been met. The three members of staff who responded to our CQC survey told us that their induction training covered everything they needed to know to do the job when they started, and that staff were receiving training and support for the job they did. The AQAA tells us that all seven permanent care staff employed have the national vocational qualification (NVQ) in care to at least level 2, and Mrs Dahiya told us that staff are supported to undertake further NVQ training. Care Homes for Older People Page 22 of 27 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 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. Evidence: The manager Mrs Dahiya continues to update her training and seeks to improve upon the service provided. The relative of a person living in the home has written to us commenting that Sailaway has a homely atmosphere and the owner and staff are caring and friendly and nothing Care Homes for Older People Page 23 of 27 Evidence: is too much trouble for them. One person living in the home told us in their CQC survey form that the manager always puts her residents first and had made big improvements in the last 12-18 months. One person we talked to said there was a happy atmosphere in the home. We carried out an observation exercise over a forty minute period in the dining room and sitting room. This indicated that there was a calm relaxed atmosphere in the home, and that staff were respectful towards people and were approachable and chatty. We talked to Mrs Dahiya about how the service seeks the views of people on how the service is performing. She advised us that there is a regular residents and relatives meeting where concerns or suggestions can be discussed. We looked at the record for these meetings held on 4/5/09 and 6/7/09. We found that they were well attended, and there were a number of suggestions at each meeting which had been recorded. Mrs Dahiya told us that suggestions taken up from these meetings had included changes to menu, food purchases, starting a mobile shop and changing bedrooms around. We looked at the supervision records for two members of staff. Staff we spoke to told us that they are receiving supervision on a regular basis and that this gives them an opportunity to discuss and improve the care they are providing. Mrs Dahiya has advised us in the AQAA of the most recent equipment checks and inspections which have been carried out. Staff training records we sampled and staff we talked to indicated that staff are attending of range of health and safety trainings such as food hygiene, infection control, lifting and handling and health and safety. Care Homes for Older People Page 24 of 27 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 25 of 27 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 1 9 13 The provider must ensure 28/09/2010 that arrangements for the administration and recording of medicines best ensure this is done safely. Lack of guidance for staff on when to administer as required medicines is not ensuring consistent practice. 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 Care Homes for Older People Page 26 of 27 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.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. 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