Care Home: Satya Nivas Residential Home

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What the care home does well The service had excellent outcomes around Choice of Home; the process by which an individual chooses Satya Nivas with comprehensive assessment procedures in place. Outcomes for Lifestyle were excellent; and covered high standards of service and support that enabled residents to maintain appropriate and fulfilling lifestyles in and outside the home. Responding to Concerns, Complaints and Protection and ensuring that residents are safe from abuse or neglect were also found to be excellent. Residents are supported and protected by well-trained staff and through recruitment practices. Residents said: "The staff are very nice." "Tara (registered provider) takes me to the market and we buy fruit." " I can tell the staff if I am not happy" Residents are involved in the running of the home. For example they are given a set budget and together with staff plan meals around this. All residents are involved in the local community visits to the local shops, pubs, Asian clubs, visits to different temples, taking part in the local religious festivities and Asian musical programmes. A resident told the Inspector," I am looking forward to Diwali going to see the lights and wear my new suits". What has improved since the last inspection? Medication is stored more securely to ensure that it is not accessible to residents for whom it is not prescribed. Medication administration procedures have been improved. What the care home could do better: To build upon staff training and consider person centred planning in order to plan for individuals, based around the principles of inclusion and the social model of disability. To improve the review of care format to ensure staff are aware of the changes for individual following on a residents review. To continually update live documents such as the Statement of Purpose and Service User Guide. Also the Sexuality and Relationships Policy to ensure resident`s best interests are protected. CARE HOME ADULTS 18-65 Satya Nivas Residential Home 71/73 Checketts Road Leicester LE4 5ES Lead Inspector Helen Abel Unannounced Inspection 8th October 2007 04:00 Satya Nivas Residential Home DS0000006443.V348298.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 Satya Nivas Residential Home DS0000006443.V348298.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. Satya Nivas Residential Home DS0000006443.V348298.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Satya Nivas Residential Home Address 71/73 Checketts Road Leicester LE4 5ES 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) 0116 224 1802 jag-jamjar@yahoo.co.uk Mrs Tara Pankhania Ms Devi Sundavadra Care Home 10 Category(ies) of Learning disability (10), Mental disorder, registration, with number excluding learning disability or dementia (10) of places Satya Nivas Residential Home DS0000006443.V348298.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. No additional conditions of registration apply. Date of last inspection 11th October 2006 Brief Description of the Service: Satya Nivas offers long-term accommodation for 10 adults with learning disabilities. It is situated on Checketts Road off the Belgrave Road, within easy reach of the City of Leicester, in a large detached property. It is within the immediate vicinity of all amenities, and bus routes. Its primary purpose is to meet the cultural, religious and language needs of Asian people. The furniture and decoration in the home is authentically ethnic to suit Asian needs. Rooms are decorated to a good standard. There is a large lounge, which has television, video, and satellite facilities. There is also a rear garden, a front patio garden and parking facilities available. Current fees range from £280 to £327. Satya Nivas Residential Home DS0000006443.V348298.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of the inspections undertaken by the Commission for Social Care Inspection is upon outcomes for service users and their views of the service provided. The primary method of inspection used was ‘case tracking’ which involved selecting three residents and tracking the care they received through looking at their records, discussion, where possible, with them and care staff and observation of care practices. The inspection took place on a weekday between 4pm and 8pm and was unannounced. The Inspector spoke in total with four residents one carer, the registered manager and registered provider. An Interpreter joined the Inspector at the beginning of the inspection and assisted the Inspector when interviewing residents. Planning for the Inspection included assessing notifications of significant events sent to the Commission for Social Care Inspection, examining the service history and Annual Quality Assurance Assessment. All the information received was considered as part of this inspection. What the service does well: The service had excellent outcomes around Choice of Home; the process by which an individual chooses Satya Nivas with comprehensive assessment procedures in place. Outcomes for Lifestyle were excellent; and covered high standards of service and support that enabled residents to maintain appropriate and fulfilling lifestyles in and outside the home. Responding to Concerns, Complaints and Protection and ensuring that residents are safe from abuse or neglect were also found to be excellent. Residents are supported and protected by well-trained staff and through recruitment practices. Residents said: “The staff are very nice.” “Tara (registered provider) takes me to the market and we buy fruit.” “ I can tell the staff if I am not happy” Residents are involved in the running of the home. For example they are given a set budget and together with staff plan meals around this. All residents are involved in the local community visits to the local shops, pubs, Asian clubs, visits to different temples, taking part in the local religious festivities and Asian musical programmes. A resident told the Inspector,” I am looking forward to Diwali going to see the lights and wear my new suits”. Satya Nivas Residential Home DS0000006443.V348298.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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. Satya Nivas Residential Home DS0000006443.V348298.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 Satya Nivas Residential Home DS0000006443.V348298.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 excellent This judgement has been made using available evidence including a visit to this service. Comprehensive assessment procedures ensure that residents needs and aspirations can be effectively met. EVIDENCE: The home provides a plain English Service User Guide which sets out clear information and a Service User Guide. The aim of the service is to meet the cultural, religious and language needs of Asian adults. The same information is available in community language- Gujarati and in a video format. In addition to main services of accommodation, authentic Asian cuisine, laundry services, manicure and hand massage is also available. The registered provider prior to admission undertakes a full assessment. This includes visiting the person in their current setting, collecting assessments from all professional involved. Assessments covered all aspects of care: physical, mental and emotional health as well as social, religious and cultural needs. The prospective resident is offered introductionary visits over different times of the day before making any decisions. The other residents in the home Satya Nivas Residential Home DS0000006443.V348298.R01.S.doc Version 5.2 Page 9 are involved in welcoming the resident. Thereafter each resident has an individual written contract. Satya Nivas Residential Home DS0000006443.V348298.R01.S.doc Version 5.2 Page 10 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. Residents are involved in day to day decisions are well supported to take reasonable risks and support plans accurately reflect their needs. EVIDENCE: Three residents care plans were examined as part of case tracking. These were detailed and included risk assessments and addressed risk to the resident as well as those around them. The care plan is drawn up with the involvement of the resident their families and any other specialists in involved. Resident’s decision choices and interests are recorded in the care plan. Care plans including risk assessments are reviewed regularly but more formally every six months. Residents and their family and supporters are invited with outcomes recorded. The Inspector recommended the six monthly care plan review format is developed further to include any changes and how staff should work with Satya Nivas Residential Home DS0000006443.V348298.R01.S.doc Version 5.2 Page 11 individual residents to meet these as currently there was not sufficient detail available. To develop care planning further the Inspector suggested bringing in person centred planning. This is a process of life planning for individuals, based around the principles of inclusion and the social model of disability. Staff have already received training around this aspect. The registered provider agreed to look into this. Residents were observed coming and going from the home independently during the inspection to go local shops, and to see family and friends. Satya Nivas Residential Home DS0000006443.V348298.R01.S.doc Version 5.2 Page 12 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): 11, 12, 13, 15, 16, 17 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. Residents have opportunities to engage in vocational, leisure and community activities are given support in maintain links with family and friends and enjoy nutritious authentic Asian food. EVIDENCE: All residents are involved in the local community visits to the local shops, pubs, Asian clubs, visits to different temples, taking part in the local religious festivities and Asian musical programmes. A resident told the Inspector,” I am looking forward to Diwali going to see the lights and wear my new suites”. Staff ensure residents are offered choices of where they want to go and can use the homes transport or travel independently on public transport. Some residents attend day centres and some have voluntary jobs. The home supports contact with family members and all residents have contact with their families regularly. With visits to the home or residents visit them Satya Nivas Residential Home DS0000006443.V348298.R01.S.doc Version 5.2 Page 13 One resident spoke about looking forward to a holiday together with some of the residents. He will be paying for himself and hopes to go to India. The registered provider confirmed annual group trips are arranged for any resident that want to go. This is planned by the residents who share the same interests. Some residents attend college for ESOL lessons or other appropriate classes. One resident said,” I don’t like the food at college so I take food from here”. A resident was out most of the inspection and returned late in the evening. The Inspector noted staff prepared a hot meal for him. Meals that meet individual residents diets are served in the dinning room. Meal times are very flexible with light music played in the background. Residents plan the menu and frequently undertake light food preparation together with staff. There is strong emphasis on choice of meals and residents being kept fully involved in the food planning and purchasing the ingredients. A resident told the Inspector “ I like to go and get the milk each day and bread, milk, honey whatever is needed.” Satya Nivas Residential Home DS0000006443.V348298.R01.S.doc Version 5.2 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. 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 appropriate personal support and their health and medication needs are well met. EVIDENCE: Residents care plans are clearly documented and they receive support in the way they prefer in order to maximise their privacy, dignity and independence. All residents have access to primary care services such as GP, dentists, community nurses, chiropodists, and opticians. Residents chose their own routine, bath and meal times, clothes, hairstyles and make up. A resident told the Inspector “ Tara (the registered provider) helps me to choose new clothes.” Residents are weighed regularly and any early signs of health issues acted upon promptly. Some residents were expecting a review of their medicines on the day of inspection. A meeting is held in private and the outcome recorded. Good Satya Nivas Residential Home DS0000006443.V348298.R01.S.doc Version 5.2 Page 15 systems are in place for storing, recording and administering medication. All staff are trained in handling medication. The registered provider reported further medication training is due soon for the staff group. Satya Nivas Residential Home DS0000006443.V348298.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. Residents concerns are listened to and acted upon and good systems are in place to protect them. EVIDENCE: There are regular residents meetings and one resident act as chairperson and writes up the notes. The notes are discussed at staff meetings and any changes made and residents informed. The complaints procedure is available in a written/pictorial format and on videotape in Gujarati, which is currently the first language of all the residents. The complaints procedure includes contact details of advocacy services. At residents meetings staff at intervals remind residents about their right to make a complaint. A resident told the Inspector “There is nothing to complain about, just trivial things come up and I tell the staff. Its like family here we are like brothers and sisters.” Staff receives regular training around protecting adults issues. Staff were confident with responding to the Inspector with what they would do if they had any concerns around protecting a resident. The registered provider reported she had identified some additional training for her staff group around adult protection and was looking to arrange this soon. Satya Nivas Residential Home DS0000006443.V348298.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24,27,30 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Residents live in a clean, comfortable and homely environment, which meets their needs well. EVIDENCE: The home is decorated cultural appropately and according to individual ethnic needs. The home is set within the Asian community near Asian grocery shops, Asian clubs and temples. The ambience reflects the homes statement and purpose. There is a car parking area to the front of the home and a small paved area at the rear of the home. Both communal and personal rooms are well decorated and furnished. The first floor bathroom needs some repair as the seal around the bath is discoloured and looks unsightly. Satya Nivas Residential Home DS0000006443.V348298.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 are supported and protected by well-trained staff and through recruitment practices. EVIDENCE: Staff are bi-lingual and speak Gujarati and English and are able to communicate fully with residents. Staff are trained in learning disabilities and mental health issues and hold National Vocational Qualifications in Care/ Management at levels 2,3,4. Staff have their own training and development plan. The registered provider spoke of currently looking at refresher training and updating staff with First Aid skills to safeguard residents. She reported that all training was open to all staff and looking to offer some training to residents (where the course content is applicable). Residents told the Inspector: “The staff are very nice.” “ Staff are fine. I like it here.” “Tara (registered provider) takes me to the market and we buy fruit.” “ I can tell the staff if I am not happy” Satya Nivas Residential Home DS0000006443.V348298.R01.S.doc Version 5.2 Page 19 “All the staff are very good” Staff have regular supervision with the registered provider and this is linked to residents, and their individual care plans. Staff recruitment records were sampled and contained all the required information including enhanced criminal record bureau checks. Satya Nivas Residential Home DS0000006443.V348298.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): 37,39,40, 41, 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Good systems are in place to ensure resident’s views inform the way the service is delivered, monitored and improved. EVIDENCE: Both the registered provider and registered manager are sufficiently qualified and experienced to manage the home effectively and undertake regular training to maintain and update their skills. The registered provider works at the home on a daily basis and personally oversees the care of the people living there. Residents and their relatives are consulted by means of questionnaires are given out at the review of care. A selection of these was examined. All comments made were very positive expressing satisfaction with the service provided. Yearly questionnaires are sent out to family and visitors and the Satya Nivas Residential Home DS0000006443.V348298.R01.S.doc Version 5.2 Page 21 outcomes are used as a quality guide for managers. Both staff and resident meetings are held monthly and are documented. Staff meetings are held and surveyed as to their opinion as are relatives, stake holders and such as social workers and other health professionals. Residents are involved in the running of the home. For example they are given a set budget and together with staff plan meals around this. Policies are reviewed at regular intervals, however the current Sexuality and Relationships policy needs updating, as does areas of the Statement and Purpose and Service User Guide to include current legislation. The registered provider agreed to do this. Overall the record keeping examined by the Inspector was found to be up to date and in good order. Staff regularly explain to residents about inspections and know the most current inspection report is held in the lounge. Good systems are in place to ensure safe working practices in the home. Risk assessments relating to safe working practices are in place and these are regularly reviewed and updated. Satya Nivas Residential Home DS0000006443.V348298.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 4 2 x 3 3 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 4 ENVIRONMENT Standard No Score 24 3 25 x 26 x 27 3 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 3 13 3 14 4 15 3 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x 3 3 3 3 x Satya Nivas Residential Home DS0000006443.V348298.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. 1. Refer to Standard YA6 Good Practice Recommendations The Inspector recommended the six monthly care plan review format is developed to include any changes and how staff should be working with residents to meet these as currently there was not sufficient detail available. To introduce person centred planning this is a process of life planning for individuals, based around the principles of inclusion and the social model of disability. The first floor bathroom needs some attention as the seal around the bath is discoloured and looks unsightly. This would ensure the bathroom area is kept well maintained and comfortable for residents use. Ensure the homes policies and procedures are up to date Including the Sexuality and Relationships Policy, Service User Guide, and Statement of Purpose. Keeping policies and procedures up to date would ensure resident’s best interests are protected. DS0000006443.V348298.R01.S.doc Version 5.2 Page 24 2. 3 YA6 YA27 4 YA40 Satya Nivas Residential Home Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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. 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