Care Home: The Saffrons

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What the care home does well The Saffrons offers residents a comfortable and homely place to live, with a separate lounge and dining room, and an attractive garden to the rear. The atmosphere in the home was relaxed and feedback from everyone involved in the inspection was very positive. Residents said the staff are `very good` and `friendly` and `the food is good`, visitors were also complementary with one saying `its like a big family`. The staff said they are well supported by the management and feel they can offer people who live in the home the care they want. What has improved since the last inspection? The owners responded positively to the requirements made following the last inspection and a number of changes have been introduced to improve the support offered at The Saffrons. The care planning system has been reviewed, this has enabled the home to ensure it can meet the needs of the people living there; and a range of activities have been introduced, which has had a positive affect on the residents day to day lives. What the care home could do better: There have neen no requirements as a result of this inspection, however there are areas for improvement, these have been included in the body of the report and the owners said they will adress these as soon as possible. Inspecting for better lives Key inspection report Care homes for older people Name: Address: The Saffrons 20 Saffrons Road Eastbourne East Sussex BN21 1DU     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: Kathy Flynn     Date: 2 4 0 6 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 26 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 26 Information about the care home Name of care home: Address: The Saffrons 20 Saffrons Road Eastbourne East Sussex BN21 1DU 01323720430 01323736654 dagmarwilliams@btinternet.com 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) : Mr Richard Williams,Mrs Dagmar Williams care home 24 Number of places (if applicable): Under 65 Over 65 24 old age, not falling within any other category Additional conditions: 0 The maximum number of service users who can be accommodated is: 24 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 needs on 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 Saffrons is registered to provide residential care for twenty four older people. It is a three-storey building, situated in an attractive, quiet residential area of Eastbourne, with the front of the building overlooking Saffrons Park. The home is within walking distance of Eastbourne town centre, the local amenities and the railway station. There are 16 single rooms and 4 double rooms. Seventeen of the rooms have en suite facilities. Communal areas include a large service users lounge and a dining room and quiet area in the new extension at the rear of the home. There is a well-maintained enclosed garden to the rear, which is accessible to all service users. Care Homes for Older People Page 4 of 26 Brief description of the care home A lift enables access to all floors, although two rooms have a short flight of steps leading to them. The home has two assisted bathrooms and an assisted shower. Care Homes for Older People Page 5 of 26 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 quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. The reader should aware that the Care Standards Act 2000 and the Care Homes Regulations 2001 use the term service user to describe those living in care home settings. However for the purposes of this report those living at The Saffrons will be referred to as residents. This unannounced inspection was carried out on the 24th June 2009 and took place over five hours. Care Homes for Older People Page 6 of 26 The inspection included looking at some rooms while talking to residents, a review of pre-admission assessments, care plans, staff records and training, medication records, activities, and menus. There were 15 residents at the home during the inspection, all of the residents were involved in the inspection and three visitors to the home were happy to discuss the support provided. The manager, care staff and cooks were happy to discuss the care and support they provide at the home. The Annual Quality Assurance Assessment (AQAA) was completed and returned on time, it identified areas where improvements have been made, and where others are planned for the benefit of residents. 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 26 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 26 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. The home provides information about the services it offers, and assessments are completed to ensure that they can meet the needs of people before they are offered a place. Evidence: The statement of purpose and service users guide reflects the support provided at The Saffrons, and this enables people to decide if the home can offer the services they want. Assessments are completed, with the involvement of people who wish to move into the home, before they are offered a place. This is to ensure that the home can meet their individual needs, and is confirmed in writing to the prospective resident or their representative. Care Homes for Older People Page 10 of 26 Care Homes for Older People Page 11 of 26 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. The care planning system provides staff with the information they need to offer appropriate support to people living in the home. Medication training is provided for staff to protect residents. Evidence: A considerable amount of work has been done to review the previous care plans and develop an appropriate care planning system at The Saffrons. The six care plans viewed contained information relevant to the needs of residents. They included a pre-admission assessment, social and medical history, residents life and social profile, appropriate risk assessments including falls. Staff spoken with said the care plans provided them with a lot of information about each resident and there was evidence that the care plans have been reviewed. The staff record daily the support and care the people living in the home recieve. On viewing these it was observed that some staff were writing short statements such Care Homes for Older People Page 12 of 26 Evidence: slept well or good day. Daily records are a good source of evidence to show that care is being provided, as detailed in the care plan, however these terms are not helpful or adequate. Daily records, when well written, help ensure a consistent approach and good quality of care for residents. It is in the homes interests to be able to show what they have done, along with providing the evidence on which to base the monthly review, and to record that they are following the assessment of needs. The manager of the home said they would be providing additional training and support to help staff complete the daily records. Feedback from visitors regarding the care provided by staff was very positive, staff are very good and very caring and the residents get all the care they need and more. Nutritional assessments are completed for all residents and they are weighed monhtly, one person who has lost weight had been referred to the dietician and the records showed that a resident is encouraged to drink reguarly. The staff spoken with said they were aware that another resident had lost weight and this was recorded in the care plan, however the manager had not been informed and she said she would be taking action to ensure that all changes in weights are reported to her immediately Policies and procedures are in place with regard to medication. Staff responsible for ordering, storing and administering medicines receive relevant training, and those spoken with said they had attended. The Medicine Administration Record MAR charts viewed were completed appropriately and the case used to transfer medicines around the home now has a lock to protect residents. Residents are registered with GPs and can access allied health professionals as required, including District Nurses and Dieticians, with visits recorded in the care plans. Staff were noted to treat residents with respect and offer support and care appropriately. Care Homes for Older People Page 13 of 26 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. A range of activities are offered at the home for residents to participate in if they wish. The meals are good and choices are offered, with staff supporting residents as required. Evidence: A range of activities are offered at The Saffrons, these include daily games and activities in the lounge, trips out to local areas of interest, and a tea party had been organised for the day after the inspection. Invitations to the tea party were sent out to local neighbours and a number of friends and relatives were expected to attend. Some of the residents were very involved, making cards and painting flower pots to sell, some relatives had made cakes, and one resident had been asked to work on the cake stall. The owner was putting flags up in the garden and clearly they were all looking forward to the party. Friends and relatives can visit at any time, and a number do so every day. Feedback from them was very positive and it was clear that the relationship between the residents, visitors and staff was relaxed, friendly and on first name terms. Care Homes for Older People Page 14 of 26 Evidence: People living at the home are encouraged to make choices about all aspects of their day to day lives, and the staff were noted to support them to do this. Those involved in the inspection said that the staff provide the support they need so that they can spend their days as they wish. Some pets are allowed to remain with people when they move in and support is provided from staff if required. The manager confirmed that this is agreed during the assessment process, and is based on a prospective residents individual needs and abilities. The meals at the home are good, residents are offered choices and they can change their minds if they want to. All those spoken with said the food is very good, and if there was any complaint it was that they could not resist the meals, especially the puddings, and I will have to watch out that I dont put on weight. Care Homes for Older People Page 15 of 26 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. Appropriate complaints procedures are in place, and training in protecting vulnerable people is provided for staff. Evidence: There have been no complaints about the services offered at The Saffrons, to the home or the Commission since the last inspection. Policies and procedures are in place and information for people who live in the home and their relatives about how to make a complaint is included in the Statement of Purpose, and the notice board in the hall. The owners and staff said that residents and visitors are encouraged to discuss any concerns they have and these are usually dealt with at that time. Feedback from people during the inspection was that they could talk to the staff and managers at any time if they were concerned, although they also said they had nothing to complain about, and they felt that if they wanted something changed or they had any suggestions then they were listened to and action was taken. Training is provided for staff to ensure they can offer approriate support and protection for people who are vulnerable. Staff spoken with said they had attended the training and were able to demonstrate that they understood what action to take if they had any concerns. The importance of enabling people in the home to make choices and in particular changing their minds if they wanted to. Care Homes for Older People Page 16 of 26 Care Homes for Older People Page 17 of 26 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. The Saffrons offers residents a comfortable and homely environment. The homes policies for infection control and the training provided for staff protect residents. Evidence: The home is a large building situated in a residential area of Eastbourne, close to the town centre. It has been extended and converted, keeping some of its original features with a large lounge on the ground floor to the front of the building and a dining room, with additional seating in the extension to the rear. There is an attractive garden which residents use when weather permits, which was being decorated in preparation for the tea party the day after the inspection. A shaft lift enables residents to safely access all parts of the home, and residents are supported to use walking aids to enable them to be independent. Wheelchairs are available for staff to use to assist residents if required. The owners confirmed that the concerns raised in the last inspection report have been addressed with commodes replaced as required and rooms have been redecorated and carpets replaced. An ongoing maintenance programme is in place and they will continue to refurbish parts of the home and provide additional aids for the protection of residents. Infection control policies are in place and training in the control of infection has been Care Homes for Older People Page 18 of 26 Evidence: provided for staff. Those spoken with said they had attended, they understand the homes policies, and are aware of the safe use of gloves and aprons to protect residents. Care Homes for Older People Page 19 of 26 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. Robust recruitment procedures are used to protect people living in the home, and relevant training is provided for staff so that they are aware of their roles and responsibilities. Evidence: The people living in The Saffrons said that there were enough staff working in the home at the time of the inspection to look after them and offer the support they need. The manager and staff supported this, and although staff continue to carry out domestic tasks in addition to personal care, they did have time to spend with residents during the activities and after lunch. However the staffing levels and staff responsibilties may have to be reviewed if the number of residents increases, there were 15 at the time of the inspection. Four staff files were examined and contained relevant information, including applications forms, two references and Protection of Vulnerable Adults (POVA) and Criminal Records Bureau (CRB) checks, to protect people living in the home. All new staff are required to complete induction training in line with Skills for Care, and they are then encouraged to work towards National Vocational Qualificatons (NVQs). Care Homes for Older People Page 20 of 26 Evidence: The home has more the the required 50 percent of staff with NVQ Level 2 or above. Care Homes for Older People Page 21 of 26 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. The management approach at The Saffrons is open and inclusive, encouraging residents, relatives and staff to be actively involved in decisions about the services provided at the home. Evidence: The manager/owner of The Saffrons is a registered nurse with a NVQ level 4 in management, the Registered Managers Award, an advanced Certificate in Care and considerable experience in providing support for older people. The management style at The Saffrons encourages residents, relatives and friends and staff to be involved in decisions about the support and services offered at the home. Feedback from everyone involved in the inspection was very positive, residents felt the staff are very good, they look after us very well and are very friendly. Relatives were equally complementary with one saying its like a big family. The staff said they Care Homes for Older People Page 22 of 26 Evidence: feel well supported by the management and are able to offer the residents the support they need and want. The owners monitor the care provided by talking to residents and visitors daily with surveys given out yearly, and they also contact the health professionals who visit the home. The manager confirmed that anyone can make suggestions and if any changes are assessed as safe they introduce them. Supervision is provided for staff on a regular basis and staff spoken with said this is arranged individually and in groups, although they feel able to discuss anything with the management at any time. The manager said that the home does not take responsibility for residents finances. The manager confirmed that the health and safety of residents, visitors and staff are protected through appropriate maintenance at the home, and relevant training for staff, including moving and handling, fire training, first aid, infection control and food hygiene. Care Homes for Older People Page 23 of 26 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 24 of 26 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 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 25 of 26 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. Copyright © (2009) Commission for Social Care Inspection (CSCI). 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