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Inspection on 17/05/05 for Clara Nehab House

Also see our care home review for Clara Nehab House for more information

This inspection was carried out on 17th May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

People living at the home spoken to felt that the home provided a supportive environment that responded to their needs. Those who live at the home said they were consulted about how they wanted things done in the home. The food was seen. Staff were seen to be supportive and understood the needs of those living at the home. Those living at the home said that a range of varied activities were offered. Those living in the home felt that the food was of a good quality and that they could choose from a range of alternatives.

What has improved since the last inspection?

At the last inspection there were three areas in which the home needed to make improvement. All of these were addressed. The moving and handling needs of those living at the home had been assessed. There were also assessments to determine if persons living at the home could take their medicines without the support of staff. A visit to the home by a senior manager to check the care being provided had been carried out.

What the care home could do better:

At this inspection there were five areas where the home needs to make improvement. The home needs to ensure that the needs of those living at the home are checked monthly. Staff need to have training on adult protection. The home must confirm that an extra member of staff will be available to meet the needs of those living at the home. 50% of those caring for the people at the home must achieve a National Vocational Qualification. All staff must receive supervision at least six times a year Staff should be given a recorded of these supervision sessions.

CARE HOMES FOR OLDER PEOPLE CLARA NEHAB HOUSE 13-19 Leeside Crescent Golders Green London NW11 0DA Lead Inspector Tony Brennan Announced 17 May 2005 @ 09.45 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. 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. CLARA NEHAB HOUSE Version 1.10 Page 3 SERVICE INFORMATION Name of service Clara Nehab House Address 13-19 Leeside Crescent, Golders Green, London NW11 0DA Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 020 8445 2286 Richard Fisher of Leo Baeck Housing Association Ltd David Lightburn PC Care Home only 25 Category(ies) of OP registration, with number of places CLARA NEHAB HOUSE Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 31 January 2005 Brief Description of the Service: Clara Nehab House is registered to provide care for twenty-five older people. The home is opperated by the Leo Baeck Housing Association. The accommodation is provided on three floors in twenty-five single ensuite bedrooms. The lounge/dinning room and an additional lounge is on the ground floor. The home is located in a residential area with shops and access to public transport close by. The original aim of the home was to provide care for people who had suffered Nazi oppression. Service users admitted to the home more recently may not have had that direct experience but choose to live there because the background ethos is relevant to their personal experience as the home maintains practices that meet the needs of service users from a Jewish background. CLARA NEHAB HOUSE Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection was undertaken as part of the annual inspection process. The inspector also sought to confirm that the three areas for improvement found at the last inspection were addressed. The inspection took place over one day. The registered manager, David Lightburn, assisted the inspector. The inspector spoke with twelve service users and five staff. The inspector received comment cards from relatives, service users and professionals which where positive about the service provided by the home. The inspector toured the building and examined a range of records relating to the care and management of the home. What the service does well: 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. CLARA NEHAB HOUSE Version 1.10 Page 6 The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. CLARA NEHAB HOUSE Version 1.10 Page 7 DETAILS OF INSPECTOR 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) Scoring of Standards Statutory Requirements Identified During the Inspection CLARA NEHAB HOUSE Version 1.10 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1 3 4 Services users and prospective service users are provided with comprehensive information about the service. Service users needs are assessed prior to admission to the home. The home meets the assessed needs of service users. EVIDENCE: The inspector spoke with service users who said that they understood what service the home provided. The statement of purpose and service users guide were both clearly written and contained all the relevant information. A service user who had recently come to the home commented that the home had assessed her needs before her admission. Service users files were examined and found to contain initial assessments from the home and social work assessments. These outlined the needs of service users. Service users commented that the staff worked hard to meet their needs and were ‘helpful and friendly’. The inspector found that service users needs were assessed and planned for. Staff spoken to understood the needs of service users and had relevant training. CLARA NEHAB HOUSE Version 1.10 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7 8 9 Care plans provided detailed information on how the needs of service users would be met, but had not been reviewed monthly. The medical needs of service users are being met. Service users are protected by safe procedures for handling medication. EVIDENCE: A service user commented that staff understood their needs. The care plans gave details of how service users needs should be met. There were risk assessments in place including ones for manual handling. The inspector found that care plans had not been reviewed monthly and so had not been updated to include changes in the care needs of service users. A service user spoken to said that staff understood their personal care needs. Another service user informed the inspector that her wishes as to how she is supported had been respected by staff. Service users commented that the medical attention provided by the home’s visiting GP was excellent. The records of medical treatment were detailed and showed that the appropriate medical attention had been provided. One service user who was going to the dentist said that staff had helped her to arrange the appointment. Since the last inspection, a risk assessment for self-medication had been put in place. The inspector found that a number of service users had been assessed CLARA NEHAB HOUSE Version 1.10 Page 10 using this. Service users and their GP had signed to say they agreed with the service users self medicating. The policy was complete and medication profiles were in place. The records of medicines received, administered and returned to the home were complete. Staff had received training and a list giving the names of those staff who had received training was seen. CLARA NEHAB HOUSE Version 1.10 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12 15 Service users are provided with sufficient and varied activities. Service users are provided with a choice of varied and balanced meals. EVIDENCE: Service users spoken to said that a range of varied activities were on offer and that they could choose what they would take part in. The inspector saw the activities programme which offered a range of activities, which service users confirmed were provided. Service users also said that they could practice their religion. A service user spoken to said that she had regular contact with the Rabbi. Service users spoken to said that a choice of meals was offered and that generally the food was of a good quality. On the day of inspection fish, meat and vegetarian meals were available. The menu, which is discussed and amended at monthly service users meetings, was found to offer a balanced diet. The dietary needs and preferences of service users were recorded. The inspector sat with service users at lunchtime and observed that meals were provided for each individual. Service users needing support with eating were assisted in a sensitive manner. Meals seen were presented in a pleasing manner. CLARA NEHAB HOUSE Version 1.10 Page 12 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 18 Service users are confident that their complaints will be listened to, taken seriously and acted upon. Staff do not have the necessary knowledge to ensure that service users are protected from abuse. EVIDENCE: Service users said that they felt confident in making their concerns known to staff. The complaints policy explained how to make a complaint and how it would be dealt with. The complaints record showed actions taken to resolve complaints. Service users said that they felt safe and could approach staff if they had any concerns regarding how they are treated. There were comprehensive policies on handling abuse and protection. Staff spoken to were clear about the signs of abuse and how suspected abuse should be handled. The registered manager agreed to arrange training on adult protection. CLARA NEHAB HOUSE Version 1.10 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24 26 Service users bedrooms are comfortable and they have their personal possessions. Service users live in a clean and hygienic home. EVIDENCE: Service users bedrooms are appropriately decorated, furnished and carpeted. The bedrooms seen were personalised. Service users commented that they had chosen the items they wanted in their bedrooms. The inspector found that the home was clean and hygienic. Staff spoken to understood how to prevent cross infection and equipment was provided for this purpose. CLARA NEHAB HOUSE Version 1.10 Page 14 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 28 29 30 Sufficient staff are not available at all times to meet service users needs. Staff don’t have all the skills and knowledge necessary to meet the needs of service users. Service users are protected by the home’s recruitment practices. EVIDENCE: The rota was seen and showed that a consistent staffing level was being maintained. There are three staff and a deputy manager on duty throughout the day. Service users spoken to said that they felt there were not enough staff as they were rushed and did not always have enough time to spend with them. A service user commented that when ‘going to the toilet sometimes you had to wait as staff were busy’. The service users records showed that service users were becoming frailer. These issues were discussed with the registered manager who said he had already reviewed the staffing and discussed the issue with his manager. They have agreed that an extra member of staff should be available. The registered manager agreed to do this as soon as possible. The commission must be informed that this has been done. Training records showed that five staff have achieved NVQ level 2 in care and that another four were about to commence the qualification. The home needs to get 50 of staff qualified to NVQ level 2 in care. The inspector spoke with staff and found that they understood and knew how to meet the needs of service users. Training records showed that the necessary statutory training had been provided. Staff files were checked. These were found to contain all the required information. CLARA NEHAB HOUSE Version 1.10 Page 15 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32 36 37 38 Service users live in a well managed service that ensures their needs are met. Staff are not appropriately supervised. Records are maintained as is required. Service users and staff health and safety is promoted. EVIDENCE: Service users commented that the registered manager was approachable and responded to their views. The inspector saw that the registered manger was involved with the staff and service users. There were minutes of staff and service user meetings. Staff spoken to told the inspector that supervision took place every six weeks. The records of supervision showed that all staff had not been receiving supervision regularly. The registered manager agreed to ensure that staff have supervision at least six times a year. The registered manager explained that notes of supervision were kept in his personal notebook. Staff were not given their own copy. The inspector recommended that staff have a copy of their supervision notes. CLARA NEHAB HOUSE Version 1.10 Page 16 All records seen were up to date and accurate. Regulation 26 visits have been carried out on a monthly basis since the last inspection and reports sent to the Commission. The inspector found that staff had training on health and safety topics. The hoists had been checked and all first aid boxes had all the necessary items. Fire procedures and a risk assessment were in place. The inspector examined the home’s records and found that the alarm system had been inspected and checked regularly. Fire drills had occurred regularly and were recorded. The training records showed that staff had received training on fire prevention. The necessary records of food temperatures and of the fridge and freezers had been maintained. Gas and electrical certificates were seen and in date. Testing had taken place for Legionella. The home had all the necessary policies and procedures in place to ensure the safety of service users and staff. CLARA NEHAB HOUSE Version 1.10 Page 17 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. Where there is no score against a standard it has not been looked at during this inspection. 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 3 x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 x 15 3 COMPLAINTS AND PROTECTION x x x x x 3 x 3 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 2 x 3 x x x 2 3 3 CLARA NEHAB HOUSE Version 1.10 Page 18 no Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. 3. Standard 7 18 27 Regulation 15(1) 13(6) 18(1) Requirement The registered persons must ensure that care plans are reviewed monthly. The registered persons must ensure that staff have training on adult protection. The registered persons must ensure and confirm to the Commission that an extra member of staff is on the rota. Th registered persons must ensure that 50 of staff achieve NVQ at level 2 in care. The registered persons must ensure that all staff have supervision at least six times a year and that staff have a copy of their supervision notes. Timescale for action 1/8/05 1/10/05 1/8/05 4. 5. 28 36 18(1) 18(2) 1/12/05 1/9/05 6. 7. 8. 9. 10. CLARA NEHAB HOUSE Version 1.10 Page 19 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 Good Practice Recommendations CLARA NEHAB HOUSE Version 1.10 Page 20 Commission for Social Care Inspection Solar House 1st Floor, 282 Chase Road Southgate London N14 6HA National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI CLARA NEHAB HOUSE Version 1.10 Page 21 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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