Inspection on 26/01/06 for Jack Gardner House

This inspection was carried out on 26th January 2006.

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 found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Jack Gardner House 07/02/07

Jack Gardner House 26/09/05

Jack Gardner House 20/01/05

Jack Gardner House 26/10/04

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

CARE HOME ADULTS 18-65 Jack Gardner House 184-186 Golders Green Road Golders Green London NW11 9AG Lead Inspector Margaret Flaws Unannounced Inspection 26th January 2006 11:00 Jack Gardner House DS0000033524.V269829.R01.S.doc Version 5.0 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 Jack Gardner House DS0000033524.V269829.R01.S.doc Version 5.0 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. Jack Gardner House DS0000033524.V269829.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Jack Gardner House Address 184-186 Golders Green Road Golders Green London NW11 9AG 020 8731 0300 020 8731 0301 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) Jewish Care Norma Elaine Christie Care Home 15 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (15) of places Jack Gardner House DS0000033524.V269829.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 26th September 2005 Brief Description of the Service: Jack Gardener House is owned and operated as a residential home by Jewish Care, a voluntary organisation that provides health and social care for the Jewish community. The home is relatively newly purpose built and registered to provide a service to fifteen people with mental health problems. The home is not registered to provide nursing. This is a very nice, well-planned building. It is situated along the Golders Green Road and provides easy access to the shops and cafes and all of the social, cultural and religious and community health provision that is in that area. There are fifteen single rooms and all have full bathroom facilities en-suite. The statement of purpose states that the home has a strong Jewish tradition and culture that offers accommodation to young Jewish people aged between 20-50 years of age who are recovering from serious and enduring mental ill health and require a supportive and therapeutic environment. The stated objective is to deliver to residents a quality service where the resident is involved in the decision making and running of the home so as to achieve his/her full potential in the home and in the wider community. Jack Gardner House DS0000033524.V269829.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over one day. It was undertaken by Inspector Margaret Flaws, as part of the routine schedule of inspections for the home. The home manager, the administrator and three staff of Jack Gardner were spoken to on the day of the inspection. The inspector also spoke to two service users and one relative. A tour of the buildings and grounds, inspection of service user files, staff records, general home records and policies and procedures formed the basis of the inspection. One new requirement was made on this inspection and none restated from the last inspection. 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. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Jack Gardner House DS0000033524.V269829.R01.S.doc Version 5.0 Page 6 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 Jack Gardner House DS0000033524.V269829.R01.S.doc Version 5.0 Page 7 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 Service users can be confident that their needs will be fully assessed before admission and that they will receive a good overview of what the home does from the statement of purpose and other information provided prior to admission. EVIDENCE: The home’s statement of purpose clearly and explicitly sets all the initial information that a prospective service user would need to make a decision about whether the home is suitable for them. A full assessment is completed by the home and by the Jewish Care assessor. The inspector spoke to the most recently admitted service user, in the company of the manager. The service user said that her needs were well assessed prior to admission and described the process, which was very thorough. Jack Gardner House DS0000033524.V269829.R01.S.doc Version 5.0 Page 8 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8 and 9 Service users’ assessed needs and the management of potential risks are carried forward into comprehensive care plans that are regularly updated and put into practice by an informed and committed staff team. Service users are well involved in decisions that affect their lives. EVIDENCE: Care plans for two service users were examined in detail. One, for a newly admitted service user, was in draft format but all key areas were covered, all risks assessed and information clearly available to staff to help acquaint them with the service user. The other care plan, for a long term service user, contained all necessary elements and was reviewed regularly. Risk assessments were on file for all service users and were regularly updated. Several days prior to the inspection, there was an incident in which a service user became violent and had to be restrained and removed to a place of safety. The Manager, who was present, provided a Regulation 37 report to the CSCI. The incident was discussed with the manager and staff and reports examined. Service users and staff had been fully debriefed after the incident and the service user involved was appropriately supported. All staff later participated in a session, ‘Reflecting on Aggression’, which they said was very Jack Gardner House DS0000033524.V269829.R01.S.doc Version 5.0 Page 9 useful. The service user’s needs are being comprehensively reviewed by the mental health services. Another service user is currently in hospital for review (for non-compliance with medication). Staff said they particularly enjoyed the rehabilitative aspects of the job. The inspector spoke to one service user, who has recently moved out of the home into supported living, and to his partner. They both said how supportive the home had been in helping them plan their forthcoming wedding and making the transition to independent living. This ex-service user is in the process of becoming a volunteer in the service and visits Jack Gardner House regularly for ongoing support. Staff said that a strength of the keyworking system is that service users always know to whom they can go, that the lines of communication are very open and that they know how to “do the right thing, at the right time”. Service users confirmed this observation and emphasised the kindness and professionalism of staff and how much they valued this way of working. Some service users are currently receiving coaching from the local Primary Care Trust as part of their ‘Expert Patients Programme’. Jack Gardner House DS0000033524.V269829.R01.S.doc Version 5.0 Page 10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13, 15, 16 and 17 Service users are able to live full and active lives with the support of the home. They also have healthy meals provided daily. EVIDENCE: Activities in the home continue to be innovative and varied. Classes and discussion groups are driven by the service users’ interests and by the home’s commitment to promoting rehabilitation and independence. Classes and activities include for example, art therapy, discussion groups on philosophy and alternative music, computer skills, exercise, theatre, film and restaurant outings, cookery classes and creative writing. A film project is still underway with service users and the home has been able to secure the assistance of a BAFTA award winning director. Service users also attend college and day centres. Several residents from the supported living homes visited at the time of the inspection, evidence of the strong relationships between these homes and Jack Gardner House. Volunteers from these supported living homes assist with activities at Jack Gardner. Jack Gardner House DS0000033524.V269829.R01.S.doc Version 5.0 Page 11 Some service users have strong family relationships, go home often and have regular interaction with the local Jewish community, and staff support them with these relationships. Many attend local day centres and other projects. There is a small kitchen on the top floor, which is used by service users for snacks and microwaving (the microwave was being repaired at the time of the inspection). The kitchen was in good state of repair and cleanliness. The Assistant Chef showed the inspector menus with evidence of rotation, variety and culturally appropriate Kosher food. The Head Chef has recently moved on and a new Chef, who has worked at the home before, was due to start. The manager said that a nutritionist is currently looking at the menus to see how they could be improved. Jack Gardner House DS0000033524.V269829.R01.S.doc Version 5.0 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20 Personal care, where provided, is delivered in a respectful manner to service users. Their physical, emotional and mental health needs are met through the professional support provided. Medication policies and procedures protect the service users. EVIDENCE: Only a small number of service users require assistance with personal care but many require prompting and support with their daily routines. Community mental health care coordinators regularly attend staff meetings and meet with service users. As described in Standard 6, the home provided a good standard of crisis management care to a service user who recently became unwell. Medication documentation has been reviewed by the home. The Manager said that the home has decided to use one medication form to cover the movement of medications in and out of the home. She also said that she is working with community mental health teams to get all service users’ blood tests to occur in the same week. Jack Gardner House DS0000033524.V269829.R01.S.doc Version 5.0 Page 13 Jack Gardner House DS0000033524.V269829.R01.S.doc Version 5.0 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Service users are protected by the home’s complaints and adult protection policies and procedures. EVIDENCE: The complaints policy is sound. There have been no formal complaints since the last inspection. There is a clear written policy in place to protect service users from abuse and neglect. No adult protection issues have arisen since the last inspection. Jack Gardner House DS0000033524.V269829.R01.S.doc Version 5.0 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 28 and 30 The physical environment is comfortable, safe and well maintained for the service users to enjoy. The service users’ bedrooms are particularly well furnished and appointed. EVIDENCE: The inspector toured the building with the Manager. The physical environment is well maintained and comfortable. The bedrooms are well laid out and furnished with good quality, modern furniture. The communal spaces (lounge, dining and private lounge/meeting room) are welcoming and service users spend considerable time there. A recommendation was made at the last inspection that the office and staff spaces be improved. The Manager said that work will be done in May 2006 to refit and improve all of these facilities, including the staff shower and toilet area, which is looking quite worn. The home now uses the services of a local handyman and there is a rolling redecoration programme in place. Cleaning is done six days a week and a good standard of hygiene is maintained and was evident on the day of the inspection. Jack Gardner House DS0000033524.V269829.R01.S.doc Version 5.0 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 34, 35 and 36 Service users’ wellbeing is protected by a stable, well supported and knowledgeable staff team, and by the home’s sound recruitment practices. EVIDENCE: New staff recruited must have a minimum of two years experience in mental health work. They have a thorough induction, a example of which was described by a new staff member. The staff files of two recently employed staff were inspected. Both were employed through an agency. Their files were in order and pre-employment checks done. Agency staff said that staff were respectful of them and that they weren’t treated as “just someone from an agency but as a member of the team”. All training provided to staff meets statutory requirements. A rolling training programme built around the specific mental health needs of the service users is in place. Over and above statutory foundation training and core Jewish Care training, staff have additional training in, for example, team building, health and safety, working with challenging behaviour, using restraint, domestic violence and law in mental health. In relation to the incident described in Section 6, it is required that training on dealing with challenging behaviour, aggression and restraint be reviewed to ensure that all staff feel confident in dealing with such incidents. Additional training has also been provided for staff with English as a second language. Over 50 of staff have NVQ qualifications or are working towards them. Jack Gardner House DS0000033524.V269829.R01.S.doc Version 5.0 Page 17 The home clearly recognises the value of good supervision. Staff said that supervision is provided very regularly, at least every three weeks. On the previous inspection, staff showed the inspector their supervision records, which covered a range of professional topics. This standard has been very well maintained. An external facilitator also assists the staff in dealing with other specific support needs in regular meetings. Jack Gardner House DS0000033524.V269829.R01.S.doc Version 5.0 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37 , 38, 41, 42 Service users benefit from a well run and safe home. EVIDENCE: Staff were very positive about the management of the home and said that the manager was very good and “valued them as human beings”. It was evident from discussions with staff and service users, and from observation, that the Manager, who has worked at the home for many years, has created a highly professional and supportive environment. Several staff said that the home is the best of its kind that they have worked in. The Administrator and the Manager described the policies and procedures for handling service users’ looked after money. The home takes responsibility for the money of several service users, who have asked for help with budgeting. Two staff must always sign, along with the service user, for any money taken in or out. Detailed financial transaction records are kept and reconciled weekly. The key principles underlying the system, according to the Administrator, are flexibility and autonomy. Locked drawers in service users’ rooms are provided for those who wish to keep their money there. Jack Gardner House DS0000033524.V269829.R01.S.doc Version 5.0 Page 19 Health and safety standards in the kitchen were good. Fridge, freezer and hot food temperatures are monitored and recorded daily and were within range. Kitchen machinery was safe and well maintained. All building and health and safety certificates are still up to date from the last inspection. Environmental risk assessments are done for each area of the house and updated as required. Most staff have obtained a four day Certificate in First Aid. The most recent fire risk assessment was done on July 2005. Staff and service users spoken to were aware of fire safety procedures but the Manager said that at a recent fire drill, some service users did not respond. She said that this will be discussed at the next service user meeting. Jack Gardner House DS0000033524.V269829.R01.S.doc Version 5.0 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 X X x Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 X 3 X 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score 3 3 X 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Jack Gardner House Score 3 3 3 X Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 3 3 X DS0000033524.V269829.R01.S.doc Version 5.0 Page 21 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. Standard YA35 Regulation 18(1) Requirement The Registered Person must ensure that training on working with challenging behaviour, aggression and using restraint is reviewed to ensure that all staff feel confident in dealing with these issues in the home. Timescale for action 31/03/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Jack Gardner House DS0000033524.V269829.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Southgate Area Office 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 Jack Gardner House DS0000033524.V269829.R01.S.doc Version 5.0 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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