Inspection on 26/09/05 for Jack Gardner House

This inspection was carried out on 26th September 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.

Other inspections for this house

Jack Gardner House 07/02/07

Jack Gardner House 26/01/06

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 September 2005 09:00 Jack Gardner House DS0000033524.V249477.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.V249477.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.V249477.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.V249477.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th January 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.V249477.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 and lasted approximately six hours. It was undertaken by Inspector Margaret Flaws, as part of the routine schedule of inspections for the home. The home manager and 10 staff of Jack Gardner were spoken to on the day of the inspection. The inspector was also able to speak to three service users. No relatives visited during the inspection. The inspector was also able to sit in on handover. Comment cards were received from all fifteen service users, seven relatives, four health/social care professionals and two care managers/placement officers. 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. No new requirements were made on this inspection and none were restated from the last inspection. One new recommendation is made. 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.V249477.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.V249477.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 and 2 Service users can be confident that their needs will be fully assessed before admission and receive a good overview of what the home does in their statement of purpose. 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. The inspector spoke to the most recently admitted service user who said that his needs were well assessed prior to admission. A full assessment is completed by the home and by the Jewish Care assessor. The London Borough of Barnet has reviewed all but two service users but their reviews are booked for the near future. Jack Gardner House DS0000033524.V249477.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 and 9 Service users’ assessed needs and any potentials for risk 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 usually well involved in decisions that affect their lives. EVIDENCE: Care plans for two service users were examined in detail and were very comprehensive. There is a sound documented rehabilitative process in place for a service user who is due move on to supported living. The files also contained excellent weekend contingency plans for each service user, which enable a risk managed, step by step process for potentially difficult situations that might occur. All of the relatives who returned survey forms said that the quality of care at the home was very good: one typical comment was that “we need more of these ‘flagships’ for the mentally ill - an extremely well run rehabilitation home”. Staff said they particularly enjoyed the rehabilitative aspects of the job. The inspector sat in on the afternoon handover. Staff spoke professionally and knowledgeably of service users’ needs, of their keyworking roles, and their liaison with other health professionals. Jack Gardner House DS0000033524.V249477.R01.S.doc Version 5.0 Page 9 Most service users surveyed said they liked living at the home and felt well cared for. The staff work hard to support the independence of service users and this is well documented in care plans. Some service users said that they were would like to be more involved in decision making at times. The home is moving on a project basis towards using independent advocacy services to support service users. Risk assessments were on file for all service users and were regularly updated. Jack Gardner House DS0000033524.V249477.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 and 17 Service users are able to live full and active lives in full with the support of the home. They also have healthy meals provided. EVIDENCE: A very well attended cookery class was in progress during the inspection. The home offers regular classes as a way of supporting the service users’ moves towards greater independence, either when they move on to supported living or supporting them to assist in the kitchen. Later in the afternoon a film script workshop took place run by a volunteer writer. This is part of the early development phase of producing a film, a project taken on after the successful publication of a book two years ago. Several service users attended an art therapy session, which staff said had been very beneficial to them. Several residents from supported living group homes were visiting at the time of the inspection, evidence of the strong relationship between these homes and Jack Gardner House. Some service users have strong family relationships, go home often and also have regular interaction with the local Jewish community, and staff support them with these relationships. Many attend local day centres and other projects. Jack Gardner House DS0000033524.V249477.R01.S.doc Version 5.0 Page 11 Kitchen staff used to be employed by a separate company, Aramark, but they now come directly under the management of the home manager. There is a small kitchen on the top floor, which is used by service users for snacks and microwaving. The assistant chef said there is a good budget to feed the service users well. Menus showed rotation, variety and culturally appropriate Kosher food. Jack Gardner House DS0000033524.V249477.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 and medication policies and procedures protect them. EVIDENCE: Only a small number of service users require assistance with personal care but many do require some prompting and support. Care coordinators regularly attend staff meetings and meet with residents. Currently the crisis team visits every two days to support the needs of one service user with challenging behaviour. Feedback from the health, social care professionals and placement officers was very positive. They all said that they had good working relationships with the home and were involved in regular liaison regarding care and support of the service users. There is a doctor’s surgery over the road from the home, which the manager said they have a good relationship with and who are helpful in emergencies. All medication storage temperatures were within the range. There is a tracking sheet for medication which records where a service user has been to balance the risks of service users taking medications on home visits. The medication systems were reviewed by the CSCI Pharmacy Inspector on a previous inspection and found to be good. A forthcoming project is the review of all Jack Gardner House DS0000033524.V249477.R01.S.doc Version 5.0 Page 13 medication documentation to check that it meets the needs of service users with mental health difficulties. The medication cabinet, controlled drug storage and controlled drug book were examined and were in order. Jack Gardner House DS0000033524.V249477.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 and 23 Service users are protected by the home’s complaints and adult protection policies and procedures. EVIDENCE: The complaints policy is sound and there was evidence that it is used effectively. There have been no complaints since the last inspection. Staff have received POVA training, as documented in the training files. There is a clear written policy in place to protect service users from abuse and neglect. No adult protection issues have arisen. Jack Gardner House DS0000033524.V249477.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, 26 and 30 The physical environment is comfortable, safe and well maintained for the service users to enjoy. EVIDENCE: The inspector toured the building with a senior staff member. The physical environment was well maintained and comfortable. The office spaces are too small for the staff and management team. At the previous inspection, it was recommended that work be done to improve this and this reiterated on this inspection. The bedroom locks on two bedroom doors have been repaired and the window in the lounge has been repaired. Cleaning is done by specific domestic staff employed by Eurest and a good standard is maintained. Jack Gardner House DS0000033524.V249477.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): 32, 35, 36 Service users’ wellbeing is protected by a stable, well supported and knowledgeable staff team, and by the home’s sound recruitment practices. EVIDENCE: There were three staff vacancies on the day of the inspection. The gaps are presently covered by Jewish Care bank staff and long term agency staff who work very regularly at Jack Gardner and know the home and service users well. The manager said that any new staff recruited must have a minimum of two years experience in mental health work. Most staff come into the home on a Wednesday, and the afternoon is used either for team meetings or training. The manager said that there is a need for additional mental health training, given the nature of the service, and that this is scheduled for later in the year on a rolling programme built around the specific mental health needs of the service users. The manager said that any new staff recruited must have a minimum of two years experience in mental health work. The home also benefits from Jewish Care’s volunteer programme. Volunteers are screened using the same preemployment checks as paid staff. Several volunteers support the service users by providing computer tuition, theatre, film and restaurant outings, cookery classes and creative writing. A new fundraising group ‘Friends of Jack Gardner House’ has been established to fundraise for service user amenities. Jack Gardner House DS0000033524.V249477.R01.S.doc Version 5.0 Page 17 All training provided to staff meets statutory requirements. Over and above foundation training, staff have had additional training in, for example, working with challenging behaviour, restraint, domestic violence and law in mental health. Over 50 of staff have NVQ qualifications and two new staff are commencing NVQ study this autumn. Several staff showed their supervision records to the inspector. Topics covered in supervision were professionally addressed and most staff said they received very regular supervision. An external facilitator also assists the staff in dealing with other specific support needs in regular meetings. Muslim staff said that the respect for cultural practices embedded in the home’s philosophy extended to supporting them during Ramadan. Jack Gardner House DS0000033524.V249477.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 and 42 Service users benefit from a well run and safe home. EVIDENCE: Staff said that the management ethos in the home was good and that this contributed to a strong stable staff team with good morale. 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. As a matter of good practice and service user involvement, four service users have completed certificated training in food hygiene. All building and health and safety certificates sighted were up to date and in order. Several accident and incident records were examined and were all in order. Action plans for matters arising from incidents and accidents were particularly detailed, as was hazard management. Environmental risk assessments are also done for each area of the house. Jack Gardner House DS0000033524.V249477.R01.S.doc Version 5.0 Page 19 The most recent fire risk assessment and fire drill were done on July 2005. Staff and service users were aware of fire safety procedures. Jack Gardner House DS0000033524.V249477.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 N/A N/A N/A Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 N/A 3 N/A Standard No 24 25 26 27 28 29 30 STAFFING Score 3 N/A 3 N/A N/A N/A 3 LIFESTYLES Standard No Score 11 N/A 12 3 13 3 14 N/A 15 3 16 N/A 17 Standard No 31 32 33 34 35 36 Score N/A 3 N/A N/A 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 N/A Standard No 37 38 39 40 41 42 43 Score 3 N/A N/A N/A N/A 3 N/A DS0000033524.V249477.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. 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 37 Good Practice Recommendations The Registered Person should ensure that the staff office facilities are expanded to provide an adequate working environment or staff and managers. Jack Gardner House DS0000033524.V249477.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.V249477.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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