Inspection on 26/01/07 for Jackson House Nursing Home

This inspection was carried out on 26th January 2007.

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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Jackson House Nursing Home 09/02/09

Jackson House Nursing Home 08/08/08

Jackson House Nursing Home 09/08/07

Jackson House Nursing Home 08/12/05

Jackson House Nursing Home 25/10/04

Jackson House Nursing Home 19/04/04

Jackson House Nursing Home 16/12/03

Similar services:

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

Whitewalls

Home Farm

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

CARE HOME ADULTS 18-65 Jackson House Nursing Home 2 Lode Hill Cottages Styal Cheshire SK9 4LH Lead Inspector Denis Coffey Unannounced Inspection 26th January 2007 09:00 DS0000018802.V289918.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address DS0000018802.V289918.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. DS0000018802.V289918.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Jackson House Nursing Home Address 2 Lode Hill Cottages Styal Cheshire SK9 4LH 01625 525443 F/P 01625 525443 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) Mr Clifford Slack Martin Treacey Care Home 4 Category(ies) of Learning disability (4) registration, with number of places DS0000018802.V289918.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. This home is registered for a maximum of four residents in the category of LD (learning disability) The registered provider must, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection Staffing must be provided to meet the dependency needs of the service users at all times and will comply with any guidance which may be issued through the Commission for Social Care Inspection 8th December 2005 3. Date of last inspection Brief Description of the Service: Jackson House provides accommodation and nursing care for up to four adults with a learning disability. Residents each have their own room and there are shared lounge and dining areas, plus kitchen and bathroom. Residents who live at Jackson House are generally physically independent, and the home does not have any aids or adaptations such as a passenger lift or mechanical hoists. The home is close to Styal National Trust village, and a small convenience store/post office and pub are within easy walking distance. The weekly fee payable at the home is between £1400 to £2700. The manager confirmed this information on 26 January 2007. DS0000018802.V289918.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced visit took place on the 26 & 30 January 2007 and lasted seven hours. This visit was just one part of the inspection. Before the visit the manager was asked to complete a questionnaire to provide up to date information about services in the home. Questionnaires from CSCI were also made available for residents, families and health and social care professionals to find out their views. Other information received since the last key inspection was also reviewed. During the visit various records and the premises were looked at. A number of residents were spoken with and they gave their views about the service What the service does well: What has improved since the last inspection? The way the care plans are written has improved. They now show the full range of residents’ needs and what has to be done to meet them. DS0000018802.V289918.R01.S.doc Version 5.2 Page 6 Medicines are stored securely, and accurate records are kept of what medicines have been given to residents so it’s possible to see that they have been given as the doctor prescribed them Staff have received training on adult protection to make sure that the residents are protected from harm. There is a new policy on managing challenging behaviour so staff can deal more effectively with any difficult behaviour from residents. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. DS0000018802.V289918.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection DS0000018802.V289918.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 4 & 5 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People considering moving into the home have their needs assessed and are able to visit the home so they know their needs can be met there. EVIDENCE: One person has moved into the home since the last inspection. There were records to show that a member of staff had visited this person before they moved in to carry out an assessment. The assessment covered daily living, a life history of the person, health, social and emotional needs. Staff from the home had visited the person six times before they moved in. The new resident had also visited the home six times, to meet the other residents and staff and to get to know the home. There was a care plan to cover the resident’s move and settling into the home. A copy of the contracts given to the residents is kept with their care records. The contract identifies the weekly fee payable, the periods of notice required by both parties to terminate residency, the bedroom to be occupied and the furniture in it. DS0000018802.V289918.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7, 8 & 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The way in which residents’ needs are met means they can make choices and maintain their independence. EVIDENCE: The care records of the person who had recently moved into the home were examined. These contained an assessment of their strengths and needs, behaviour chart, and a range of care plans that identified specific problems/needs, the outcomes to be achieved together with the actions needed to arrive at the outcomes. Daily records relating to the resident’s health and welfare were descriptive and informative. Staff spoken with said that residents are able to choose who they wish to help them with their care and that as a general rule it is the male staff who help the residents with care of a personal nature. Residents spoken with confirmed this. They also said that they are able to choose what they wear, when they go to bed and get up, and what food they have at meal times. DS0000018802.V289918.R01.S.doc Version 5.2 Page 10 Two of the residents manage their own money; the assessment of one resident shows they need help with this. The finances of the newest resident are still being sorted out with the authority that arranged his placement at the home. A record was seen of money paid in and withdrawn, and of receipts being obtained for all cash transactions. One of the residents spoken with confirmed that residents’ meetings are held regularly and that they are given a copy of the minutes from these. They also confirmed that they knew of the risk assessments carried out on them. DS0000018802.V289918.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are able to take part in activities that suit their lifestyles and maintain their interests. EVIDENCE: Two of the residents attend a local college each week. One goes to music and life skill classes and the other does leisure and life skills classes. Another resident does voluntary work with three different organisations, and attends a band practice class once a week. At the time of this visit, one of the residents had gone out for the day with a member of staff, to go to a football match followed by a meal out. All of the residents went on holiday last year, and the staff member in charge said that the residents would be asked where they wanted to go to on holiday this year. One resident attends church regularly and another goes to church when he asks to. The lock on one of the resident’s bedroom doors was broken, and this was replaced during the course of the visit. A resident who spoke with the DS0000018802.V289918.R01.S.doc Version 5.2 Page 12 inspector said that the staff respect his privacy, and that he can choose who helps him with his care. Staff were seen to be friendly and supportive with the residents and were heard to address them appropriately. An individual record is kept of all meals provided for the residents. These showed that residents have a varied and nutritious diet. One of the residents cooks some of his own meals and does his own shopping. DS0000018802.V289918.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care is carried out so that residents’ privacy and dignity is respected. EVIDENCE: The routines at the home are flexible and residents’ are able to decide how they spend their time. They can choose who they want to help them, what they want to wear, and when they get up and when they go to bed. All of the residents are registered with a general practitioner and are helped to use any other healthcare services they might need. The home has a medicines policy and procedures to make sure that residents’ get their medicines as prescribed. The medication administration record (MAR) sheets had been filled in correctly, and medicines checked for stock reconciliation were also found to be correct. A record was seen of medicines received into the home, administered, and returned when not needed. DS0000018802.V289918.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff have the knowledge and awareness required to prevent the residents from being at risk of harm. EVIDENCE: There have been no recorded complaints received at the home since the last inspection. The home has a complaints procedure, a copy of which was on display in the dining room, and one of the residents spoken with said that he knew who to complain to if he was unhappy. The home has a copy of the Department of Health’s document ‘No Secrets’ (this includes guidance on what abuse is and what to do if abuse is witnessed or suspected). One member of staff spoken with knew the different forms that abuse can take, and the possible signs that would indicate that this is occurring. This person knew how to report any alleged abuse and was clear about their role in protecting the residents. All but two of the staff have received training in the protection of vulnerable adults within the past three years, and a record was seen to show that these staff will receive this within the next three months. A policy for the management of challenging behaviour has just been implemented at the home, and places have been booked for staff to receive training in this subject. DS0000018802.V289918.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well maintained so that residents live in comfortable, clean and safe surroundings. EVIDENCE: The standard of décor has been well maintained throughout the home, and the communal areas are furnished with domestic style furniture. All of the residents have their own bedrooms that have been individually decorated and furnished. Two residents gave the inspector permission to look at their rooms. Both has been personalised and both residents said that they liked their rooms. On the day of inspection the home was clean, tidy and free from unpleasant smells. The staff at the home are responsible for preparing and cooking residents’ meals. The kitchen and the equipment used to prepare food were clean but the staff had not had training in basic food hygiene. On the second day of the visit, the staff member in charge showed the inspector a confirmed booking for staff to undertake this training within the next few weeks. DS0000018802.V289918.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 & 35 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Although staff have done training to help them develop their skills and provide safe care, recruitment procedures are not thorough enough to ensure that residents are protected. EVIDENCE: Staffing levels have increased since the last resident moved into the home. The staffing levels are now one trained nurse and two support workers during the day and one trained nurse and one support worker at night. The staffing rotas confirmed this. Three of the support workers are currently undertaking training leading to an NVQ level 3 in care, and one has completed a nursing access course. The personnel file of a new member of staff was checked. This contained most of the information required. However, the person’s employment history contained gaps that had not been explained and a Criminal Record Bureau (CRB) disclosure had not been obtained. When this was pointed out to the person in charge, the member of staff was withdrawn from work until a POVA (protection of vulnerable adults) 1st check was received. DS0000018802.V289918.R01.S.doc Version 5.2 Page 17 Staff training records showed that six members of staff had completed an emergency first aid course last year, and that all of the staff had undertaken training in safe moving and handling practices in February 2006. The member of staff in charge showed the inspector confirmation that training in the protection of vulnerable adults, moving and handling, and basic food hygiene would be completed for all staff by April this year. DS0000018802.V289918.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 Quality in this outcome area is good. This judgement has been made using The management available evidence including a visit to this service. arrangements at the home ensure that the health and safety of the residents and staff is well promoted. EVIDENCE: The registered manager has an appropriate nursing qualification for the category of people accommodated at the home and is currently undertaking a management training course. At the time of this visit, the registered manager was on sick leave that is expected to last for six more weeks. In his absence the deputy manager who has worked at the home for a number of years is in charge of the home. The records show that the owner of the home visits regularly and talks with residents, checks the environment and reviews activities and accidents. The DS0000018802.V289918.R01.S.doc Version 5.2 Page 19 owner was present for part of this visit and was seen to be positive and friendly with the residents who were at home at the time. An officer of the Cheshire Fire Service visited the home recently and made two recommendations with regard to fire safety that have been complied with. The fire alarm system and fire extinguishers were serviced in January 2007. A fire drill was carried out recently, and records were seen of six members of staff having received fire safety training. Products subject to the Control of Substances Hazardous to Health legislation were seen to be stored safely and securely. Records were maintained of untoward incidents that were detailed in content, and accidents were recorded on individual forms that when completed are kept in the residents’ care records. DS0000018802.V289918.R01.S.doc Version 5.2 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 Standard No Score 1 X 2 4 3 X 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 1 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X DS0000018802.V289918.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? Yes 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 YA34 Regulation 19(1)(b) Requirement A satisfactory enhanced Criminal Records Bureau disclosure must be obtained for all staff employed at the home. This requirement remains outstanding from the last inspection. A full employment history, together with a satisfactory written explanation of any gaps in employment must be obtained for all new staff before they start working in the home. Timescale for action 28/02/07 2 YA34 19(1)(b) 28/02/07 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 DS0000018802.V289918.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI DS0000018802.V289918.R01.S.doc Version 5.2 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!