Inspection on 09/08/07 for Jackson House Nursing Home

This inspection was carried out on 9th August 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 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

Jackson House Nursing Home 09/02/09

Jackson House Nursing Home 08/08/08

Jackson House Nursing Home 26/01/07

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 Ms Julie Porter Unannounced Inspection 9 August 2007 10:00 Jackson House Nursing Home DS0000018802.V342353.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 Jackson House Nursing Home DS0000018802.V342353.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. Jackson House Nursing Home DS0000018802.V342353.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 Jackson House Nursing Home DS0000018802.V342353.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. This home is registered for a maximum of four residents in the category of LD (learning disability) 26th January 2007 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. The people who live there each have their own room and there are shared lounge and dining areas, plus kitchen and bathroom. People 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 from £1400 to £2700. The manager confirmed this information on 26 January 2007. Jackson House Nursing Home DS0000018802.V342353.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 09 August 2007 and lasted four 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. All of people who live at the home were spoken with and they gave their views about the service What the service does well: What has improved since the last inspection? Improvements have been made to the process of recruiting staff to make sure that new staff are suitable to work with the people who live at the home. Jackson House Nursing Home DS0000018802.V342353.R01.S.doc Version 5.2 Page 6 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. Jackson House Nursing Home DS0000018802.V342353.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 Jackson House Nursing Home DS0000018802.V342353.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&5 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People who are thinking of moving into the home would have their needs assessed before they moved to make sure these could be met at the home. EVIDENCE: Although no-one had moved into the home since the last inspection, the process that would be used remains the same. The assessment document that is used for the home covers daily living, health, social and emotional needs and includes a life history of the person. Staff from the home would visit the person who was thinking of moving in. The person would have the opportunity to visit the home and maybe stay overnight before deciding whether to move there. A care plan would be drawn up to cover the person’s move and settling into the home. The file for one of the residents was checked and contained a copy of the contracts given to the people who live at the home. The contract identified 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. Jackson House Nursing Home DS0000018802.V342353.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. Residents are encouraged to make choices so they stay in control of their lives and can be as independent a possible. EVIDENCE: The care records of two people were checked as part of the inspection visit and one was discussed at length with the person whose record it as. The plan 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 person’s health and welfare were descriptive and informative. The care plans had been regularly reviewed and updated. The people who live at the home 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. One person budgets, shops and cooks for himself. Jackson House Nursing Home DS0000018802.V342353.R01.S.doc Version 5.2 Page 10 A copy of a survey completed in July 2007 about what the resident thought of the home was seen in one person’s care file. A person who lives at the home who was spoken with confirmed that residents’ meetings are held regularly. One resident who was spoken with said that he knew there were risk assessments for activities he was involved in. He also said that he was annoyed that he was not allowed to manage his own medicines as he had done before he moved to the home and continued to do when he went on an annual holiday away from the home. The information sent to the Commission before the inspection identified that one of the people who lives at the home was working towards managing their own medicines. A risk assessment was seen on file but senior staff reported that the doctor had said this person should not manage his own medicines. Records were scant and appear to be conflicting. Jackson House Nursing Home DS0000018802.V342353.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): 11, 12, 13, 14, 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 take part in activities which they choose so they can keep busy and keep up their interests. EVIDENCE: People who live at the home attend a local college each week although at the time of the visit they were all at home because of the college holidays. One person goes to music and life skill classes and another does leisure and life skills classes. One person who was spoken with does voluntary work with three different organisations, and attends a band practice class once a week. Residents have chosen their holidays for this year and the tent had been put up in the garden to help them prepare for their camping trip. One of the people who live at the home was going on holiday independently. Jackson House Nursing Home DS0000018802.V342353.R01.S.doc Version 5.2 Page 12 One resident attends church regularly and another goes to church when he asks to. One resident spoken with has a love of music and bands and spoke during the visit of bands he had recently seen. A resident who spoke with the 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 speak to them appropriately. An individual record is kept of all meals provided for the people who live at the home. These showed that they have a varied and nutritious diet. One of the residents cooks most of his own meals and does his own shopping. Jackson House Nursing Home DS0000018802.V342353.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. The health of the people who live at the home is monitored to ensure they stay well and receive the care/support they need. EVIDENCE: The routines at the home are flexible and the people who live there 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. None of the people who live at the home has a problem with mobility and at the time of the visit specialist equipment was not needed. All the residents are registered with a doctor (GP) and the two care plans that were checked during the inspection visit showed that other health care professionals involved with their care. There is a medicines policy and procedures for the home to make sure that the people who live at the home get their medicines as prescribed. Qualified staff administer the medicines in the home and the medication administration record (MAR) sheets had been filled in correctly. Jackson House Nursing Home DS0000018802.V342353.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. There are procedures for complaints and protection in place and staff have received appropriate training to ensure that residents welfare is safeguarded. EVIDENCE: There is a written complaints procedure for the home and a copy of this was seen in the dining room of the home. Staff said there had been no complaints since the last inspection. Three of the people who live at the home who were spoken with said they knew who to complain to if they thought anything was wrong. The person in charge of the home said that verbal complaints made by residents are dealt with as they arise. However, these are not recorded. All staff working in the home have received training regarding adult protection and the Department of Health’s document “No Secrets” is available in the home. There have not been any referrals made under adult protection. Jackson House Nursing Home DS0000018802.V342353.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 & 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Improvement work is due to take place at the home to ensure that residents continue to live in comfortable, safe surroundings. EVIDENCE: The home is in pleasant surroundings and the people who live there were seen on the day of the inspection visit taking advantage of the good weather and having lunch outdoors. A number of areas of the home needed work doing. The owner of the home confirmed that work will be carried out towards the end of August when the people who live there will be away on holiday. A number of window frames are rotten and need replacing, the boiler it to be replaced, both bathrooms are to be refurbished and all the residents’ bedrooms will be redecorated. On the day of inspection the home was clean, tidy and free from unpleasant smells. Jackson House Nursing Home DS0000018802.V342353.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 good. This judgement has been made using available evidence including a visit to this service. Thorough staff recruitment processes and training are in place to ensure that the residents are safeguarded from possible harm and poor practice. EVIDENCE: Residents are supported by qualified nursing staff and carers. Information from the last inspection in January identified that staff had received training as follows: six staff are qualified 1st aiders, all staff completed moving and handling training in February 2006. Staff completed vulnerable adults training and food hygiene training in April 2007. The person in charge of the home confirmed that no new staff have been employed since the last visit. Information received since the last visit confirms that enhanced Criminal Record Bureau checks have been obtained for all staff working at the home. The manager provided information to confirm that systems are now in place to ensure that thorough recruitment processes are followed. Jackson House Nursing Home DS0000018802.V342353.R01.S.doc Version 5.2 Page 17 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 available evidence including a visit to this service. The management arrangements in the home ensure that the welfare of the residents and staff is promoted. EVIDENCE: The manager has an appropriate nursing qualification for working with people with learning disabilities and is registered with the Commission for Social Care Inspection. The records show that the owner of the home visits regularly and talks with residents, checks the state of the building and reviews activities and accidents. The owner was present for part of this inspection visit and was seen chatting to residents and staff. Jackson House Nursing Home DS0000018802.V342353.R01.S.doc Version 5.2 Page 18 The fire records show that the alarm systems and emergency equipment are serviced appropriately. Policies and procedures for the home are available and have been reviewed by the manager in January 2007. 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. However, it is difficult to form an overall view of how many accidents and incidents occur so it is recommended that simple system of recording is developed to enable the management to monitor what is happening. Jackson House Nursing Home DS0000018802.V342353.R01.S.doc Version 5.2 Page 19 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 X 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 2 25 X 26 X 27 2 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 2 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 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 Jackson House Nursing Home DS0000018802.V342353.R01.S.doc Version 5.2 Page 20 Are there any outstanding requirements from the last inspection? No 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 YA9 Regulation 13(4) Requirement Risk assessments must be produced to show why a particular activity is not being pursued so that residents understand why they cannot take part in that activity. Timescale for action 30/09/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA22 Good Practice Recommendations A log should be maintained of all verbal complaints made/concerns raised by residents including the outcome, to show that residents are listened to and their concerns are acted upon. The work planned to refurbish the home, including replacing the rotten window frames, should be carried out as planned A simple record/reference system of accidents and incidents that occur should be kept to ensure that accidents/incidents can easily be monitored. 2 3 YA24 YA42 Jackson House Nursing Home DS0000018802.V342353.R01.S.doc Version 5.2 Page 21 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. 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