CARE HOMES FOR OLDER PEOPLE
Jah Jireh 72-76 Main Street Ellenborough Maryport Cumbria CA15 7DX Lead Inspector
Nancy Saich Unannounced Inspection 28th December 2005 10:30 X10015.doc Version 1.40 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 Jah Jireh DS0000022593.V269328.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 Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Jah Jireh DS0000022593.V269328.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Jah Jireh Address 72-76 Main Street Ellenborough Maryport Cumbria CA15 7DX 01900 816943 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) Miss Joanna Hindmoor Miss Joanna Hindmoor Care Home 15 Category(ies) of Dementia - over 65 years of age (5), Old age, registration, with number not falling within any other category (15), of places Physical disability (1) Jah Jireh DS0000022593.V269328.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 1 named service user in the category of (PD) (physical disability) who is under sixty-five years of age may be accommodated within the overall number of registered places. 16th September 2005 Date of last inspection Brief Description of the Service: Jah Jireh is an older property that has been extended and adapted to provide accommodation for older people. The home is in a residential area of Maryport and is within walking distance of local amenities and is served by public transport. The home has its own garden and car park. The home is run by Ms Joanna Hindmoor and owned by the Hindmoor family. It is one of a number of Jah Jireh homes across the country but operates independently from the Jah Jireh organisation. The residents and staff of the home are all Jehovah’s Witnesses and this commitment is essential before anyone comes to live –or work- in the home. The home is next to the Kingdom Hall and the congregation play an important part in the life of the home. The home has just increased its bed numbers and may now take up to seventeen older people, five of whom may have dementia. Jah Jireh DS0000022593.V269328.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection. The lead inspector arrived mid morning and stayed until mid afternoon. She met with the manager and the staff team. She saw all of the residents and spoke to people individually in their rooms and in small groups in the lounge or dining room. She also toured the building, ate lunch with the residents and checked on documents that backed up what was said or seen on the day. A number of resident and visitor’s questionnaires were received at the Penrith Office. What the service does well:
This home is good at making sure that any new resident is the right person to fit in with the existing group of residents and that they only take people they can give high levels of care to. The home delivers sensitive and appropriate care. Each resident had a written plan that showed what was important to him or her, what they could manage for themselves and what they needed help with. These ‘care plans’ gave a simple outline of each person’s special needs. The manager talked about how she planned to continue to improve these. Residents were happy with the way they were cared for and about the way they were encouraged to keep as much independence as possible. They especially appreciated how they were valued and respected as members of the congregation. Residents are involved in study and discussion with other J Jehovah’s Witnesses and see no reason why age and infirmity should prevent them from having a worthwhile role in the wider community. Several people go out into the community to minister to people in the local area. Residents were happy with the way their individual care was managed. One person said “it’s the attention to the small things …that make the difference, that make this home…”. She also said she was treated “with the greatest respect”. Other people backed this up and several men said they appreciated having men on the staff who could help with personal care. Residents said they were helped with their health care and there was evidence to show that the manager and staff were supportive of the residents needs. Medication was being dealt with properly. This home provides very good standards of catering. Meals have a high nutritional content and no convenience foods are used in the home. Residents explained how the food they ate met with their habits and beliefs. Meal times are important to the residents as a time to share with others.
Jah Jireh DS0000022593.V269328.R01.S.doc Version 5.0 Page 6 The home is good at consulting with residents and in listening to them. They are also good at making sure that the residents are protected from any potential harm. The home provides residents with a safe, warm and homely environment. The residents said they liked their individual rooms and many of them use these for private study or to follow individual hobbies. Several people have their own computers in their rooms. The shared spaces are well decorated and have comfortable furniture. Residents enjoy using these spaces to come together to study, talk and to socialise. The home has good levels of staffing and residents felt the staff had the right kind of training and more importantly had the right kind of attitude to be in their home. The inspector spoke to staff and was impressed with their knowledge and eagerness to learn and improve as workers. This home has a well-established staff team who see the residents as part of their total community and treat them as “brothers and sisters”. This can be seen in the respectful and considerate way they talk to and about the residents and in how they care for them. Joanna Hindmoor manages the home in an efficient and sensitive way. She is very much a ‘hands-on’ manager and knows her residents and staff very well. She is committed to making sure that the service meets high quality standards. She has very good systems that allow the home to run smoothly and she is keen to keep on improving these while not loosing the informality or closeness of what she sees as a home that is run like a caring family. What has improved since the last inspection?
Since the last inspection two new bedrooms have been created in the home and a new kitchen and laundry built. This new part of the building is of a very high standard. Staff and residents were pleased with the way had turned out. All of the external doors are now connected to the alarm bell system. This gives residents extra security and alerts staff to people entering or leaving the building. There have been other ongoing improvements to the home with new carpets and furniture in different areas of the home. Together these things have improved what was already a comfortable home. The manager and staff have introduced some new activities into the home and staff now have ready access to transport so that residents can go even more frequently than before. Jah Jireh DS0000022593.V269328.R01.S.doc Version 5.0 Page 7 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. Jah Jireh DS0000022593.V269328.R01.S.doc Version 5.0 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Jah Jireh DS0000022593.V269328.R01.S.doc Version 5.0 Page 9 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 This home is good at only admitting people who will fit into the home and who they can care for. EVIDENCE: The inspector talked to the latest admission to the home and this had been handled properly. The residents said they had been given time to make the choice to come to the home and all of them said this had been positive. Residents’ files had detailed notes about each person as they came into the home. Jah Jireh DS0000022593.V269328.R01.S.doc Version 5.0 Page 10 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10,11 Residents’ health and personal care are very well looked after by the staff team and this helps them to stay as independent as possible. EVIDENCE: All of these standards were checked out by talking to residents and watching how well the staff interacted with them. Residents said that the staff team were all very kind and caring. It was important to residents that all of the staff were also Jehovah’s Witnesses as they felt they were best cared for by people who had the same beliefs as themselves. Staff knew residents very well and there was an easy and comfortable exchange of views and ideas between staff and residents. Staff spoke politely and warmly to residents, were careful of their right to privacy and dealt with personal care in a discreet way. Each resident had a written plan that outlined his or her care needs. These care plans covered both basic and more complex needs and the manager shared her plans for improving on these. Residents were involved in drawing up the plans and on the monthly updates.
Jah Jireh DS0000022593.V269328.R01.S.doc Version 5.0 Page 11 Residents have access to health care by either visiting the doctor or by having a visit in the home. They see G.Ps, nurses and other health care professionals when they need treatment but the home also makes sure that they do the best they can to help people stay well and prevent illness from worsening. The inspector checked on medicines and the staff are managing them well. Some residents look after their own tablets and the staff just keep a watchful eye on how this is done. This is one of the ways staff help people remain independent. Residents said that they wanted to stay in the home right up to the time of their death and felt that the care other people had received at the end of life had been “excellent…and what I want for myself when the time comes…”. The management and the staff were fully aware of how to care for a resident at the end of life. Jah Jireh DS0000022593.V269328.R01.S.doc Version 5.0 Page 12 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Residents in this home were completely satisfied with their daily lives and felt these met with their beliefs and values. EVIDENCE: This home is very focussed on the residents’ spiritual beliefs and values. Residents study independently and together, they attend meetings at the Kingdom hall or if they are too frail they join in by closed circuit TV. Some people go out into the community to spread the message of their beliefs and this work is valued and supported by the congregation. Residents had recently enjoyed some different activities that staff had arranged for them and were looking forward to some other things that had been planned. The visitors’ book showed that friends, family and Jehovah’s Witnesses from other parts of Cumbria visited regularly. Residents said they went to meetings and conventions as part of their involvement with the church. In general the inspector thought that the resident group were very much valued as the senior members of the community and that their experience and knowledge valued. This means that the residents are encouraged to stay involved with the wider community. This helps people to stay independent and to be confident to ask for what they need. Residents in jah Jireh are able to speak up for themselves and for each other.
Jah Jireh DS0000022593.V269328.R01.S.doc Version 5.0 Page 13 The inspector enjoyed sharing lunch with the residents and saw the preparation for dinner. The meals in the home are very well thought out with a lot of attention paid to careful preparation of good quality food. The manager is careful to ensure that food and mealtimes are organised so that residents’ beliefs and choices are taken into account. Jah Jireh DS0000022593.V269328.R01.S.doc Version 5.0 Page 14 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 This home is good at allowing the residents’ voice to be heard and in protecting them from harm. EVIDENCE: The home had received no complaints in the past year. Residents had no complaints on the day but were aware of how they might deal with any issues they had. They said they could talk to the manager or her parents about any concerns. Residents said that everyone in the home was well cared for and protected from harm. They knew how they would report anything untoward. Staff were very aware of how they would deal with any abuse and had received training on how to protect the residents. Jah Jireh DS0000022593.V269328.R01.S.doc Version 5.0 Page 15 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,23,26 Residents were relaxed in a comfortable and safe environment that gave them private space and the opportunity to spend time with each other. EVIDENCE: This house has just been extended to provide two new bedrooms, a new kitchen and a new laundry. All of these areas were of a good size, nicely decorated and properly equipped. The home is right next-door to the Kingdom Hall and residents enjoy going to the meetings. There is a large sitting room that is used for social events and for meetings. There is a small quiet lounge that looks out onto the garden. Residents said they used this for private meetings or to see their visitors. The home has a good-sized dining room and residents said they enjoyed sitting together at mealtimes and people spent a lot of time talking at lunchtime. The home had a relaxed atmosphere and residents were very comfortable in their environment. Most of the bedrooms have ensuite toilet and wash hand basin. The rooms were well decorated and above the minimum size. The rooms have good
Jah Jireh DS0000022593.V269328.R01.S.doc Version 5.0 Page 16 quality furnishings and some residents have brought their own furniture. Many of the residents have a lot of personal possessions including books, computers and a lifetime of papers and journals. Residents are encouraged to have their rooms just as they want them. Externally the home has a car park and a small garden. A bus route serves the home and one or two people use this service. The staff can use the manager’s car and one resident went out during the inspection. The home is well maintained and the inspector saw the records of this. These were in order. The home was clean, fresh and hazard free in all areas. Staff said the new kitchen and laundry made the routine tasks much easier to complete and gave them more time to spend on residents. Jah Jireh DS0000022593.V269328.R01.S.doc Version 5.0 Page 17 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,30 This home has a well-established, properly trained team of staff who are committed to giving residents the best care possible. EVIDENCE: The inspector saw the staff rosters and spoke to staff. They said that they were well staffed and this meant they had time to spend with residents. Staff said they could go to the manager with any issue and were well supported. They had received training in all the basic things they needed to know to do their jobs. Staff had National Vocational Qualifications at level 2 and 3 and one person was working towards level 4. Staff also had a good ‘working knowledge’ of how to run the home and care for residents. Residents were happy with the staff group saying that there were enough people on duty and that they knew how to do their jobs properly. The male residents commented on how much they appreciated having a male carer to help with their personal care. Jah Jireh DS0000022593.V269328.R01.S.doc Version 5.0 Page 18 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,38 This is a well managed home where things run smoothly and residents need not worry about how things are arranged. EVIDENCE: The home is owned by the Hindmoor family. Joanna Hindmoor is in charge of the management of the home and is helped in this by her parents. Joanna is well liked and respected by the staff and residents. She has grown in confidence in the last few years. She has undertaken training to help in this role and is suitably qualified and experienced. The inspector was impressed with her commitment to improving things for the people who live in the home. The manager has a simple but effective quality assurance system that helps make sure that the residents get what they need and want. These systems also make sure that things run smoothly in the home and that problems are dealt with swiftly.
Jah Jireh DS0000022593.V269328.R01.S.doc Version 5.0 Page 19 The manager discussed some changes to health and safety routines that she had put into place after taking advice from Environmental health. The inspector saw the fire logbook and this was in order. Jah Jireh DS0000022593.V269328.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 Older People 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 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X X 3 X X 3 STAFFING Standard No Score 27 3 28 3 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X X X X 3 Jah Jireh DS0000022593.V269328.R01.S.doc Version 5.0 Page 21 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. Refer to Standard Good Practice Recommendations Jah Jireh DS0000022593.V269328.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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