Inspection on 15/06/05 for Jane`s House

This inspection was carried out on 15th June 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 found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Jane`s House 31/05/07

Jane`s House 01/06/06

Jane`s House 30/12/05

Jane`s House 07/10/04

Jane`s House 23/04/04

Jane`s House 20/01/04

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

CARE HOME ADULTS 18-65 Janes House 89 Barrow Road Streatham London SW16 5BP Lead Inspector Lynne Field Unannounced 15 June 2005, 10:00am th 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 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 Stationary 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. Janes House G52-G02 22736 Janes Hse V233557 150605 Stage 4 UIV.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Jane`s House Address 89 Barrow Road, Streatham, London, SW16 5BP Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 0208-677-6196 Jane`s House Limited Ms Chan Bisessar Care Home 5 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (4), Mental Disorder, excluding of places learning disability or dementia - over 65 years of age (1) Janes House G52-G02 22736 Janes Hse V233557 150605 Stage 4 UIV.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 07/10/05 Brief Description of the Service: Jane’s House is situated in a residential street off the main road leading to Streatham High Street and is close to public transport routes, shopping and leisure facilities. The home is a semi-detached house on four floors. The home is not identifiable as a care home. The home provides long term care for people who have enduring mental health problems. There are currently 5 men, although the home has accommodated mixed genders since opening in 1990. The registered manager owns the property and also owns two other small homes nearby. The philosophy of care states: “The home is flexible with care and support provided as required by anyone who has suffered mental ill health”. Janes House G52-G02 22736 Janes Hse V233557 150605 Stage 4 UIV.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over four hours on one day and was carried out as the first of the two inspections that must be conducted on the service in this inspection year. On the day of the inspection the registered provider had just gone on annual leave and had taken keys to locked cabinets with her. The manager from another of the groups homes was standing in as acting manager. A tour of the premises took place and care records were inspected. There was one member of staff on duty. Four of the service users were spoken to during the course of the inspection. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Janes House G52-G02 22736 Janes Hse V233557 150605 Stage 4 UIV.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Janes House G52-G02 22736 Janes Hse V233557 150605 Stage 4 UIV.doc Version 1.30 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 standard(s) 1-5 The home has all the relevant documentation in place. Service users are encouraged to spend time at the home prior to admission. Before and after admission service users needs are assessed and are documented. EVIDENCE: The manager told the inspector the service users’ guide and the statement of purpose has been reviewed and updated to include all the relevant information that a prospective service user and their family would want to know to help them decide if the home would be able to meet the needs of the service users. Assessments were on the files of most recently admitted service users who had come to live at the home as stated in the last inspection report. Contracts and risk assessment were seen on file for this service user. At the time of the inspection there had been no new admissions since the last inspection. The home continues to meet the standard. Janes House G52-G02 22736 Janes Hse V233557 150605 Stage 4 UIV.doc Version 1.30 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 standard(s) 6, 7 & 8 Service users are encouraged to and make their own choices with staff support when necessary. The home involves families and other professionals when reviews are held. EVIDENCE: Two service user files were seen and the inspector noted the care plans focused on self care and independence. Service users have a key worker who supports the service user at reviews, which are held annually. There was also evidence of input from other professionals involved with the service user as well as the service users families. The manager told the Inspector that service users are encouraged to make decisions concerning their daily activities. Risk assessments are in place, reviewed and records kept on service users files. Service users said they were encouraged to personalize their bedrooms by putting up pictures and posters. One service user told the inspector he was pleased with the armchair he had in his room. It had become very shabby and the home had offered to replace it but he had not wanted that to happen. With Janes House G52-G02 22736 Janes Hse V233557 150605 Stage 4 UIV.doc Version 1.30 Page 9 the help of the staff he had recovered it. He said he would rather do this than have it replaced as he found it very comfortable. Janes House G52-G02 22736 Janes Hse V233557 150605 Stage 4 UIV.doc Version 1.30 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 standard(s) 11,12, 13, 14,16 & 17 Service users are encouraged to develop independent skills and interests as well as access the community with the support of staff when required. EVIDENCE: The inspector spoke to the home’s activities coordinator who said she keeps a daily log on each service users activities in their care plan and personal file which details the activities and needs of each service user. This is verbally discussed at shift hand-over meetings. Service users described how they are encouraged to develop independent living skills and take part in household tasks such as cooking, cleaning and washing up with staff support. One service user as part of his development plan will sometimes choose what he wants to eat and cook his own meal. Two service users said they enjoyed the meals provided by the home. The inspector observed service users going into the kitchen and making themselves drinks. Janes House G52-G02 22736 Janes Hse V233557 150605 Stage 4 UIV.doc Version 1.30 Page 11 Service users are encouraged to take part in a variety of leisure activities inside and outside the home. At home service users read, watch television and videos, listen to music, and play games. Outside of the home, service users visit the cinema and local pubs. All the service users attend the Effra Centre at sometime during the week. One service user attends one of the centres four days per week. Service users are encouraged to help with the daily shopping. They also attend different places of worship. The registered manager stated that local events are noted from the local newspaper. The registered manager takes service users to vote to ensure that they are enabled to take part in the democratic process. Links are maintained where families are involved. A recommendation from a previous Inspection was to start life story work with two of the service users who are not in contact with their families. The activities coordinator started this piece of work with the service users concerned and has continued with this. All service users have a front door key and a key to their room. Service users open their own post and ask for support if required. Service users confirmed that staff do not enter their bedrooms without permission. Janes House G52-G02 22736 Janes Hse V233557 150605 Stage 4 UIV.doc Version 1.30 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 standard(s) 18, 19 &20 Service users receive personal support when it is necessary but are encouraged to develop independent living skills as far as possible. The staff are aware of the service users physical and mental health needs and contact the appropriate professional if and when the need arises. The home must devise a way of keeping a clear record of the balance of each medication on the medication chart. EVIDENCE: During the inspection the inspector observed service users being supported in daily living tasks by the staff. Documentation was seen in the two service users files that indicated service users have regular contact with the local psychiatric team. Staff said they contact the team if service user’s mental health starts to deteriorate. All service users are registered with the local surgery and are invited for an annual health care check. There were notes on file of all medical appointments and outcomes from these were recorded. Janes House G52-G02 22736 Janes Hse V233557 150605 Stage 4 UIV.doc Version 1.30 Page 13 One service user is self-medicating. Risk assessments have been completed for all service users, but it was considered too great a risk for other service users to self medicate. There were some gaps in the signing of the medication records. The way the medication is checked and recorded when it comes into the home made it difficult to know whether the medication had been given and just not signed for. The registered person must make sure all medication received is recorded accurately at the time of receipt and a running total is kept on the medication sheet. Janes House G52-G02 22736 Janes Hse V233557 150605 Stage 4 UIV.doc Version 1.30 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 standard(s) Service user’s views are listened to and acted upon and there are safeguards in place to protect them from abuse, neglect and self harm. EVIDENCE: The home has a complaints policy, a copy of which is in the service users’ guide. The policy states that complaints will be responded to within 28 days and that they can be referred to NCSC at any stage. The complaints book was seen by the Inspector and confirmed that no complaints have been recorded since the last inspection. There is an adult protection policy and procedure in the home as well as a copy of the local authorities POVA policy and procedure. The staff at the home are aware of abuse and protection and how to deal with cases of suspected abuse. The home safeguards service user finances with appropriate recording systems. The registered manager has developed a policy on physical intervention to ensure that physical restraint is a last resort, and that it is used only in accordance with Department of Health guidance. Janes House G52-G02 22736 Janes Hse V233557 150605 Stage 4 UIV.doc Version 1.30 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 standard(s) 24-30 The home is bright, clean and comfortable. Service users rooms are comfortable and are decorated to reflect their personalities. The hall and stairs would benefit from being redecorated and for health and safety reasons the stair carpet replaced. EVIDENCE: Janes House G52-G02 22736 Janes Hse V233557 150605 Stage 4 UIV.doc Version 1.30 Page 16 The home is a semi-detached house on four floors. It is comfortable and homely and was clean and tidy on the day of the inspection. There is a large garden at the back of the house. Although the home is generally well maintained, much of the decoration in the hall and stairs is shabby. Some of the carpet has been repaired on the stairs but there are other areas that are worn and the whole of the stair carpet should be replaced. All service users have single rooms. One of the rooms is less than 10sq metres but this is noted in the statement of purpose. The service user who is currently resident in the smaller room has lived in the home for over 10 years. He has moved into larger rooms when they have become available but has then requested to move back to his original room. This is recorded in his notes. Service users showed the inspector their rooms and they were furnished adequately and some service users had individualised them with personal items. There is one bathroom and a separate toilet on the first floor and a toilet on the ground floor. Five people share the bathroom. There are plans to make one bedroom smaller and use the space to install another bathroom. The registered provider is discussing the changes with the service user and their family. The bedroom will still meet with the required regulation. There is a large comfortable lounge, which leads into a small conservatory, which is used as a smoking room. The kitchen, which leads into a large dining area, that has a large round table where the service users eat their meals. A small paved patio and garden with grass and borders is to the rear of the home. The home provides care for people who have problems with their mental health but are ambulant so there are no adaptations or disability equipment in the home. The laundry facilities are located in the basement away from where food is prepared and eaten, and the machines can wash on a minimum 65oC cycle. Janes House G52-G02 22736 Janes Hse V233557 150605 Stage 4 UIV.doc Version 1.30 Page 17 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 33 & 35 The home provides training for staff to meet the needs of the service users and a number of staff are taking NVQs in level 2 & 3. EVIDENCE: The registered manager had reviewed the staffing levels in relation to promoting independence and supporting and motivating the service users in daily living skills. An activities coordinator who works across the three homes in the group and has organised an activities program, which involves the service users from the homes has been employed. A member of staff told the inspector that staff had been given training as part of their induction within the first six months. Training has also been provided for staff in aspects of care, such as abuse and protection training, principles of risk management, managing abusive and aggressive behaviour and the safe handling of medication. It was not possible to inspect staff files at this inspection because the registered manager was on leave and the acting manager did not have access to the cabinet the files are kept in. These will be inspected at the next inspection. Janes House G52-G02 22736 Janes Hse V233557 150605 Stage 4 UIV.doc Version 1.30 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37-43 The home is well run with the service users best interests promoted and protected by the home’s policies and procedures. Service users views are listened to and acted on. EVIDENCE: Service users said they felt comfortable in the home and staff treated them with respect and listened to them. This was demonstrated in how the home dealt with the service user who did not want to replace his comfy chair. Staff and service users made it is clear that the home is managed in a positive and open way. Staff felt they are able to influence the way the home is run via staff meetings and supervision. Service users are able to influence decisions via key working sessions and service user meetings. Staff and service users all said the registered manager is approachable and well respected by staff and service users. There are a number of systems by which success can be monitored, such as the monthly audit check, which the registered manager does to monitor the environment. It continues to use a Department of Health Janes House G52-G02 22736 Janes Hse V233557 150605 Stage 4 UIV.doc Version 1.30 Page 19 questionnaire called CUES (carers and users expectations of services) to evaluate and monitor service users satisfaction and care planning. The home has a monthly health and safety checklist. Service users have meetings every two months where they can feed back any concerns they may have. Two service users files were seen and these appeared to have the relevant documentation required. Records seen include, records of service user finance, including one where the service user had signed an agreement about how to control his finances, accidents and incidents, medication administration, complaints and record of visitors to the home. There was more evidence in the records about how service users are involved in reaching goals on a daily/weekly basis. Recording of activity involvement had improved since the employment of the activities coordinator. Janes House G52-G02 22736 Janes Hse V233557 150605 Stage 4 UIV.doc Version 1.30 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 3 3 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score x 3 3 3 x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Janes House Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 3 2 G52-G02 22736 Janes Hse V233557 150605 Stage 4 UIV.doc Version 1.30 Page 21 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA20 Regulation 13(2) Requirement The registered person must ensure that staff complete all medication records fully and accurately at the time of administration, including reasons for non-administration. The registered person must make sure all medication received is recorded accurately at the time of receipt and a running total is kept on the medication sheet. The registered person must replace the stair carpet. Timescale for action 12 October 2005 2. YA20 17(1)(a) 12 October 2005 3. YA24 13 (4) (a) 16 (2) (c) 30 December 2005 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 YA24 Good Practice Recommendations The hall and stairs would benefit from being redecorated. Janes House G52-G02 22736 Janes Hse V233557 150605 Stage 4 UIV.doc Version 1.30 Page 22 Commission for Social Care Inspection 46 Loman St Southwark SE1 0EH 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 Janes House G52-G02 22736 Janes Hse V233557 150605 Stage 4 UIV.doc Version 1.30 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. 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