Inspection on 24/07/06 for Jasmine

This inspection was carried out on 24th July 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Jasmine 19/12/07

Jasmine 23/02/06

Jasmine 29/06/05

Jasmine 25/01/05

Jasmine 23/06/04

Jasmine 09/03/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Jasmine Dod Lane Glastonbury Somerset BA6 8BZ Lead Inspector Lesley Jones Unannounced Inspection 24th July 2006 09:30 Jasmine DS0000030092.V302439.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 Jasmine DS0000030092.V302439.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. Jasmine DS0000030092.V302439.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Jasmine Address Dod Lane Glastonbury Somerset BA6 8BZ 01823 423126 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) Somerset County Council (LD Services) Mrs Beverley Eileen Chant Care Home 9 Category(ies) of Learning disability (9) registration, with number of places Jasmine DS0000030092.V302439.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Service users may be admitted who have concurrent physical disabilities. The service user in the lower ground floor accommodation has dedicated staff support, separate from the other 8 service users. The use of the two rooms on the lower ground floor, for an additional bed, is temporary and approved until 31 March 2004 23rd February 2006 Date of last inspection Brief Description of the Service: Jasmine is service that is registered to provide support for nine service users in the younger adult with Learning disability category. Some of the service users also have physical disabilities. Somerset County Council runs the home. A registered manager is in charge of the day-to-day running of the home. Staff are employed at the home for care provision. Jasmine is situated in a residential area of Glastonbury and is close to the town centre. This has the local facilities of shops, banks, pubs and leisure amenities. Jasmine is adapted to be able to support highly dependent service users whilst maintaining a homely atmosphere. All accommodation is in single rooms. Outdoor space includes pleasing gardens to the rear. There is a large living / dining area and an additional lounge. There are sufficient numbers of adapted bathrooms. The lower ground floor contains a small self-contained flat. The flat consists of a bedroom with en-suite and a small living area including a kitchen. This area is registered to provide emergency placement with a maximum stay of three months. Jasmine DS0000030092.V302439.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was conducted over the course of one day by one inspector. The inspector was able to speak to most of the staff on duty although the manager was not present. With the exception of the person currently living in the flat, all of the people who live at the service were seen and spoken to during the inspection. The parent of one resident was also seen. Surveys for staff and residents were also sent to the home, although not all of these had been returned at the time of writing this report. Overall Jasmine provides a good standard of care and support. What the service does well: The staff are dedicated to meeting the sometimes complex needs of the people whom they support. There are a wide range of social activities, which meet the needs of all the people who live at the home. Staff have an excellent rapport with the people who live at the service and communication systems such as pictures, symbols and signs are used on a day to day basis. Staff receive a wide range of training opportunities in the majority of areas. Jasmine DS0000030092.V302439.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Although the manager was not present on the day of the inspection verbal feedback was given. The feedback raised a small amount of areas for consideration. These included staff training in the management of medication, the frequency of external training in moving and handling, and the need to formally record complaints made about the service. There has been some concern expressed by staff about the adequacy of their training to deal with certain situations, as well as feedback, which indicates some lack of clarity for some about what duties they should not undertake. This should be investigated by the team leader. Planned developments into the care planning system will be welcomed. Finally, the registration arrangement for the flat limits its use to not more than three months. The current resident moved in on 6th April. This means that the home is in breach of its registration. Immediate action must be taken to address this situation. Jasmine DS0000030092.V302439.R01.S.doc Version 5.2 Page 7 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. Jasmine DS0000030092.V302439.R01.S.doc Version 5.2 Page 8 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 Jasmine DS0000030092.V302439.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality outcomes in this area are good. There is good information made available to prospective and current people who live at the home and their representatives about the service in a range of formats. Staff are skilled and are able to meet the current needs of individual. Each person living at the home has a contract, the contents of which may not always be fully understood by people with severe learning disabilities. EVIDENCE: The home has produced a Statement of Purpose and Service User Guide. The Service Use Guide has been produced using Somerset Total Communication (STC) symbols. There have not been any new service users to the main house since the last inspection. The “flat” is now registered with the CSCI as the tenth bed and has worked well for the people who have been accommodated there. The admission process to the flat may be different to the main house as the admission may be due to the breakdown of a previous placement and therefore on an emergency basis. People may not have the opportunity to visit the home prior to admission. This is usual in the main area of the house. Jasmine DS0000030092.V302439.R01.S.doc Version 5.2 Page 10 The current resident has lived in the flat longer than three months, which is contrary to the conditions of registration. During the inspection, this was discussed with the Network manager Charlotte Hamlin. The current resident moved in on 6th April. This means that the home is in breach of its registration. Immediate action must be taken to address this situation. Jasmine DS0000030092.V302439.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9, Quality outcomes in this area are good. All people who live at the service have a plan, which informs staff of their individual care and support needs. Individuals are consulted about choice and their preferences, although due to their disability it is not possible for them to be formally involved in the development or review of their plan. People who live at the service are involved in the day-to-day running of the home. Information is stored in a secure manner. EVIDENCE: In the last report a recommendation was made with regard to the care planning system. Improvements since then include staff signatures and regular reviews. Since the last inspection Somerset County Council have worked towards updating and reviewing the care planning system, and produced a new document, which encourages resident involvement. These plans have yet to be implemented. For this reason there have been no significant changes to the Jasmine DS0000030092.V302439.R01.S.doc Version 5.2 Page 12 care plans at Jasmine. The recommendation from the last inspection therefore remains. Service users rights to make decisions are promoted. This may be limited for some of the current service users whose assessed needs do not allow them to make choices readily. Staff were observed supporting people to make choices about what food they would like to eat. Staff work closely with the individual’s to promote this skill. The staff have a good working relationship with the people they support. Due to this staff are aware of the non-verbal signs that may indicate if people are enjoying an activity. The nature of people’s disabilities means that input into the development of policies and procedures is not generally possible. Information is handled and stored in a secure manner. Since the last inspection work has continued in the development of communication systems. There are now a range of Total Communication boards in place including “what am I doing today” and a menu board. Points of reference are also used. The development in communication systems has enabled people living at the home to make decisions and be involved in the day to day running of their home. During this visit, positive feedback was received from the parent of one resident who was visiting at the time. Jasmine DS0000030092.V302439.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17, Quality outcomes in this area are good. There is a good range of opportunities available for personal development, recreation and community involvement. People who live at the service are supported to maintain links with family and friends. EVIDENCE: The duty and staff rota’s demonstrated that people who live at the service attend a range of activities. Activities include swimming, “atmospherics”, going out for walks and music therapy. The service also has it’s own transport. The number of staff needed to support service users in activities is relatively high. One visitor was spoken to during this inspection. People choose whom they see and when; and can see visitors in their rooms and in private. Photographs of friends and relatives are on display in the service users bedrooms. Jasmine DS0000030092.V302439.R01.S.doc Version 5.2 Page 14 The kitchen was viewed on the day of the inspection. The kitchen was clean and tidy on the day of the inspection. A range of food was available including fresh fruit and vegetables. Staff are aware of the individual diets of people living at the home. Staff support individuals to make appropriate food choices. During this inspection, positive feedback was received from a visiting family member about the care provided, being kept well informed, and the range of activities provided. This person confirms that her visits were mainly unannounced, and that she was always made to feel very welcome. Her son was always clean and well dressed and well cared for. Jasmine DS0000030092.V302439.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20, The quality in this outcome group is adequate. People who live at the service are support to meet personal care needs in a dignified manner. The health care needs of individuals are recognised and specialist advice sought if necessary. Procedures for the safe handling, storage and administration are well managed except where liquid medication is administered, where administration practices place service users at potential risk. EVIDENCE: Staff were observed to interact with people in a relaxed and comfortable manner. All personal care is conducted in the privacy of people’s bedrooms. Staff were observed to interact with people in a relaxed and comfortable manner. All personal care is conducted in the privacy of people’s bedrooms. Jasmine DS0000030092.V302439.R01.S.doc Version 5.2 Page 16 People visit the GP as and when required, staff give support when needed. Specialist support with regard to various support needs is sought on a regular basis e.g. psychology, speech and language and dietician. Service users key worker arrange visit to the dentist and other appointments when needed. All visits to all services are well documented in the service user plan. The district nurse visits the service to carry out any nursing duties. Medication was reviewed on the day of inspection. There was some evidence of double dispensing (setting up liquid medication in advance of administration). Staff are also asked to check that water taken from sinks in individuals rooms is safe as drinking water. Otherwise medication was stored and administered in line with Royal Pharmaceutical guidelines for care homes No people currently self medicate. Jasmine DS0000030092.V302439.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 The quality in this outcome group is adequate. People who live at the service are protected by a clear complaints procedure and robust prevention of abuse policies. EVIDENCE: The home’s complaints procedure was included in all service user’s care plans and management confirmed that parents or guardians were issued with a copy of the Council’s complaints procedure. The information on how to complain is also available in pictorial form, or a video is available. Service users spoken to, where able, confirmed that they felt comfortable raising issues of concern to staff and management. Staff are aware of the vulnerable adults and whistle blowing policies. In addition to this training there is in place a policy for the two areas. The policies complied with the Public Disclosure Act and the DOH Guidance No Secrets. During the inspection, I was told that there had been one complaint, but on further discussion, and observation of records it was evident that there had been two complaints to the home. One from a neighbour about music from the home being too loud, and the other from a parent who complained that the support her son was receiving was not good enough (told that this related to outside activities not being available for a while) which was not the fault of home. Of Issue here is that both complaints/concerns were not recorded formally, or in house policies followed. Where recording is incomplete, it is Jasmine DS0000030092.V302439.R01.S.doc Version 5.2 Page 18 difficult to assess whether complaints raised are managed appropriately. This must be addressed. Jasmine DS0000030092.V302439.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,30 The quality in this outcome group is adequate. The service (currently excluding the flat) is suitable for its intended use. There is sufficient specialist equipment. EVIDENCE: A tour of the building was conducted during the inspection. The flat was not inspected on this occasion as the resident was ‘not in a happy mood’ so it was not possible to assess the continued suitability of the flat for purpose. This will be inspected on a future visit. As mentioned above the current resident has lived in the flat for longer than three months, thus exceeded the existing condition of registration. All the bedrooms viewed showed a degree of individuality. All the people who live at the service are able to choose their own furniture and décor. All the rooms had personal possessions such as music systems and televisions. People who live at the service spoke of liking their rooms and all stated that staff respected their privacy. Some of the bedrooms have specialist equipment if required such as adjustable beds and overhead hoists. Jasmine DS0000030092.V302439.R01.S.doc Version 5.2 Page 20 The communal space is clean, tidy and very homely in style. Some of the areas have been redecorated in the last year and new carpeting has been laid. The overall quality of the communal areas is satisfactory. Jasmine DS0000030092.V302439.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35 The quality in this outcome group is good. A competent and enthusiastic staff group supports the people who live at the service. Some training needs have been identified. Staff have regular supervision and are well supported. EVIDENCE: Feedback from staff indicated that overall there is clarity about their job roles. Staff stated that they felt that they have received adequate training in order to support the people who live at the service effectively. Staff training records were viewed. These showed that there are a wide range of training opportunities available. Fifty per cent of staff have completed total communication training. A number of staff are completing an NVQ qualification. Most staff had received refresher training in the prevention of and action to be taken in the event of a fire. A number of people who live at the home require staff support in moving and handling. Most staff had not received external training for over one year in manual handling (12 of 19) but in house training is given each time a new Jasmine DS0000030092.V302439.R01.S.doc Version 5.2 Page 22 piece of equipment is introduced. Staff have not received refresher training in this area in line with good practise guidelines. (External training once each year) Most staff were up to date with food hygiene and medication training. Staff sign when training is given. There is currently one twenty eight hour vacancy, which is usually covered with relief and agency staff. A new staff member commences work in August. Staff confirmed that there were designated staff to work with the resident in the flat, and that overall staffing levels were good. All staff stated that they received regular supervision from the manager. There was documented evidence to confirm this. Staff also stated that they felt that they could raise any concerns with the management team. There are regular staff meetings. Jasmine DS0000030092.V302439.R01.S.doc Version 5.2 Page 23 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39,42,43, The quality in this outcome group is good. The service is efficiently managed and run. The introduction of a quality assurance system to assess the views if residents their representatives, and other agencies involved with the home is required. EVIDENCE: The service is well managed and run. The registered manager Mrs Chant has recently completed her NVQ4 manager’s award. Staff spoken to confirm that they received regular supervision and would have no hesitation in approaching the manager with any concerns they had. Some health and safety records were viewed these were satisfactory. The introduction of a quality assurance system remains outstanding. Currently the network manager audits the service with monthly visits, but this should be extended by formally seeking the views of residents, their representatives and any other outside agencies involved with the home. Jasmine DS0000030092.V302439.R01.S.doc Version 5.2 Page 24 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 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 2 ENVIRONMENT Standard No Score 24 1 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 2 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 X 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 2 X 3 X 3 X X 3 2 Jasmine DS0000030092.V302439.R01.S.doc Version 5.2 Page 25 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 YA22 Regulation 22 Requirement The manager must ensure that the investigation of all complaints/concerns follow information contained in Regulation 22. The registration arrangement for the flat limits its use to not more than three months. The current resident moved in on 6th April. This means that the home is in breach of its registration. Immediate action must be taken to address this situation. Timescale for action 01/09/06 2 YA24 23, 44, 01/09/06 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 YA6 Good Practice Recommendations It is recommended that the management team review and develop systems which would enable people to become involved in the review and development of care and support plan. It is recommended that individual risk assessments are reviewed dated and signed. DS0000030092.V302439.R01.S.doc Version 5.2 Page 26 Jasmine 2. 3. YA39 YA32 It is recommended that the management consider the implantation of a quality audit tool. It is recommended that staff receive training in Moving and handling in line with good practise guidelines. Medication training to all staff that administer medication. It is recommended that procedures for the safe handling, storage and administration be reviewed where liquid medication is administered, where administration practices place service users at potential risk. 4 YA20 Jasmine DS0000030092.V302439.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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 Jasmine DS0000030092.V302439.R01.S.doc Version 5.2 Page 28 - 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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