Inspection on 10/10/05 for Jasmine Court Nursing Home

This inspection was carried out on 10th October 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Jasmine Court Nursing Home 31/10/07

Jasmine Court Nursing Home 09/01/07

Jasmine Court Nursing Home 27/04/05

Jasmine Court Nursing Home 19/11/04

Similar services:

Fairfields Country Rest Home

Queensmount

Poldhu

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Jasmine Court Nursing Home 13 Park Place Weston Super Mare North Somerset BS23 2BA Lead Inspector Carrolle Wise-Scanlan Announced 10 October 2005 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 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. Jasmine Court Nursing Home D53-D02 S61537 Jasmine Court Nursing Home V247243 101005 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Jasmine Court Nursing Home Address 13 Park Place Weston Super Mare North Somerset Bs23 2BA 01934 622028 01934 626100 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) Charis House Limited Mrs Christine Cynthia Grist Care Home 24 Category(ies) of OP - Old Age (24) registration, with number of places Jasmine Court Nursing Home D53-D02 S61537 Jasmine Court Nursing Home V247243 101005 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home may provide nursing care for up to 24 service users over the age of 65 years (OP). 2.Staffing Notice dated 09/10/1998 applies. 3. Manager must be RN on part 1 or 12 of the NMC register. 4. Jasmine Court may provide nursing care for one named person, as per variation application 26/04/05, aged 56 years and over until such time that the named person reaches the age of 65 years or ceases being at the home. Date of last inspection 27th April 2005 Brief Description of the Service: Jasmine Court is a nursing home providing accommodation for 24 residents.It is located close to Weston-Super-Mare sea front with its lounge and patio garden area having a very pleasant view of the sea. The shops and local amenities are close by, within walking distance of less than a few minutes. The home has a passenger lift and a stair lift allowing access to all floors. It has a front garden in the form of a patio garden for its residents. Jasmine Court Nursing Home D53-D02 S61537 Jasmine Court Nursing Home V247243 101005 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection, which took place over eight hours. The inspector sough the views of six residents and they were all complimentary about the care they received. Three care staff and two visitors were also consulted. The commission received feedback cards from seventeen relatives/visitors to the home. In respect of being satisfied with the overall care provided all comments received were positive. Several chose to comment further and included such comments as; the home has a ‘cheery atmosphere’, ‘I wish to highly praise the staff’ and that there are ‘usually’ sufficient staff on duty. Thirteen comment cards were received from the residents again giving generally positive views about the home. Three residents commented that activities could be improved. Staff had sat with several of the residents writing down their views and had completed the feedback on their behalf. The pre inspection documentation completed by the registered manager gave valuable information with regard to various aspects in the running of the home. The random checks made against the pre inspection record verified good practice. Several records required to be kept by the home were randomly selected and reviewed. A ‘case tracking’ methodology was used by the inspector. What the service does well: What has improved since the last inspection? Since the last inspection the medication administration procedures with regard to ‘Homely remedies’ has improved. The visiting General Practitioner has agreed a list of medications with guidance on its use, which the staff hold on file and refer to. The registered manager has completed the homes ‘Fire risk assessments’ and discussed these with the homes staff. Jasmine Court Nursing Home D53-D02 S61537 Jasmine Court Nursing Home V247243 101005 Stage 4.doc Version 1.40 Page 6 In the lounge area the television has been replaced with a larger wide screen version for the residents to enjoy. There is brighter lighting in the lounge areas with new decorative wall lights. In several of the residents rooms there are new televisions. Those care plans reviewed contained sufficient detail to enable staff to safely look after the residents care needs. The home has replaced the old tumble dryer by purchasing a new one enabling staff to attend to the residents laundry needs. 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. Jasmine Court Nursing Home D53-D02 S61537 Jasmine Court Nursing Home V247243 101005 Stage 4.doc Version 1.40 Page 7 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 Standards Statutory Requirements Identified During the Inspection Jasmine Court Nursing Home D53-D02 S61537 Jasmine Court Nursing Home V247243 101005 Stage 4.doc Version 1.40 Page 8 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 standard(s) 1, 2, & 3. The home provides sufficient information for prospective residents to make an informed choice to live here. Assessments are undertaken to ensure that the home can safely meet the resident’s needs. EVIDENCE: The home has produced a new brochure for its prospective residents containing several internal and external photographs, these are offered to all enquirers. A copy of the service user guide and statement of purpose lies in the reception area of the home and copies are offered to residents or their representatives. Residents receive copies of the homes terms and conditions or contracts and records sampled demonstrated good practice. Good practice was also observed in assessing resident’s needs prior to admission to the home. Several residents recalled meeting with the matron, Mrs Christine Grist, prior to moving in. The residents met during the inspection had been assessed whilst in hospital. They said they were generally unfit to Jasmine Court Nursing Home D53-D02 S61537 Jasmine Court Nursing Home V247243 101005 Stage 4.doc Version 1.40 Page 9 visit the home prior to moving in but that their families or friends had done so on their behalf. Residents felt that they had enough information for them to make a choice about living here. Jasmine Court Nursing Home D53-D02 S61537 Jasmine Court Nursing Home V247243 101005 Stage 4.doc Version 1.40 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 standard(s) 7, 8, 9 & 10 Residents care plans set out the care to be provided by the staff and are evaluated monthly. Including the social aspects of care would improve these further. More accurate recording of the ‘as required’ medications onto the Medication Administration record is needed but otherwise medication procedures continue to improve and are robust. EVIDENCE: During the course of the day the inspector noted that there were very few residents who chose to remain in their rooms following breakfast and receiving their personal care. A few residents were reading, one completing a crossword, the majority were relaxing and watching some television in the lounge. Many said they enjoyed the company of the other residents in the lounge area and it gave them an opportunity to meet others. There were a few frail and less mobile residents who appeared relaxed and were enjoying the sea-front view. One said that ‘its lovely sitting outside on the patio area, (when its not so windy) watching people’. Jasmine Court Nursing Home D53-D02 S61537 Jasmine Court Nursing Home V247243 101005 Stage 4.doc Version 1.40 Page 11 Residents gave positive reports of the care they received and of how the staff met their individual care needs. One resident said, ‘I feel so much better since I’ve come to live here. I am now more independent than I thought I would ever be again, thanks to the staff’ ‘Case tracking’ residents care plans verified good practice in recording the care provided and these are evaluated at least monthly. However, including the identified social need preferences and planning how to meet these needs could improve care planning further. A risk assessment for each resident in accommodation, which includes a balcony area, is needed. There was an easy manner and appropriate banter noted between the residents, staff and visitors. There were very few call bells heard during the inspection and the staff answered those heard promptly. Residents felt that their privacy and dignity was preserved. Examples were given of staff ensuring that their private room doors were closed during personal care and that their visitors are received in the privacy of their room should they wish it. Pharmacy Plus supply medication to the home in the form of blister packs. The ‘homely remedy’ procedure and documentation has been significantly improved with written instructions in place. The ‘as required’ medication stock as written on the Medication Administration Record needs further improvement and should reflect the actual stock in the home for the resident. At the time of the inspection there were no residents who had chosen to self-medicate. Jasmine Court Nursing Home D53-D02 S61537 Jasmine Court Nursing Home V247243 101005 Stage 4.doc Version 1.40 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 standard(s) 12, 13, 14 Residents were able to participate in some social and recreational activities. The home needs to take further account of their views regarding the activities offered and plan to meet their social needs. Residents are encouraged to maintain their independence in so far as they are able. Residents continue to have the choices to maintain contact with the local community and family and friends. EVIDENCE: Several residents met during the inspection said that they enjoyed the activities offered by the home but would like more of them. On the day of the inspection a member of the staff team had organised ‘bingo’. The majority of the residents enjoy events such as bingo and musical entertainments. A few residents suggested more one-to-one activities or to go out in smaller groups to the promenade or to the shops on outings as something they would enjoy. The resident’s religion is taken account of and various church representatives have visited the home. The home notes the activities offered and those who attend which is good practice. Staff felt that the residents would benefit from further activities in the later part of the afternoon before their evening meal. Jasmine Court Nursing Home D53-D02 S61537 Jasmine Court Nursing Home V247243 101005 Stage 4.doc Version 1.40 Page 13 It was acknowledged by the matron that the homes activity events had been lacking over the summer months. A recent purchase for the social activities afternoons was that of ‘musical chairs’ but it had not yet been used. The inspector suggested that the staff survey the views of the current residents and plan to meet their social needs. Resident’s friends and family are welcomed into the home at any reasonable time and the home has an open visiting policy in place. Residents are encouraged to maintain contact with their friends and any local community ties they may have. This was further evidenced in a care plan in which travel arrangements and risk assessments were in place to safeguard the resident. Jasmine Court Nursing Home D53-D02 S61537 Jasmine Court Nursing Home V247243 101005 Stage 4.doc Version 1.40 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 standard(s) 18 Staff receive training in adult abuse awareness and there are policies in place. EVIDENCE: Staff demonstrated awareness of adult protection issues. The staff were alert to the reporting mechanisms in place within the home and of the policies such as ‘whistleblowing’. Staff had every confidence that any concerns raised of this nature would be taken seriously and acted upon promptly. The qualified Nursing staff were clear about what they would do should an incident occur. Several staff had received training in abuse awareness and the care staff had further training during their NVQ course. Jasmine Court Nursing Home D53-D02 S61537 Jasmine Court Nursing Home V247243 101005 Stage 4.doc Version 1.40 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 standard(s) 19, 20, 22, 23, 24, 25, 26. Residents continue to benefit from a pleasant and comfortable environment. EVIDENCE: All areas of the home are pleasantly decorated and furnished to a good quality. It presents as clean and tidy and the only smells were that of ‘home cooking’ during meal times. The home is arranged over three floors. A passenger lift provides access and there is a wheelchair accessible chair lift provided for the third floor. The communal space is arranged over the ground floor with a large open plan lounge area. One side of the lounge has glazed patio doors, which allows great views over the sea front and leads onto a patio garden area with seating. There is a pleasant separate dining room. This room when not used for dining is screened off for use by the homes hairdresser. The home can accommodate twenty-four residents, with several of the private rooms having ensuite facilities. Since the last inspection the proprietor has Jasmine Court Nursing Home D53-D02 S61537 Jasmine Court Nursing Home V247243 101005 Stage 4.doc Version 1.40 Page 16 purchased several new televisions for the residents rooms. The fire panel has been replaced and three further fire door guards to further safeguard the residents. Corridors have grab rails and radiators are covered with low temperature guards for the safety and comfort of the residents. One residents’ room had an ensuite shower room, which was not being used and needed updating. A few of the window restrictors needed some maintenance, as did a residents’ windowsill. The registered manager said she would look into getting the repairs done as quickly as possible. Residents had personalised their rooms with their own belongings, such as pictures and photographs giving them a homely feel. Several residents brought their own lounge chairs with them when they moved in, individualising their rooms. The laundry is housed on the homes grounds but not within the home. The staff sometimes use the fire escape to access to the laundry area. Care is needed to ensure that the home remains secure should this route be used. The proprietor has also purchased a new tumble dryer which lies in the laundry room. There was evidence of the use of alcohol gel for additional hand washing throughout the home and good practices regarding use of aprons and gloves were observed. Jasmine Court Nursing Home D53-D02 S61537 Jasmine Court Nursing Home V247243 101005 Stage 4.doc Version 1.40 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 29 & 30 Resident’s benefit from the consistency of care received from the staff team. Although recruitment procedures are generally thorough they need to improve further to ensure that residents are safeguarded. EVIDENCE: Residents have developed a good rapport with the carers and nursing staff. The home uses a ‘Named nurse’ and ‘keyworker’ system in which residents have an allocated carer who is their ‘keyworker’ who reports to the qualified nurse ‘named nurse’ regarding the day to day care events. Staff have regular team meetings and a ‘handover’ in which any particular communication about changes in care provision or events such as hospital appointments etc are discussed and planned for. The staff receive various forms of training, some of which is via educational training videos. Others include in-house lectures with handouts and questions, distance learning on topics such as infection control and attendance at training days offered by the Primary Care Trust (PCT). The induction currently consists of two days orientation and then an induction of four to six weeks duration, which the registered manager said she would be revamping to conform to changes in ‘Skills for Care’. Jasmine Court Nursing Home D53-D02 S61537 Jasmine Court Nursing Home V247243 101005 Stage 4.doc Version 1.40 Page 18 Mandatory training is monitored to ensure that staff attend training sessions for example on fire and manual handling. Each staff member has his or her own training file within his or her personnel folder. Staff attended a study day on ‘Dementia and Behaviour’ recently which they found very useful and they feel this will benefit the residents in their care. Twenty percent of the staff are NVQ level two qualified currently. There are six staff currently enrolled on NVQ training at either Bristol or Weston College and four staff have up to date first aid qualifications according to the pre inspection questionnaire. Staffing at the home includes four Enrolled Nurses, two Registered General Nurses and the Registered Manager. There are nine care assistants and one senior care assistant. The care assistant staff group has stabilised since the last inspection and there was a notable improvement in staff morale. However the first level qualified staff group who appear to be more transient currently. Staff personnel records were generally in good order. The records to be kept by the home however include a Criminal Record Bureau (CRB) check and a Protection Of Vulnerable Adults (POVA) check. These are not transportable between homes unless part of the same group of homes. Jasmine Court Nursing Home D53-D02 S61537 Jasmine Court Nursing Home V247243 101005 Stage 4.doc Version 1.40 Page 19 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 34, 35, 36, 37 & 38. The home is being well managed a more open culture is being developed in the best interests of the residents. EVIDENCE: Mrs Christine Grist is the registered manager at Jasmine Court. She is an experienced Registered General Nurse who has recently, successfully, achieved the Registered Manager Award. In her role as Matron at Jasmine Court she demonstrates a strong leadership style and is well respected by the residents, staff and visitors alike. The residents find matron approachable willing to help and an easy person to discus ‘things’ with. The staffing structure of the home is well understood by the residents. One resident remarked that they preferred the ‘new dress uniforms’ that the staff now wear. Staff remarked that there was a lack of understanding and appreciation at times between each other about their various roles and Jasmine Court Nursing Home D53-D02 S61537 Jasmine Court Nursing Home V247243 101005 Stage 4.doc Version 1.40 Page 20 responsibilities. The inspector suggested that this might be something they could discus further at one of the staff meetings. The appointed deputy manager is a very experienced enrolled nurse who is considering the conversion course. In the interim in the event of the full time need to deputise in the role a first level nurse on the team is designated to be ‘on call’. The residents or their families take care of their own financial affairs. The home does safe keep for those residents and families who wish it the residents ‘personal allowances’ or ‘pocket monies’. These are kept in a lockable safe with restricted access to the keys. The accounting records for these monies were randomly checked during the inspection and found correct with clear debit and credit records with signatures. The staff personnel files seen contained staff appraisal records and supervision dates recorded. The registered manager has also attended a training course on supervision. Residents care plans and records are stored appropriately in a lockable office, which houses lockable metal filing cabinets. Fire drills and fire safety training are undertaken with fire risk assessments recently completed by the registered manager. Regulation 26, auditing of service provision visits, which are completed by the proprietor, are currently undertaken on a monthly basis. These could be developed further and contain more detail. Jasmine Court Nursing Home D53-D02 S61537 Jasmine Court Nursing Home V247243 101005 Stage 4.doc Version 1.40 Page 21 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 x COMPLAINTS AND PROTECTION 3 3 x 3 3 3 3 3 STAFFING Standard No Score 27 3 28 2 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x 3 2 x x 3 3 3 3 2 Jasmine Court Nursing Home D53-D02 S61537 Jasmine Court Nursing Home V247243 101005 Stage 4.doc Version 1.40 Page 22 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 OP9 Regulation 13(2) Requirement Timescale for action 10/11/05 2. 3. 4. OP38 OP38 OP29 13(4) 13(4) Sch2 The stock of as required medication stock as written on the MAR sheets must reflect the actual stock. Risk assessments to be 10/11/05 completed on the residents whose room has balcony access. Residents ensuite shower room 10/01/06 should be fit for use. CRB checks and POVA checks are 10/11/05 to be undertaken prior to commencing employment. The CRB is not transportable between homes unless part of the same group of homes. It is good practice for the home to have a recruitment procedure which can demonstrate is based on equal opportunities. 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. 2. Refer to Standard OP28 OP31 Good Practice Recommendations NVQ training for the care staff to meet the target of 50 . Staff roles and responsibilities should be clear and D53-D02 S61537 Jasmine Court Nursing Home V247243 101005 Stage 4.doc Version 1.40 Page 23 Jasmine Court Nursing Home understood by all staff. Jasmine Court Nursing Home D53-D02 S61537 Jasmine Court Nursing Home V247243 101005 Stage 4.doc Version 1.40 Page 24 Commission for Social Care Inspection Riverside Chambers Castle Street Tangier 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. 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