Inspection on 12/09/07 for Jasmine House

This inspection was carried out on 12th September 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Jasmine House 11/01/07

Jasmine House 16/01/06

Jasmine House 18/05/05

Jasmine House 05/01/05

Jasmine House 28/07/04

Jasmine House 12/09/03

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Jasmine House Jasmine House 1a Upherds Lane Ely Cambridgeshire CB6 1BA Lead Inspector Mr Neil Fernando Key Unannounced Inspection 12th September 2007 10:30 Jasmine House DS0000033483.V350546.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 House DS0000033483.V350546.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 House DS0000033483.V350546.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Jasmine House Address Jasmine House 1a Upherds Lane Ely Cambridgeshire CB6 1BA 01353 662261 F/P 01353 662261 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) www.cambridgeshire.gov.uk Cambridgeshire County Council Care Home 6 Category(ies) of Learning disability (6), Learning disability over registration, with number 65 years of age (1) of places Jasmine House DS0000033483.V350546.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. One named person over 65 years of age in the category LD(E) Date of last inspection 11th January 2007 Brief Description of the Service: Jasmine House provides a long-term home to up to six service users with a learning disability. It is owned and operated by the local authority. Some of the service users have associated physical disabilities. The home is situated close to the centre of Ely, and within walking distance of the city centre. Service users are encouraged to use the nearby local facilities. The accommodation is on two floors, with one ground floor bedroom and communal facilities, and the remaining five bedrooms on the first floor. There is a lift to facilitate access to the first floor. The local authority operates the service, with contractual arrangements in place with the local learning disability partnership. The fee levels vary depending on the needs of individuals accommodated; the current fees for the services range between £62.35 and £94.45 per week. A copy of the last inspection report was in the office and available to residents and families. Jasmine House DS0000033483.V350546.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced key inspection took place on the 12 September 2007. The inspection lasted for just under 5.5 hours. At the time of the visit there were five people accommodated, including one person at hospital. The inspector had an opportunity to speak to two people, five members of staff including the unit administrator and acting Manager. We had a look round the building, checked some of the records the home must keep and observed staff care practices. Comment cards have been left at the home for residents and relatives, to seek their views and experiences about the service. The Annual Quality Assurance Assessment has also been left for the Manager to complete. These were not available at the time of the inspection; any feedback would be included in the next inspection report as appropriate. The registered manager retired at the end of April 2007 and because of the uncertainty over the future of this service, a permanent manager has not been recruited. Various options are being considered and a decision is expected from the local authority by October 2007. As an interim arrangement, the registered manager of another service has been appointed to provide management cover for two days weekly. The manager was present for part of this inspection. What the service does well: What has improved since the last inspection? Three of the four requirements made following the previous inspection in January 2007 have been implemented to good effect. Arrangements are in Jasmine House DS0000033483.V350546.R01.S.doc Version 5.2 Page 6 place for all residents to have a review of their care completed by a care manager. Daily activities and entertainment has provided a good level of stimulation and interest for residents. The residents spoken to were very positive about the service, staff team including the acting manager. Their comments have been included in the text of the report. Relief staff have been recruited to fill vacancies on a short term basis, whilst the future of the service is being considered. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Jasmine House DS0000033483.V350546.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Jasmine House DS0000033483.V350546.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 1, 2 & 3 People who use this service experience good quality outcomes in this area. The home ensures it can meet people’s needs by getting detailed information about new residents before they are offered a place at Jasmine House. This judgement has been made using a range of evidence, including a visit to this service. EVIDENCE: Two residents who were spoken to said that they had visited Jasmine House before moving in. Both people said that they liked living at this home. Staff members spoken with were clear that any prospective resident and their family would be fully supported by the care staff team, in order to enable them decide if the home is suitable to meet their needs. The last admission to Jasmine House was in December 2006 and the care file of this person was viewed. The home had made sure they had gathered detailed information about this person’s needs before they were admitted. A comprehensive assessment of needs was also available from the person’s care manager (social worker). Records provided detailed information about the arrangements to support that individual as they came for day visits and they settled in. Following admission, staff continued to review and make Jasmine House DS0000033483.V350546.R01.S.doc Version 5.2 Page 9 adjustments to the assessments they had made as they got to know the person concerned. Jasmine House DS0000033483.V350546.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6, 7 and 9 People who use this service experience good quality outcomes in this area. The people who live at Jasmine House receive the support they need to make decisions about how they wish to lead their lives. This judgement has been made using a range of evidence, including a visit to this service. EVIDENCE: Information collected shows that the resident’s care plan is drawn up from a range of assessment of needs including care manager’s reports, input from family and friends, staff’s on going assessment and contributions from any other professionals. The care plans for two people using the service were seen; each person has a very detailed person centred care plan, which identifies how they would like their individual needs to be met. The information had been kept up to date and reflected what two people using the service and staff had told the inspector Jasmine House DS0000033483.V350546.R01.S.doc Version 5.2 Page 11 about the support being provided. ‘We always do what we like; staff spend times talking to me and I like this’ said one resident. Annual reviews for four of the residents have been completed and records show that a date had been arranged for the outstanding review to be held shortly. It is clear from the manager and staff that they seek to involve residents in all aspects of their care, but this should be better documented. For example, obtaining the resident’s signature in their care plan where appropriate, would demonstrate their participation. Where risks have been identified residents and staff have information about how this can be managed. There is evidence that individuals are involved and given support to understand the reason specific risk reduction strategies are used to promote their safety and improve the quality of their lives. Risk assessments had been carried out for all residents but two of these require updating. Jasmine House DS0000033483.V350546.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 16, and 17 People who use this service experience good quality outcomes in this area. The home provides a familiar range of activities and services that are based upon the individual needs and wishes of the service users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home aims to create a relaxed atmosphere. Details of group activities are well advertised and staff members also remind individuals before an event is due to take place. The level and variety of recreational activities has improved since June 2007 due to two relief staff joining the team, thus providing an extra ten hours of care per week. This has meant that additional support is available to assist residents with their appointments without the risk of having to cancel any leisure activities arranged for other people. The care records viewed confirmed that the services available reflected the needs of each individual in relation to their interests, abilities and age. Where Jasmine House DS0000033483.V350546.R01.S.doc Version 5.2 Page 13 individuals had identified through one to one discussion with staff that they wanted different things to do, the care records confirmed the action being taken to address this. Individual needs associated with culture and diversity are identified through assessments, reviews and one to one discussion with residents. The menu viewed included good variety, the provision of good nutrition and choice. The residents spoken with echoed a high level of satisfaction about food offered to them – ‘It is very good’ and ‘Excellent’, they said. Residents are proactively encouraged to maintain social contact with family and friends. People can receive their visitors in private and there are no strict visiting times. Jasmine House DS0000033483.V350546.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 18, 19 and 20 People who use this service experience good quality outcomes in this area. The residents at Jasmine House are provided with good support to make decisions about their health and lifestyle, which may have an effect on their quality of life. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The way in which personal care should be provided was recorded in the care plans. This had been reviewed on a regular basis and amended as the needs of the resident changed. This information was shared with the care staff to ensure that people had continuity of care and so that care was provided in a manner familiar to them. Files showed when there had been contact with health and social care professionals and what advice had been given. The people currently accommodated at Jasmine House are unable to manage their own medication. There are safe systems in place to support residents who take prescribed Jasmine House DS0000033483.V350546.R01.S.doc Version 5.2 Page 15 medication to ensure it is stored and given in line with the GP’s written instructions. The staff who administer medication have undertaken training and their competency has been assessed and is kept under review. Jasmine House DS0000033483.V350546.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 22 and 23 People who use this service experience good quality outcomes in this area. Residents know that their concerns will be addressed; all staff have received training in safeguarding adults and this will help them to ensure that residents are safe from harm. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is a good complaints procedure in place. Two people we spoke with said they would be able to speak with any member of staff, if they had any concern. “I am very comfortable here and would not like to change anything”, stated one person; another person said that “good support” is available and that they are “very happy” at this home. Staff who spoke with us had a good understanding of what to do if anyone raises a concern. There had been one complaint since the last inspection. The parent of a resident complained that they were concerned about the future of Jasmine House and its possible adverse effect on the welfare of their relative. The acting manager stated that a senior operational manager from the local authority is dealing with the matter. Staff have received training in safeguarding adults. All four members including the unit administrator demonstrated a good understanding of the procedure for reporting any concerns or events, which may affect the safety or welfare of any person living at Jasmine House. There is currently one adult protection Jasmine House DS0000033483.V350546.R01.S.doc Version 5.2 Page 17 matter concerning an allegation made by one resident against a person with a learning disability, living in the community. This matter has been referred to the appropriate safeguarding team to deal with. Jasmine House DS0000033483.V350546.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 24 and 30 People who use this service experience good quality outcomes in this area. Although Jasmine House offers its residents a clean and safe environment, some redecoration work is required. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The building is spacious and airy, with single bedrooms provided to each person. All bedrooms seen are well personalised to reflect the tastes and interests of the occupants, with gadgets, pictures and hobby materials. Furniture and fittings in all areas viewed including the dining room and lounge are of a domestic type and of good quality. However, the paint has come off in some parts of the building and requires redecorating. This is a requirement that remains outstanding since 31 March 2007. The Manager said that refurbishment work identified had not been undertaken mainly because of the uncertainty about the future of the service. Jasmine House DS0000033483.V350546.R01.S.doc Version 5.2 Page 19 There is a good size garden to the back of the building, which is managed by staff and some residents. Residents spoken with on the day stated - “We do really enjoy the garden”. A good standard of cleanliness was evident throughout those areas we viewed. There were no offensive odours present. The laundry facility is suitable and adequate for the people in residence. There are infection control policies and procedures in place. The storage and collection of domestic and clinical waste is satisfactory. Health and safety matters were being attended to; there were no health hazards noted. Jasmine House DS0000033483.V350546.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 32, 33, 34 and 35 People who use this service experience adequate quality outcomes in this area. The existing staff team are dedicated, competent and committed to improving the quality of care. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is a minimum of two members of care staff on duty between 7:30 am and 10 pm to support six residents. There is one waking night staff with a member of staff providing an on-call facility each night. The home had three care staff on duty on the day of inspection. Scrutiny of the duty rota showed the minimum staffing levels to be maintained. Staffing levels are therefore adequate. Care staff vacancies have remained unfilled for a while, due to the uncertainty of the future of this service. The manager said that permanency could only be considered once the future of Jasmine House has been decided; a decision is expected from the local authority by October 2007. A review of the staffing arrangements had been carried out resulting in three relief staff, including a Jasmine House DS0000033483.V350546.R01.S.doc Version 5.2 Page 21 senior joining the team. They provide a total of 18 hours input per week since June 2007. This has meant staff being available to assist with appointments and various activities for residents. The unit administrator’s time has also been increased from two to three days weekly. Positive interaction between residents and staff was observed during the visit. Staff were on hand to assist where required but also felt able to give residents the opportunity to follow their own routines and preferences. Both residents said staff treated them well. One person stated that “They are very good” and another, “Very helpful and good”. The recruitment files for two staff were scrutinised and these were found to be in order, except for the CRB check certificate not being available in one case. It is however positive to note that all members of staff spoken to reported that they have had their CRB checks completed. Staff said that training level has improved since June 2007. All staff receive regular supervision sessions from the acting manager to enable them to discuss the running of the home and their own professional practice. Jasmine House DS0000033483.V350546.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 37, 39 and 42 People at Jasmine House experience adequate quality outcomes in this area. Whilst the interim management arrangements remain adequate the long-term future of the service must be decided upon quickly, in order to minimise any adverse effects on residents and staff. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager retired at the end of April 2007. Considering the uncertainty over the future role of the service, the local authority decided not to appoint a full time permanent manager until such time various options have been explored. As an interim arrangement, an acting manager (a registered manager for another service) has been in post for two days per week. Jasmine House DS0000033483.V350546.R01.S.doc Version 5.2 Page 23 The manager said that he is working closely with the staff team through regular visits to the home, attending staff and resident meetings, and supervision with individual staff. He has also attended a couple of review meetings for residents. Staff said he is supportive, approachable and he is clearly committed. He is also well supported by the operations manager. The morale of staff members has improved tangibly. Monthly visits by the proprietor to ensure appropriate standards are being maintained had not occurred for about four months, which is not acceptable. A senior manager has started visiting since July 2007 and a report of the monitoring visit carried out was available at the home. However there is no formal quality monitoring system that involves canvassing the views of all interested parties such as residents, relatives, social workers and significant other professionals. This should be developed, perhaps using questionnaires and any feedback received taken into account when planning developments to the service. A number of records in relation to health and safety were viewed (including fire, emergency lighting, lift, fridge/freezer and hot water temperatures, and electrical appliances): these were all up to date and in good order. Records viewed showed that staff had undertaken training in moving and handling, infection control, food hygiene and fire safety. Cleanliness in the kitchen was good and all foodstuffs were stored correctly. Jasmine House DS0000033483.V350546.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 3 2 3 3 3 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 x 32 3 33 3 34 2 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 x 2 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 x 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x 2 x x 3 X Jasmine House DS0000033483.V350546.R01.S.doc Version 5.2 Page 25 YES 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 YA9 Regulation 13 (4) Requirement Risk assessments must be reviewed and updated, in order to promote residents’ welfare. A programme of redecoration must be carried out. (This requirement remains outstanding since 31/03/07) Staff recruitment files must include all documents as detailed in Schedules 4.6 of The Care Homes Regulations 2001. There must be an effective quality monitoring system based on seeking the views of the service users, their representatives and other stakeholders, for the purpose of reviewing and improving the quality of care. Timescale for action 30/11/07 2. YA24 23(2)(b) 31/12/07 3. YA34 17 (2) 15/11/07 4 YA39 24 31/12/07 Jasmine House DS0000033483.V350546.R01.S.doc Version 5.2 Page 26 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 Residents should sign their care plan where appropriate, in order to demonstrate their participation. Jasmine House DS0000033483.V350546.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Cambridgeshire & Peterborough Area Office CPC1 Capital Park Fulbourn Cambridge CB21 5XE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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