Inspection on 15/06/05 for Jasmine 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 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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Jasmine House 05/12/06

Jasmine House 12/12/05

Jasmine House 11/01/05

Jasmine House 17/08/04

Jasmine House 20/02/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE JASMINE HOUSE 22 Westcote Road Reading Berks RG3 2DE Lead Inspector Ruth Lough Unannounced 15 June 2005, 9.15 am 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 HOUSE H51-H01-S43986-Jasmine Care-V228002-150605Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Jasmine House Address 22 Westcote Road, Reading, RG3 2DE 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) 0118 9590684 Jasmine Care Ltd Ms Helena Jane Hawkins Care Home (CRH) 40 Category(ies) of Old age, not falling within any other category registration, with number (OP) 40 of places Terminally ill (TI) 6 Terminally ill over 65 years of age (TI(E)) Physical disability (PD) JASMINE HOUSE H51-H01-S43986-Jasmine Care-V228002-150605Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 11 January 2005 Brief Description of the Service: Jasmine House is a medium sized nursing home opened in September 2003 that is registered for 40 residents. The home is two residential Edwardian semi – detached properties that were converted to a care home by previous owners. It is situated in a quiet road just off major road links to the centre of Reading and has easy access by public transport. Jasmine House is one of three homes owned by the company Jasmine Care Ltd. JASMINE HOUSE H51-H01-S43986-Jasmine Care-V228002-150605Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection visit to review the quality of service provided and the outcomes for the service users living there. The inspection visit took approximately 6 hours and involved looking at records, tour of the home and discussions with service users and staff. The Deputy Manager and Senior Nurse were managing the home on the day of inspection as the Registered Manager was attending training to support her role. What the service does well: What has improved since the last inspection? What they could do better: The home needs to improve its management of the health, safety and the control of infection to protect service users and staff. A requirement made in the last inspection for this has not been met. JASMINE HOUSE H51-H01-S43986-Jasmine Care-V228002-150605Stage 4.doc Version 1.30 Page 6 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 HOUSE H51-H01-S43986-Jasmine Care-V228002-150605Stage 4.doc Version 1.30 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 HOUSE H51-H01-S43986-Jasmine Care-V228002-150605Stage 4.doc Version 1.30 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) 2 and 3 The home ensures that service users are given information and terms and conditions for staying in the home and the provision of services. EVIDENCE: The care documents for some service users who have recently been admitted to the home support that a comprehensive needs assessment is undertaken prior to admission to the home. The Manager or Deputy Manager are responsible for this and ensure that consideration is taken to the current service users group before a place is offered. The home offer service users and relatives the opportunity to visit to review the suitability of the services provided. The Deputy Manager and staff welcomed visitors to do this whilst the inspector was in the home. The Manager has developed a leaflet with a summary of the facilities and services provided at the home and the local transport and accommodation to support families and friends to visit their relatives. JASMINE HOUSE H51-H01-S43986-Jasmine Care-V228002-150605Stage 4.doc Version 1.30 Page 9 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) 7,9 and 10 The home has implemented service user care plans that support staff to give a good quality of care. Service users are put at risk as risk assessment for specific identified problems have not been undertaken. EVIDENCE: The care plans reviewed showed that staff are given comprehensive information to provide care in accordance to the assessment of need of the individual. Risk assessment are carried out routinely for moving and handling and skin integrity but the home does not currently implement them for identified problems such as aggression, self medication or diminishing mental health. The Standard for medication was not reviewed fully. Through discussion with a resident the inspector was made aware that protocols for Self- medication had not been fully implemented. A review of the service users care plan indicated that a risk assessment/ agreement for this had not occurred. The service users did have the facilities in their room to lock all medications away safely. JASMINE HOUSE H51-H01-S43986-Jasmine Care-V228002-150605Stage 4.doc Version 1.30 Page 10 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) 15 The service users receive a well balanced diet that they enjoy. EVIDENCE: The service users expressed that the majority of the meals provided were very enjoyable, prepared and presented well. They also expressed that their opinion of their likes and dislikes were taken and time and consideration was spent, by the kitchen staff, to meet these wishes. This was supported by the recorded information that the kitchen staff keep. The kitchen staff have implemented a rolling menu programme of meals that are traditional in content but accommodate service users preferences or nutritional needs as and when required. The service users were complimentary about the provision of cakes by the staff for a service users birthday or a significant celebration. The inspector reviewed the kitchen areas inclusive of the food preparation, storage and dishwashing facilities and observed that the home had implemented changes required during the previous inspection visit. The inspector was concern with current work practices that put staff at risk whist serving and transferring large containers of hot food from the stove and oven area as there was a lack of suitable work-surfaces close by. The trays used to serve food to service users were worn and discoloured and did not assure that they could be cleaned appropriately. JASMINE HOUSE H51-H01-S43986-Jasmine Care-V228002-150605Stage 4.doc Version 1.30 Page 11 The kitchen floor had areas where food debris had gathered and was ‘ sticky’ underfoot in places. The inspector was informed that the proprietor was intending to replace the floor surface as soon as possible in line with the redevelopment plans for the home. The inspector discussed with the kitchen staff and Deputy Manager alternative methods of ensuring that hygiene control is maintained. The kitchen staff informed the inspector that a recent Environmental Health inspection had not indicated any concerns, although a copy of the report was not seen. JASMINE HOUSE H51-H01-S43986-Jasmine Care-V228002-150605Stage 4.doc Version 1.30 Page 12 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) 16 The service users are protected by the homes complaints policy and procedures. EVIDENCE: The home has the necessary policies and procedures and recoding methods for managing complaints. The service users did confirm that complaints are dealt with as and when made but did pass comment that occasionally concerns raised were not always quickly remedied to the satisfaction of the service users. The Manager does not have a system in place to monitor trends for complaints or comments for Quality Assurance processes. JASMINE HOUSE H51-H01-S43986-Jasmine Care-V228002-150605Stage 4.doc Version 1.30 Page 13 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) 26 The home has areas that are not suitable for purpose and are not maintained well and does not ensure that service users and staff are protected fully. Staff are not ensuring that work practices maintaining the prevention of cross infection are carried out. EVIDENCE: The inspector was concerned that the working areas of the kitchen (see Standard 15) and laundry still remain in a poor state in parts. The current practices of storing clean linen for the home in the Laundry area puts the health and safety of staff at risk and compromises the control of infection in the home. All soiled laundry passes the stored clean laundry before it can be placed in the washing machines. Effective cleaning regimes are difficult to carry out in the laundry as there is a lack of space to move bulky storage facilities and equipment around the room. The room houses 2 industrial washing machines, 1 gas tumble dryer and equipment to iron and press clothing. There are poor facilities to dry or air clothing that cannot be placed in the tumble dryer. The staff are not adhering to principles of the prevention of cross infection as clean linen had been left on the dirty laundry skip. JASMINE HOUSE H51-H01-S43986-Jasmine Care-V228002-150605Stage 4.doc Version 1.30 Page 14 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) 27,29 and 30 The staffing level, skills and qualifications almost meet the needs of the service users. EVIDENCE: The Staff rota indicates that there is sufficient skilled and experienced staff on duty at all times. The service users commented that on occasions it was felt that the staff took to long to arrive when called at night. The Deputy Manager informed the inspector that a review of the staffing level at night would be undertaken in light of these comments. The inspector examined recently recruited staff files and found that service users are protected by the recruitment policies, procedures and practices that are carried out. The staff files reviewed indicated that not all staff had undertaken the required mandatory health and safety training necessary. JASMINE HOUSE H51-H01-S43986-Jasmine Care-V228002-150605Stage 4.doc Version 1.30 Page 15 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) 32,36,37 and 38 The ethos of the management team is reflected in the service users enjoyment of living in the home and the staff team who are focussed on providing good care. The management team have not implemented sufficient supervision processes to ensure that staff are competent and confident to carry out their roles. EVIDENCE: The service users expressed that they had confidence in the management team in the home but felt that on occasions they were slow to respond to concerns or queries raised. The staff who spoke to the inspector confirmed that the service users experience of living in the home is of the staff teams prime concern. A full programme of supervision and clinical supervision has not yet been fully implemented and some annual appraisals have been carried out. The Senior nurse informed the inspector that research will be carried out to find the most appropriate process is found for clinical supervision. JASMINE HOUSE H51-H01-S43986-Jasmine Care-V228002-150605Stage 4.doc Version 1.30 Page 16 Records kept for service users care planning have improved in quality since the last inspection, however the lack of risk assessments for specific identified needs have not always been carried out. Standard 38 was partly reviewed. The working practices in the kitchen and laundry area indicate that staff are not always following the principles of safe working and infection control. ( See Standards 15 and 26) The Staff have now put information on display in the kitchen in regard to Control of Substances Hazardous to Health (COSHH) 1988 for all those working there to read. The fridges and freezers have been updated and the staff carry out the required checks on temperature control and food has appropriate labelling. JASMINE HOUSE H51-H01-S43986-Jasmine Care-V228002-150605Stage 4.doc Version 1.30 Page 17 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 x 3 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 x 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 3 COMPLAINTS AND PROTECTION x x x x x x x 1 STAFFING Standard No Score 27 3 28 x 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x x 3 x x x 2 2 2 JASMINE HOUSE H51-H01-S43986-Jasmine Care-V228002-150605Stage 4.doc Version 1.30 Page 18 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 7,9 Regulation 13.2 Requirement Timescale for action Immediate 16/06/05 2. 26,38 23 3. 30,36,38 18 That a risk assessment and suitable strategies for self medication is put in place to protect one service user and others. That risk assessments are 30/06/05 carried out for those service users with specific identified possible risks. That the home implements 30/08/05 changes to ensure that the health, safety and infection control practices are carried out to protect the service users and staff. This was a previous requirement. That a planned programe for 30/09/05 staff to receive the appropriate training and supervision is developed and implemented. 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. JASMINE HOUSE H51-H01-S43986-Jasmine Care-V228002-150605Stage 4.doc Version 1.30 Page 19 Refer to Standard Good Practice Recommendations JASMINE HOUSE H51-H01-S43986-Jasmine Care-V228002-150605Stage 4.doc Version 1.30 Page 20 Commission for Social Care Inspection 1015 Arlington Business Park Theale Berks RG7 4SA 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 HOUSE H51-H01-S43986-Jasmine Care-V228002-150605Stage 4.doc Version 1.30 Page 21 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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