Inspection on 21/08/08 for Jasmine House

This inspection was carried out on 21st August 2008.

CSCI found this care home to be providing an Poor service.

The inspector found no outstanding requirements from the previous inspection report, but made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Jasmine House 18/02/09

Jasmine House 14/09/06

Jasmine House 06/12/05

Jasmine House 14/07/05

Jasmine House 09/12/04

Jasmine House 10/06/04

Jasmine House 04/12/03

Similar services:

The Maypole Nursing Centre

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Briars

Extracts from inspection reports are licensed from CQC, this page was updated on 23/11/2008.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Jasmine House 7 Pensclose Witney Oxfordshire OX28 6EG     The quality rating for this care home is:   zero star poor service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Ruth Lough     Date: 2 1 0 8 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Jasmine House 7 Pensclose Witney Oxfordshire OX28 6EG 01993 702860 Telephone number: Fax number: Email address: Provider web address: peacockgeorge@hotmail.com Name of registered provider(s): Name of registered manager (if applicable): Type of registration: Number of places registered: Mrs Margaret Peacock,Mr George Peacock Mrs Margaret Peacock care home 3 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: 0 Over 65 3 Date of last inspection Brief description of the care home Jasmine House is a family run home. The registered proprietors are Mrs Margaret Peacock and her son, Mr George Peacock. Mrs Peacock is the main carer and Mr Peacock deals with administration. Mrs Peacock?s husband also lives in the home. Jasmine House is situated on the edge of Witney in an attractive residential area and admits up to three male and female residents aged from 65 years. The residents share two lounges, a dining room and conservatory with the family. There is one bedroom on the ground floor with en-suite facilities consisting of toilet, washbasin and shower for a resident. On the first floor there are two further bedrooms for residents and two for family members. A bathroom with a washbasin, toilet and domestic bath is also situated on the first floor shared by the family and residents. The home does not have a lift and this means that residents must be able to climb the stairs unaided to be able Care Homes for Older People Page 4 of 28 to live in the home. There is an attractive garden with good access from the conservatory. The fee is #342.00 per week. Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: zero star poor service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This was a key inspection process to assess the quality of the service and the outcomes for the people who use it. This inspection included reviewing information provided by the service prior to an unannounced one- day day visit to the home. Any information that the commission has received since the last inspection in 2006 has been taken into account in this inspection process. During the day visit to the service the records for care planning, recruitment, and the administration of the home were assessed. We also consulted with the two current residents and a visiting relative in regard to obtaining their opinion of the services Care Homes for Older People Page 6 of 28 provided. From this visit a number of requirements were made to ensure that the people living in the home are protected from possible harm or risks to their safety. Recommendations were also given to the Responsible Individual, Mr George Peacock, as to assist with improving the quality of the service. Some of these can be found in the body of evidence in this report. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line – 0870 240 7535. Care Homes for Older People Page 8 of 28 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The needs of the individual are assessed before they are offered a place in the home. Evidence: The home provide prospective residents with information about the service in the Statement of Purpose and Service User Guide. The assessment records for the two residents currently living in the home were reviewed to see how their needs had been identified before a decision to admit them to the home is taken. Through discussion with the most recently admitted resident it was apparent that they had been given the opportunity to visit the home before deciding that this was where they wanted to live. This was confirmed by a visiting relative to whom we spoke to during the day visit to the service. There were no records to reflect the outcomes of the pre- admission visits by the individual before they came to live in the home. Care Homes for Older People Page 10 of 28 The assessment records show that the key questions are asked including information about their physical health and mental well being. However, the detail of the information is not in great depth and could of been expanded to give a better picture of the person concerned. Care Homes for Older People Page 11 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The current needs of the people living in the service are met. Evidence: The care records for both people in residence were reviewed. These documents included a summary of the key areas in the assessment record. Closer examination of these documents showed that there is very little specific information of how they are providing the personal care and support to the individual. Through discussion with the Responsible Individual, Mr George Peacock, it was apparent that help with personal care is carried out by the Responsible Individual and Registered Manager, Mrs Peacock. Very rarely that these tasks are carried out by another carer. The residents did confirm that they had the assistance when they needed it. Care Homes for Older People Page 12 of 28 Very little had been recorded in the care records about the personal mobility and the risks to the individuals health and safety had not been assessed. There should be at minimum a moving and handling risk assessment that incorporates using the stairs and access and use of the bathroom/ toilets. A recommendation had been made during the last inspection process for these to be undertaken. However, this has not been carried out. Other records for care and support included separate documents to log hospital visits and medical treatment. Plus dental, opticians, and chiropody appointments. Some of the handwriting made it difficult to read the detail in these documents. Mr Peacock confirmed that he took the lead in the responsibilities for the medication administration carried out in the home. From information included in the records, both residents had declined to continue carrying out this task for themselves. Information about the persons medication needs and the reason for it being prescribed is recorded in the care records. Any changes to the prescription are logged as and when they occur. Each medication has a separate administration record sheet with the times and doseage noted at the top of the document. The records seen appear to be accurate but the handwriting is poor. Both residents medications are provided in individual dispensing bottles or packages from the local pharmacy. All of the medications are stored in a lockable domestic bathroom cabinet in the single toilet upstairs. This area is really not appropriate for storing medications. The policy and procedure for medication administration is brief and has the bare minimum of instruction included. Mr Peacock confirmed that neither residents had been prescribed medications that should be held securely under the Misuse of Drugs (Safe Custody) Regulations 1973. He was advised to obtain a copy of the new guidence from the Royal Pharmacutical Society,The Handling of Medicines in Social Care, as to assist with ensuring that the medication adminstration and storage facilities meet with current good practice guidelines. From observation during the day the people living in the home were spoken to respectfully and given privacy in their own rooms to meet with relatives. Information about the individuals personal preferences and choices should their health deteriorates or at the end of their life, has not been sought and recorded in the care plans. This is particularly significant as the care home is not physically adapted to support people who need an increased level of physical care. Care Homes for Older People Page 13 of 28 They do not as an usual practice record the outcomes of the individuals day. A summary of the key points over the last month are noted and written as a chronological list of events as they occur. This is used to identify any changes in care to be provided. Care Homes for Older People Page 14 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. That the people living in the home are given the opportunity to exercise choice over their lives and are supported to maintain their interests. Evidence: The care records did not show much information about the individual such as personal history, interests or pastimes. However, through discussion with Mr Peacock and the residents they clarified that they were enabled to continue with activities such as listening to the radio, watching television, reading, and the their puzzle books. They are supported to go out should they wish and be able to, with the assistance of Mr Peacock or a member of their own family. This is usually short walks, shopping, and visits to the hairdresser. The residents and a relative we spoke to confirmed that their families were made welcome to visit at any time. Again through observation it was evident that the providers had a good understanding of the person concerned as they were able engage in conversation and discussion about their interests. Care Homes for Older People Page 15 of 28 Individuals choices and wishes, although not recorded in detail in the care plan records are listened to and acted upon. An example of this was during the midday meal seen during the day of the visit. One resident prefers to eat alone in the privacy of her room the other enjoys the company of Mr Peacock having his own meal with her. Comments from the residents in the home indicated that they enjoyed the food provided. They did state that they were not involved with the menu planning but that their likes and dislikes were accommodated. Also, if they did not wish for the meal offered alternatives were provided and should they feel hungry between meals, snacks were made available. One resident stated that her biscuit tin in her room was topped up regularly. Individuals weight is monitored monthly and one resident expressed that she now ate well and was pleased that she had managed to regain som weight since her arrival at the home three years ago. Care Homes for Older People Page 16 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who use the service are not protected by the knowledge of staff and the information available in regard to safeguarding them from possible abuse or harm. Evidence: The complaints process is provided to residents in the Statement of Purpose when they arrive in the home. The procedure includes the relevent points including the timescales but is quite brief. We were provided with information that they have had no formal complaints since the last inspection process in 2006 and also that they do not use a method of recording any minor concerns or comments made. Mr Peacock did emphasied that they usually responded immediately to any concerns made, and that this information is noted in the summary care notes made at the end of the month for each individual. The residents we spoke to confirmed that the providers were very approachable and listened if they had any worried or concerns. Comments they made included,Approachable, and,Put things right. During the last inspection process it was identified that the manager and the responsible individual did not have any training in Protection of Vulnerable Adults and Care Homes for Older People Page 17 of 28 they were advised to obtain this. From information provided by Mr Peacock this has not been carried out. The information available in regard to this topic including access to the local interagency procedure were assessed as to see what is in place to guide the manager should a concern be raised. The information was minimal and they could not provide a copy of the relevent procedure for reference should an incident occur. During discussion, Mr Peacock was also not able to provide supporting evidence that they had a good understanding of their responsibilities for this. Care Homes for Older People Page 18 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people living in the home are not protected by the processes in place to reduce the risk of harm through contact with unprotected hot surfaces such as radiators and hot water outlets where they are at risk from burns and scalds. Evidence: The home is not purpose built and is able to accommodate three resident who are mobile and able to use stairs. It does not have the enviroment or equipment to be able to provide support to those who have greater physical disabilities. One residents room with en suite shower and toilet is on the ground floor, off the main sitting room. The other two residents bedrooms plus two further bedrooms used by the providers family are on the first floor. A family bathroom with toilet and a separate toilet shared between all people living in the home are also on the first floor. The resident living in the ground floor room stated that she found the shower in her en suite to high to step up into and she did not have the confidence to use it. The home is kept clean and tidy throughout. There is a programme of redecoration being carried out, and at the time of the inspection the conservatory was in the process of being repainted. Carpets had been recently replaced in the hall, stairs and Care Homes for Older People Page 19 of 28 landing. The risks to people living in the home from hot surface temperatures (radiators) and hot water outlets have not been assessed. This was an area of concern identified during the last inspection period that has not been addressed. There should be a documented assessment of these areas and information recorded about the action taken to prevent residents from burns and scalds from radiators or hot water. Residents said that their clothes were looked after when being washed and ironed and returned promptly to them. The home has a domestic washing machine in the small utility off the kitchen for this purpose. Care Homes for Older People Page 20 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The homes staffing levels meets the needs of the current residents in the home but they could be put at risk through staff not obtaining the necessary training to carry out their roles. Evidence: From documented information provided in the Annual Quality Assurance Assessment and through discussion it was confirmed that there has been no changes in the staff team providing care and support since the last inspection process. There are two main carers who support the people who live in the home. The responsible individual and manager Mrs Peacock, and her son, the other responsible individual. Additional support is obtained very rarely from another family member who does not live on the premises. They do not have a recorded rota of who is on duty to evidence that residence are not left alone without support. According to the information provided by Mr Peacock, none of the people providing support have any formal qualifications in care. We were informed that no training had been undertaken since the last inspection visit in 2006. Care Homes for Older People Page 21 of 28 The records for recruitment were not examined as there had been no changes in the people employed and the records would not give a clear picture of current recruitment practices. The last checks carried out for Criminal records were looked at to see if they have been reviewed. The records seen varied between 2003 and 2004, and none had been revisited. They had carried out an addition Criminal records check for the one other family member living in the home. Care Homes for Older People Page 22 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service is run in friendly homely way and provides a comfortable enviroment that is not necessarily managed in the best interests of the people living there. This is because safe working practices are not always carried out. Evidence: There have been no changes in the management and administration of the home since it was registered over 10 years ago. The administration and management of the home is lead by Mr Peacock and the care provision is the responsibility of Mrs Peacock. The management records for the small amounts of personal money that the home Care Homes for Older People Page 23 of 28 keeps on the residents behalf were reviewed to see what processes are in place and that safe practices are carried out. Any transactions are recorded and any expenditures are noted with receipts kept. Summaries of the account transactions are provided with the receipts on a regular basis back to the families of the residents. A sample of the some of the records for safe working practices were reviewed to see what is in place to protect the health and welfare of the people living in the home. These did include assessing any risk assesments they may have in place. However, as previously identified these had not been carried out for any activity in the home. Through discussion it was identified that basic food safety checks are not carried out. This was in particular reference to monitoring that food is kept at the required temperature and labled when opened. It was observed that care had not been taken to cover food left in the utility of the home. Residents commented that they liked living in the home and that it had a friendly homely atmosphere and they felt well cared for. A member of a residents family who we spoke to during the day expressed confidence in the support provided to their relative. Care Homes for Older People Page 24 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 7 13 That the unnecessary risks to the health and safety of individuals are identified, reduced or eliminated through carrying out risk assessments. You have a duty to ensure that any risks to the people living in home are identified and eliminated. This is particularly relevent to their mobility and bathing. 02/10/2008 2 9 13 That medication is stored in an appropriate secure and hygienic place. You have a responsibility to protect the people living in the home from the risk of possible infection. 02/11/2008 3 18 13 That staff working in the home are provided with sufficient training and knowledge to protect the people who use the service from possible harm or abuse. 21/11/2008 Care Homes for Older People Page 26 of 28 You need to ensure that staff have the necessary training and knowledge to recognise, manage, and eliminate risks of possible abuse or harm to the people living in the home. 4 25 13 Risks to people using the service from hot surfaces(radiators) and hot water outlets should be assessed and reduced. You have a responsibility to protect the people living in the home from risks of burns or scalds if they come into contact with unprotected hot surfaces or hot water. 5 38 13 That the people living in the home are protected by safe food hygiene practices carried out in the home. You should ensure that any food kept in the home is managed in accordance to the requirements for food safety as to protect the people living in the home from infection and risks from contaminated food. 02/10/2008 02/10/2008 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 27 of 28 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 28 of 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!