Inspection on 05/12/06 for Jasmine House

This inspection was carried out on 5th December 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 House 12/12/05

Jasmine House 15/06/05

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 Jasmine Care Ltd 22 Westcote Road Reading Berks RG3 2DE Lead Inspector Kerry Kingston Unannounced Inspection 5th December 2006 10:30 X10015.doc Version 1.40 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 DS0000043986.V322000.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 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 DS0000043986.V322000.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Jasmine House Address Jasmine Care Ltd 22 Westcote Road Reading Berks RG3 2DE 01189 590684 01189 585458 jasminecare@btconnect.com 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) Jasmine Care Ltd Mrs Helena Jane Hawkins Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40), Physical disability (2), Terminally ill (6), of places Terminally ill over 65 years of age (6) Jasmine House DS0000043986.V322000.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Service users category TI - not to be admitted under the age of 45 years. Service user category PD - not to be admitted under the age of 40 years. Date of last inspection 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. The home provides care to older people and to some younger people who have serious illnesses that require nursing care. The fees are £527 per week to £880 per week. Jasmine House DS0000043986.V322000.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A routine unannounced site visit took place between the hours of 10.30am and 6.00 pm on the 5th December 2006, to collect additional information to inform the report for the key inspection. The information was collected from a pre-inspection questionnaire, completed by the manager, surveys completed by five of the forty service users, discussions with three staff members, the manager and three service users. Other service users were spoken to and observations of practice were made throughout the day. A tour of the home, service user and other records were also used to collect information, on the day of the visit. As part of this unannounced inspection, the quality of information given to people about the care home was looked at. People who use services were also spoken to, to see if they could understand this information and how it helped them to make choices. The information included the service users’ guide (sometimes called a brochure or prospectus), statement of terms and conditions (also known as contracts of care) and the complaints procedure. These findings will be used as part of a wider study that CSCI are carrying out about the information that people get about care homes for older people. This report will be published in May 2007. Further information on this can be found on our website www.csci.org.uk. The home provides an excellent service and there were no requirements or recommendations made as a result of this key inspection. What the service does well: What has improved since the last inspection? The home continues to develop to make sure that the care of the residents stays at a high standard. Jasmine House DS0000043986.V322000.R01.S.doc Version 5.2 Page 6 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 DS0000043986.V322000.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Jasmine House DS0000043986.V322000.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3 an 6 Quality in this outcome area is good. The home ensures that service users are able to make an informed choice about where they want to live.The home does not admit service users unless it can meet their assessed needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Service User Guide is made available to all service users prior to admission (whenever possible), it contains information about fees, how fees are arrived at, what the home offers, what residents can expect, what is expected of them, a comprehensive complaints procedure and a full description of the home and its’ amenities. Sometimes the Service User Guide is given to relatives or advocates, if they are making decisions on behalf of a service user who is too ill or unable to understand. Two of the three service users spoken to said that they had seen all the information prior to moving into the home and it helped them make the decision (they did not visit prior to admission). One of the three servicve users said that he had not taken much notice at the time but staff had helped him to read it all through when he felt ‘up to it’. Two of Jasmine House DS0000043986.V322000.R01.S.doc Version 5.2 Page 9 the three service users said thay had a copy in their rooms, for reference. One of the three service users said that she had not seen the Guide because all decisions had been made by a relative. The manager confirmed that this was the case as there were specific protection issues around her admission, decisions had, therefore been made by the family and social work team. Five of the five service users’ questionnaires received, noted that they had enough information about the home to enable them to make a choice about whether they wanted to live there. Every resident has a contract (private) or terms and conditions (local authority) these are all signed by service users and ammended as costs change. Two service users confirmed that they had read and signed the statement of terms and conditions, and one said she vaguely remembered signing something and her relative explaining it to her but she wasnt listening. A service user was seen being supplied with a new document that detailed terms and conditions as the fees had changed. He confirmed that staff would go through it with him if he was unsure what it meant. All residents have assessments completed by care managers prior to admission, some included written comments and feelings of the service users (sometimes their families). The home has one respite bed and new assessments are sent through at every visit if the service user’s needs/ circumstances have changed, or a fax confirmatiom is sent by the social work team that the individuals’ needs have not changed since the last visit. The home also do an assessment of need prior to admission and adjust the assessment as the service user settles in. The manager or deputy complete the residential assessments and staff afre being trained to participate in this work. The home places great importance on the assessment of the service users’ needs. Assessments are comprehensive and include all the necessary information to ensure good quality of care can be provided to service users. The admissions policy also includes a six week trial period and the appropriateness of the placement is reviewed after this time. Jasmine House DS0000043986.V322000.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. The home offers exellent standards of health and personal care. The ethos of the home ensures that service users are treated with respect and dignity. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Six care plans were seen, they are comprehensive and include daily notes, supplementary daily notes for specific purposes, long term assessments, psychological needs, personal care needs and chart, bowel movement chart, doctors’ notes, activities chart, nursing assessment and instructions, pressure area assessment, weight chart and an end of life plan if appropriate. The recording is of a good quality and charts are filled in on a daily basis. The records also include choices and how service users are persuaded to take their medication or supported to decide not to. Health care plans and records are excellent and there is evidence of very good relationships with both the primary health care team and the local hospital. The home retains a GP and although service users can keep their own GP. this is not usual. The GP offers an excellent service to the home and to individuals and is available to discuss health issues with relatives, as is appropriate. He visits a minimum of once a week and has a regular monthly meeting with the deputy manager and the Jasmine House DS0000043986.V322000.R01.S.doc Version 5.2 Page 11 nursing team to discuss any ‘end of life’ or health issues. The home has also developed a relationship with the out of hours GP service to ensure that the home can obtain the best care for the service users at all times of the day and night. The GP’s surgery support the home with their end of life programme to ensure service users are comfortable and pain free in their final days. The home is pioneering the Gold Standard Framework for end of life care. Only one service user, currently, has a small pressure sore and the homes service users have no infections. The home has had thirty-five deaths in the past year but approximately 70 (as discussed with the manager and estimated from the records kept) of these have been of service users who have been admitted with a 12-week life expectation. The home records, monitors and analyses the deaths to ensure that service users have received the best possible care prior to the end of their life. The GP commented that the staff team give good and competent care. Medication is stored safely and is administered by the registered nurses, the senior nurse audits all medication administration records monthly. The pharmacist visits every 3 months to audit the system, the manager confirmed that there have been no recommendations made this year. No service user administers their own medications currently, but a policy and risk assessment is available if this was appropriate and chosen by the service user. Care practice, observed evidenced that service users are treated with respect and dignity and the residents were seen to be interacting well with staff and each other. Staff explained clearly how they ensured that they treated people with respect, and how they preserved their dignity during personal and health care procedures. Three of the three service users spoken with confirmed that the staff treat them very well. One service user said that some staff dont always listen carefully enough and seem a bit sharp. The manager is aware of this issue and there was evidence that this is discussed in supervision. Five of five questionnaires commented that staff always listen and act on what they say. The home’s individual care plans ensure hat any equality and diversity issues, needs are addressed. Jasmine House DS0000043986.V322000.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15. Quality in this outcome area is good. The home ensures that service users have a positive daily life experience. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has an acivities programme that is organised by a care worker who is given approximately two hours a day five times a week, to pursue communal and individual activities. Motivation of service users can be an issue. External entertainers are provided for special occasions and on occasions throughout the year. Two young people volunteer one evening a week and spend time with individual service users. A minister of religion of three denominations visit the home throughout the month (three visits a month). The home welcomes visitors who were observed to be very comfortable visiting their relatives and friends in the home, one relative spoken to was very happy with the care being given to the family member. The manager has an open door policy and relatives were observed to be very comfortable to pop in to impart information, or ask for information about their family member. A daily activity log is kept for each service user, one service user has a computer, telephone and television in his room as the computer is his main interest (he is a younger resident).Two of the younger residents are suported to go into the community when they are able and told the inspector Jasmine House DS0000043986.V322000.R01.S.doc Version 5.2 Page 13 that they had plenty to do and they do not get bored, they also said that ‘they are helped to be as independent as they could be’. The home has regular resident meetings and minutes of these are kept. These are used for information giving and recieving residents comments and views, the success of the meetings depends on the resident group at the time. Service users are also given questionnaires to complete about the care they recieve and the manager acts on this information, for example the laundry has been reorganised as a result of service users’ and relatives’ comments that they were not happy with the care of the clothes in the home. Menus are varied and nutritious,fresh ingredients are used and the chef has no resrictions on her budget. The lunch and tea time meals were well presented and attractive. Special meals i.e. kosher are provided, as necessary and service users can have alternatives if they do not want what is on the menu. Service users were seen having 2nd helpings of pudding and asking for specific things, they were also observed being given biscuits and drinks between meals (at their request). One of the three service users spoken to said the food was excellent one said its plentyfor me and one said it was very nice. The GP commented that the home is a happy place. Jasmine House DS0000043986.V322000.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. The home offers good protection to service users,takes all complaints seriously and deals with them appropriately. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a comprehensive complaints procedure which includes how staff should respond to service users or relatives making a complaint. Service users are provided with a copy in the service user guide and copies are displayed around the home. Three of the three service users spoken to said that they had a copy of the procedure and would know how to use it, they were also able to identify who they would talk to if they had a complaint. Four of the five questionnaires noted that they knew how to complain and the other said Ive never had to. The Comission for Social Care Inspection have received information about two complaints (since the last inspection), these were passed onto the home and have been dealt with efficiently and appropriately. A further complaint and an adult protection issue have also been dealt with by the home. A staff member was dismissed following an adult protection allegation. Staff recieve training in dealing with complaints and adult protection matters, those spoken to were able to describe how they would deal with them and confirmed that they had training in these areas. The three service users spoken to said that they felt safe in the home. Jasmine House DS0000043986.V322000.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good. The home is comfortable, pleasant ,clean and hygienic. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is currently having building works completed, the manager advised that this should be completed by March 07. Service users spoken to said that it was not a problem and staff said that it just meant that there wasnt as much room as usual, in the communal areas. The dining room is not used as much as usual because of building equipment. All areas affected by the refurbishment have been properly risk assessed and the manager has insisted on keeping disruption to the service users to a minimum. The home is well maintained and bedrooms seen were personalised according to the tastes and choices of individuals. Some rooms are shared and screens are provided, as appropriate. All areas of the home were seen to be clean and there were no unpleasant odours in evidence. The environment is homely and comfortable and all the furniture and fittings are of a good standard. Jasmine House DS0000043986.V322000.R01.S.doc Version 5.2 Page 16 The laundry has been re-organised to ensure there is minimum opportunity for cross-infection and the home has hygiene as a priority. Staff were observed constantly washing their hands, and wearing the appropriate protective clothing. Jasmine House DS0000043986.V322000.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30. Quality in this outcome area is good. The home has a well trained and efficient staff team, who are safely recruited and are able to meet the needs of the service users in their care. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a staff team of fourty two, thirty six are carers and six are support staff. There have been three new staff members since the last inspection. There are a minmum of six care staff and one registered nurse on duty during day time hours, in addition there are several support staff. Staff were seen talking to service users, checking if they had any needs and answering the call bells very quickly. All three service users said that staff were always available when needed. Three of five questionnaires noted that staff were always available and two said that they usually were. The staff team are experienced and there is a low turnover, nineteen staff have been in post for at least two years. The home uses no agency staff, it is uses bank staff (mainly Registered Nurses as carers) if necessary to cover shifts. Twelve staff are Registered Nurses and sixteen have N.VQ. 2 or above, approximately 80 of staff team are qualified. There is a good programme of induction, foundation and health and safety training is provided regularly. Staff confirmed that they have good training opportunies that assist them to do their work better. New staff sign an equality and diversity declaration, on appointment. Staff that do not have English as their first language are supported to attend an english course run by the local college. The home has all the necessary information in Jasmine House DS0000043986.V322000.R01.S.doc Version 5.2 Page 18 the recruitement files. Staff spoken to were very knowledgeable about their work and the individual needs of the service users. Support staff were seen to be an integral part of the staff team, interacting with service users in the course of their daily duties and giving support to the care team to provide the best possible care to the service users. Jasmine House DS0000043986.V322000.R01.S.doc Version 5.2 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 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 and 38. Quality in this outcome area is excellent. The home is extremely well managed and is run in the best interests of service users. The staff team are committed to further developing the service to ensure that service users are provided with as positive a lifestyle as is possible. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager has been in post since the home opened in 2003 and is suitably qualified and experienced. The GP commented that it is a very professionally run home. The home has a deputy manager who works very closely with the manager and has delegated responsibilities, there is also a senior nurse who provides supervision to the nurses and has delegated responsibility for nursing tasks. The home is well organised, is constantly developing and service users needs are of paramount importance to the management team. Jasmine House DS0000043986.V322000.R01.S.doc Version 5.2 Page 20 The manager and deputy were aware of all current developments in the field of caring for the elderly and are pioneering an ‘end of life’ programme in the area, which enhances the care given to service users and is regularly monitored by an external agency. Staff members confirmed that management is open, clear and that senior staff will listen and act upon any ideas that may enhance the lifestyle of service users. The home does not deal with any of the service users’ finances but will keep valuables for short periods of time, these are signed in and out. The homes policy describes the process for caring for personal possessions. One service user who has no relaives has been provided with an advocate to assist him with his finances, he is very happy with this arrangement. The home ensures that service users have enough resources to meet their personal care needs. The home has a robust health and safety policy, all regular maintenance checks are completed and staff are provided with health and safety training up-dates. Water temperature testing is carried out three monthly but this is to be carried out weekly, in future. A fire officer visited in December 2005 and noted that all his recommendations had been complied with. The environmental health officers visit in April 2006 resulted in some minor recommendations that have been complied with. The home operates a quality assurance system that seeks the views of service users, relatives and other interested parties, the results are analysed by the manager and developed into the home’s development plan the laundry was reorganised as a result of service users and relatives being unhappy with the care of clothing in the home. Jasmine House DS0000043986.V322000.R01.S.doc Version 5.2 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 4 4 X 3 X X 3 Jasmine House DS0000043986.V322000.R01.S.doc Version 5.2 Page 22 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Jasmine House DS0000043986.V322000.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Oxford Office Burgner House 4630 Kingsgate Oxford Business Park South Cowley, Oxford OX4 2SU 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. Extracts may not be used or reproduced without the express permission of CSCI Jasmine House DS0000043986.V322000.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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