Inspection on 10/01/06 for Jeian

This inspection was carried out on 10th January 2006.

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

Jeian 07/01/08

Jeian 09/07/07

Jeian 10/07/06

Jeian 05/09/05

Jeian 29/11/04

Jeian 14/07/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Jeian Jeian Care Home 322 Colchester Road Ipswich Suffolk IP4 4QN Lead Inspector Tina Burns Unannounced Inspection 10th January 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 Jeian DS0000047113.V277096.R01.S.doc Version 5.1 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. Jeian DS0000047113.V277096.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Jeian Address Jeian Care Home 322 Colchester Road Ipswich Suffolk IP4 4QN 01473 274593 01473 274593 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) Mr Felix Emejulu Chukwuma Mr Felix Emejulu Chukwuma Care Home 10 Category(ies) of Old age, not falling within any other category registration, with number (10) of places Jeian DS0000047113.V277096.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 5th September 2005 Brief Description of the Service: Jeian is a care home registered for up to ten older persons. It is situated in a busy suburb of Ipswich close to local amenities and shops and directly opposite the Ipswich Hospital. All bedrooms are fully furnished single bedrooms. There is a communal main lounge area with adjacent dining room. The home also has an enclosed garden area and small car park. The registered owner and manager is Mr Felix Chukwuma. Jeian DS0000047113.V277096.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was a routine unannounced inspection that took place on a weekday between the hours of 10.30am and 5pm. It was the homes second inspection since March 2005. The inspector toured the premises, spoke with staff and residents and examined a range of policies, procedures and records. The registered manager was at the premises throughout the inspection and fully contributed to the process. What the service does well: What has improved since the last inspection? What they could do better: Care plans should be developed so that they are of consistent quality and detail, and should include service users wishes in relation to death and dying. The manager must also ensure that medication records are appropriately completed to avoid errors in administration and medication is transported safely and in line with pharmaceutical guidelines. The home must also ensure that staff are familiar with, and have access to, local authority adult protection procedures, further more recruitment records must include employees photographs. The manager must also review staffing levels to ensure that there are appropriate numbers of staff at all times to meet service users needs. Jeian DS0000047113.V277096.R01.S.doc Version 5.1 Page 6 Finally, a risk assessment must be undertaken in relation to hot water temperatures and action must be taken to maintain the hot water temperature close to 43 degrees centigrade. The homes Fire Policy should also be reviewed to reflect current fire safety advice. 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. Jeian DS0000047113.V277096.R01.S.doc Version 5.1 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 Jeian DS0000047113.V277096.R01.S.doc Version 5.1 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 the following standard(s): 1, 3, 4 and 5. Prospective service users are able to make an informed choice about living at the home, further more they can be expect the home to carry out suitable assessments in order to meet their needs. EVIDENCE: The home had a Service User Guide on display and service users spoken with confirmed that they each had a copy of the guide in their rooms. The guide outlined the objectives of the home and its overall philosophy of care and included details of the facilities it provides, information regarding terms and conditions and information about fees and charges. The records of two service users were examined, one of whom was recently admitted to the home. Both included evidence of pre admission assessments. The Roper, Logan and Teirney model of assessment had been used and covered twelve activities of daily living: maintaining a safe environment, breathing, eating and drinking, elimination, dressing and undressing, controlling body temperature, mobility, working and playing, expressing sexuality, sleeping and dying. There were also records of nutritional Jeian DS0000047113.V277096.R01.S.doc Version 5.1 Page 9 assessments; falls risk assessments and pressure sore risk assessments in place. Service users spoken with confirmed that they felt “well looked after” and satisfied with the care and support they received. One service user explained that he had significant health ‘problems’ but the home had a good understanding of their condition and were very supportive. The Service User Guide stated that introductory visits are encouraged and new service users can be admitted on a trial basis, to ensure the home is suitable for their needs. Jeian DS0000047113.V277096.R01.S.doc Version 5.1 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 and 11. Service users are not entirely safeguarded by their individual care plans and risk assessments, further more they cannot be certain that they will be protected by the homes medication procedures. However, service users can expect to be treated with respect and have their privacy upheld. EVIDENCE: The two service users records examined contained appropriate care plans that reflected the needs identified in the service users assessments. However, the inspector highlighted the fact that the care plan for the most recently admitted service user was more detailed and more clearly identified the tasks that needed to be undertaken to meet needs. The manager confirmed that the care planning process had been developed and agreed that more established service users would benefit from updated plans. The Inspector also noted that the records relating to service users wishes in the event of their death was incomplete and their care plans did not include clear instructions for staff to follow. Two individual risk assessments were also examined and in both instances found to need some development to clearly identify risks and record the Jeian DS0000047113.V277096.R01.S.doc Version 5.1 Page 11 management strategies in place to minimise or eliminate them. However, at the last inspection a requirement was made regarding the need to develop risk assessments in place to prevent pressure sore areas. One of these assessments was examined during the inspection and found to be thorough and detailed. Records seen and service users spoken with evidenced that the home supports residents to access health care services such as, GP’s, Community Nurses, outpatient’s appointments and Chiropody. Service users were particularly positive about the managers understanding of their health needs. Medication was supplied to the home by a large pharmacy using a monitored dosage system and kept stored in a locked cabinet in an office area. The manager confirmed that the pharmacy also provided the homes medication training and this was due again, and rebooked, for February 2006. The medication administration records examined had been signed, dated and completed appropriately with the exception of one instance where neither a code nor signature had been used. Consequently it was not clear whether or not the medication had been given. The inspector also found that the method of transporting medicines for administration was not entirely safe. Medicines must be transported in a secure manner; an open trolley does not comply with pharmaceutical guidelines. Resident’s spoken with and observations made during the inspection indicated that residents are treated with respect and have their right to privacy upheld. Resident’s confirmed that staff are polite and positive comments were made regarding the personal care they receive and the home’s welcoming attitude towards their visitors. Comments included “I have been well looked after since I’ve been here, I have no complaints” and “Staff are lovely, very, very nice people”. Jeian DS0000047113.V277096.R01.S.doc Version 5.1 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13 and 15. Service users find that their families and friends are made welcome at the home and the lifestyle experienced satisfies their wishes and needs. Furthermore meals are flexible and special diets and personal preferences are catered for. EVIDENCE: Service users spoken with confirmed that they were able to exercise choice in relation to their life style and daily activities and observations were that individuals were able to spend their time as they wished, in the privacy of their own rooms or with the company of others in the communal lounge or dining area. Observations were that staff seemed to have a good understanding of the service user’s preferred routines and offered flexibility around how and when support was offered, for example meal times and support with personal care. Service users spoken with confirmed that the home always gave their visitors a warm welcome and that they were able to meet with them in the privacy of their own rooms or join them in the communal lounge or dining area. Jeian DS0000047113.V277096.R01.S.doc Version 5.1 Page 13 Observations made and service users spoken with also confirmed that they could take their meals in either of the communal areas or in the privacy of their rooms. The dining area was comfortable and suitably furnished but on the day of inspection most service users chose to eat in their rooms or the communal lounge. Service users were asked to make a selection from the homes menu each morning or request an alternative if they wished. Comments regarding the food were generally positive and indicated that there was a reasonable choice of meals available, comments included “I am a fussy eater but they always provide alternatives for me, they are very flexible”, and “the meals are fairly good and there is always a choice of at least two things”. One service user also confirmed that they are provided with a ‘special diet’ due to their health needs. Jeian DS0000047113.V277096.R01.S.doc Version 5.1 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Service users can expect the home to listen to their complaints and concerns and take them seriously but they cannot be certain that there are adequate procedures in place to protect them from abuse. EVIDENCE: There had been no complaints recorded since the previous inspection and service users spoken with confirmed that they had not had cause to complain. Discussion around the complaints procedure indicated that service users knew how to make a complaint if they wished but issues raised were resolved promptly, before becoming a matter of complaint. The homes training plan indicated that staff had received training in the protection of Vulnerable Adults in June 2005 and further training was planned for July 2006. However, the home did not have a copy of the Suffolk Inter Agency Policy and Procedures for the Protection of Vulnerable adults in place. All staff must have access to and be familiar with the local authority procedures for reporting concerns regarding adult protection. Jeian DS0000047113.V277096.R01.S.doc Version 5.1 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 24, 25 and 26. Service users can expect to live in a clean, and comfortable environment. Further more they can expect to have rooms that meet their needs and enjoy having their own possessions around them. However, the environment is not entirely safe while hot water is not maintained at required temperatures. EVIDENCE: On the day of inspection the home was clean, comfortable and ‘homely’. Communal areas consisted of a lounge and adjacent dining area, and another small lounge area at the back of the building that ‘doubled’ as a staff sleeping in room. Service users also had easy access to a safe, tidy and enclosed garden area. An appropriate fire alarm system was in place and records evidenced that equipment was routinely tested and inspected by the manager, ‘handyman’ or contractors as appropriate. The home had sufficient toilet and bathroom facilities including two assisted bathrooms, one upstairs and one downstairs. Following a requirement made at Jeian DS0000047113.V277096.R01.S.doc Version 5.1 Page 16 the previous inspection the downstairs bathroom had been fitted with a radiator cover. Hoists in place had been serviced in April 2005. The hot water in the upstairs bathroom was tested at 37 degrees centigrade and the downstairs at 35 degrees centigrade. This was significantly lower than the recommended 43 degrees. Records seen in relation to the homes routine water temperature tests indicated that the upstairs bathroom usually tests at a suitable temperature but the downstairs one is often low. This was in contrast to the findings of the previous inspection where the water was found to be above suitable temperature. However service users spoken with said that they found the water temperature and heating satisfactory and improved since the last inspection. All bedrooms were single, private rooms. Bedrooms seen were all individually furnished and decorated and provided sufficient and comfortable facilities. Service users had equipped their rooms with many of their own belongings and personal effects. All bedrooms had a call system in place, and in working order on the day of inspection. On the day of inspection the premises was warm, clean and free from unpleasant odours. Suitable laundry facilities were in place and infection control procedures were actively promoted by the home. Jeian DS0000047113.V277096.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Service users can expect to be supported by trained and competent care workers, however they cannot be certain that the home consistently provides adequate staffing to meet their needs. EVIDENCE: The recruitment records of two care workers were examined during the inspection. The records evidenced that an Enhanced Criminal Record Bureau Check (CRB) had been undertaken and was satisfactory for one member of staff, the other had commenced work recently following a POVA first check and was working under supervision whilst waiting for their CRB check to be processed. With the exception of Individual’s photographs all other required documentation was in place and satisfactory. Staff spoken with confirmed that all new staff undertake TOPPS training as part of their induction programme. They also confirmed that the home had provides core skills training such as manual handling, fire safety, medication and food hygiene. The homes current annual training plan also included ‘foot health’, abuse training and NVQ 2 training for two care workers. One of the three members of staff spoken with was NVQ qualified. Comments received by staff and service users indicated that the home was appropriately staffed with the exception of some periods of staff sickness or when a carer was ‘assigned’ as cook for the kitchen. At the time of inspection Jeian DS0000047113.V277096.R01.S.doc Version 5.1 Page 18 there were two carers on duty in the morning but one was responsible for the kitchen. The manager was on duty and supernumerary. Jeian DS0000047113.V277096.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 37 & 38. Service users can expect to find the manager approachable and competent, further more they can expect to contribute to the homes self-monitoring process. However, health and safety procedures do not entirely safeguard staff and residents. EVIDENCE: The proprietor has become the Registered Manager since the previous inspection. He is currently undertaking the Registered Managers Award and is supported by an assistant manager who has completed National Vocational Qualifications in care (levels 2 and 3) and care management (level4). Observations and staff spoken with on the day of inspection indicated that there were clear lines of accountability within the home and staff and residents confirmed that they found the manager competent and approachable. The manager confirmed that the homes next quality assurance audit was due in April 2006, and this would include a survey of service users views. Views of Jeian DS0000047113.V277096.R01.S.doc Version 5.1 Page 20 service users and their relatives are also welcomed via the homes ‘suggestion box’ positioned in the ground floor hallway. The current and up to date certificate of registration was displayed, together with the previous inspection report, certificate of insurance, fire procedures and Service User Guide. Records seen and conversations with the manager and staff evidenced that the home provides appropriate training in relation to health and safety, fire safety, and manual handling. The laundry area was clean and adequately equipped and indicated that the home had infection control measures in place. The homes fire risk assessment had been appropriately developed following a requirement made at the previous inspection and records confirmed that fire equipment and alarms had been maintained in safe working order. However, the homes Fire Policy did not reflect current fire prevention guidance. Procedures for recording incidents and accidents had also been updated since the last inspection and were seen to comply with current legislation in relation to data protection. COSHH product data sheets were also seen to be in place on this occasion however risk assessments in relation to hot water temperature had not been developed. Jeian DS0000047113.V277096.R01.S.doc Version 5.1 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 X 3 3 3 X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 3 3 3 X 3 2 3 STAFFING Standard No Score 27 2 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X X X 3 2 Jeian DS0000047113.V277096.R01.S.doc Version 5.1 Page 22 Are there any outstanding requirements from the last inspection? Yes, see 4 and 7 below. 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 Regulation 13(4c) Requirement The registered manager must ensure that individual risk assessments clearly identify actual and perceived risks and set out the management strategies in place to eliminate or minimise them. The registered manager must ensure that medication is transported safely and in line with pharmaceutical guidelines. The registered manager must ensure that records of medicines administered are completed appropriately and in line with pharmaceutical guidelines. The registered manager must ensure that staff have access to, and are familiar with, the local authority Policy and Procedures for the Protection of Vulnerable Adults. The registered manager must ensure that hot water temperatures are maintained close to 43 degrees centigrade. The registered manager must undertake a review of staffing DS0000047113.V277096.R01.S.doc Timescale for action 31/03/06 2 9 13(2) 03/02/06 3 9 13(2) 03/02/06 4 18 13(6) 20/02/06 5 25 18(4) 01/03/06 6 27 18(1.a) 20/02/06 Jeian Version 5.1 Page 23 7 29 19(1.b) Sch 2 8 38 13(4) 9 38 13(4) needs and ensure that there are suitable staffing levels, as appropriate for the health and welfare of service users, at all times. The registered manager must 20/02/06 ensure that all documentation required by legislation is in place for all employees, including photographs for the two identified care workers. The registered manager must 03/02/06 ensure that risk assessments are in place regarding hot water temperatures. The registered manager must 01/03/06 review the homes Fire Policy and ensure that it reflects current fire safety guidance. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard 7 11 Good Practice Recommendations Care plans should be consistently detailed and developed in accordance with national minimum standards. Service users should be consulted about their wishes regarding death and dying and these views should be clearly recorded within the individuals care plan. Jeian DS0000047113.V277096.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Suffolk Area Office St Vincent House Cutler Street Ipswich Suffolk IP1 1UQ 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 Jeian DS0000047113.V277096.R01.S.doc Version 5.1 Page 25 - 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!