CARE HOMES FOR OLDER PEOPLE
Jenkin House Jenkin Road Horbury Wakefield West Yorks WF4 6DT Lead Inspector
Susan Vardaxi Unannounced Inspection 15 February 2006 09:30 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 Jenkin House DS0000006192.V277606.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. Jenkin House DS0000006192.V277606.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Jenkin House Address Jenkin Road Horbury Wakefield West Yorks WF4 6DT 01924 275143 01924 275143 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 Anthony Harry Robinson Mrs Glenys Rhodes Care Home 25 Category(ies) of Dementia - over 65 years of age (25), Old age, registration, with number not falling within any other category (25) of places Jenkin House DS0000006192.V277606.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 24th August 2005 Brief Description of the Service: Jenkin House is situated in Horbury near Wakefield. It is a listed building that has been refurbished internally to provide accommodation for people over the age of 65 years, including some who have dementia type illnesses. The home stands in its own grounds overlooking the countryside, which provide a pleasant environment for the service users to sit and relax or to walk in. There are two large lounges, one being designated as a smoking area and also two very pleasant and spacious dining areas. The service users rooms are available on three floors in the home and a shaft lift is installed. The home has the required number of baths and toilet facilities and handrails and ramps have been fitted to assist with accessing all parts of the home. Service users’ medical care is provided by the local Health Centres. Specialist care needs are referred through the local GPs. Jenkin House DS0000006192.V277606.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place on 15th February 2006 over five hours and included discussions with the manager, talks with staff, service users and a visitor, a health professional, a walk round the building and checking some records. The inspector would like to thank the service users, visitor, manager and staff for their cooperation and hospitality throughout this inspection. What the service does well: What has improved since the last inspection? What they could do better:
The home generally provides a good standard of care and the manager and staff work hard to achieve and maintain this, however the arrangements for receiving, administering and recording medications were not satisfactory on this occasion. The emergency call system needs to be installed in the smoking lounge and dining areas to ensure all service users are able to access staff when needed. Staff have had manual handling training, however updated training delivered by a person accredited to do so would ensure staff and service user safety. Jenkin House DS0000006192.V277606.R01.S.doc Version 5.1 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Jenkin House DS0000006192.V277606.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 Jenkin House DS0000006192.V277606.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): 3 The work of the staff and the systems operated at the home make sure that people move into the home once assurances have been given that their assessed needs can be appropriately met. EVIDENCE: Service users’ records showed that pre admission assessments are completed. Before coming to living at the home, the needs of new people are assessed by the staff at the home. The needs of new service users are recorded, and used to put together a plan of care for daily living. Each person has their own file where records are kept. Intermediate care is not provided at the home. Jenkin House DS0000006192.V277606.R01.S.doc Version 5.1 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,11 The care plans are adequate, daily records do not confirm that the assessed needs have been met. Service users’ health could be at risk if medications are not administered as prescribed and accurate records kept. EVIDENCE: The care plans are currently being developed, those seen included service users assessed needs appropriately, however there was not enough evidence seen in the daily records to show that the care had been delivered. Records seen showed that health care professionals visit the home as required. Weights are being checked and recorded and include the action to be taken should weight loss be observed, however nutritional assessments had not been completed as recommended at the last inspection. The records of a new admitted service user showed that an assessment of need had been undertaken. Sadly this service user passed away soon after being admitted to the home. The manager explained that arrangements for a district nurse and GP to visit were made when there were concerns about the service user’s health and welfare. The records supported the comments of the manager.
Jenkin House DS0000006192.V277606.R01.S.doc Version 5.1 Page 10 An audit of medication was difficult, as staff had not recorded the actual amount of medication received from the pharmacy. However one discrepancy was seen on the balance shown on the records and number of sachets of medication in stock. The dose for an analgesic had not been written on the medication sheet. Very positive comments had been made on cards of thanks seen for the care service users’ who had been terminally ill and the support offered to their families. Jenkin House DS0000006192.V277606.R01.S.doc Version 5.1 Page 11 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 Service users and relatives are satisfied with the care provided. EVIDENCE: Service users spoken with made some positive comments about the provision of activities and their care. The manager said they often have social mornings watching service users’ choice of videos, eating popcorn and enjoying a glass of sherry. Relatives spoken with said they were satisfied with the care provided and that they can visit and are made welcome. Jenkin House DS0000006192.V277606.R01.S.doc Version 5.1 Page 12 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 17,18 The arrangements to enable service users to vote are satisfactory. All staff need to be aware of the various forms of abuse and the home’s Whistleblowing policy to ensure that service users are fully protected from abuse at all times EVIDENCE: The manager said all service users are registered to vote. An allegation of abuse had been investigated since the last inspection; the manager dealt with the allegation immediately and appropriately. Two staff spoken with had not had abuse training; the manager said that there wasn’t a training course available at the moment. Jenkin House DS0000006192.V277606.R01.S.doc Version 5.1 Page 13 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23,24, 25,26 The home provides a pleasant well-maintained environment for service users to live in. Some service users sitting in the communal rooms are not able to use the emergency call system. EVIDENCE: The manager said two fire doors that did not fit securely into the doorjambs had been repaired and the fire officer said that the doors would need regular adjustment and this had been included in the home’s maintenance programme. Emergency call points have not been installed in the smoking lounge and dining areas. Service users’ bedrooms seen were clean and comfortable some floor coverings had been replaced. The laundry room was clean and tidy, a new washing machine and tumble dryer have been installed. Jenkin House DS0000006192.V277606.R01.S.doc Version 5.1 Page 14 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission 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): Not assessed on this occasion. EVIDENCE: Jenkin House DS0000006192.V277606.R01.S.doc Version 5.1 Page 15 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 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): 35,38 Arrangements are in place for ensuring service users’ financial interests are safeguarded. The health and safety arrangements are generally satisfactory. However staff and service user safety could be compromised if manual handling training is not delivered by a person accredited to do so. EVIDENCE: Some service users’ records were seen of money held by the home for hairdressing, chiropody payments which were adequate. Records were seen of some completed system and equipment checks. The records showed two-fire training sessions had been held in 2005. Jenkin House DS0000006192.V277606.R01.S.doc Version 5.1 Page 16 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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 1 10 X 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 3 18 2 X X X 1 3 3 3 3 STAFFING Standard No Score 27 X 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X 3 X X 2 Jenkin House DS0000006192.V277606.R01.S.doc Version 5.1 Page 17 Are there any outstanding requirements from the last inspection? NO 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 OP9 Regulation 13(2) Requirement The registered person must ensure that medication is administered as prescribed and accurate records kept. The emergency call system must be available and accessible to all service users when sitting in the communal areas. Timescale for action 24/02/06 2 OP22 16(1) 28/02/06 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 3 Refer to Standard OP7 OP8 OP18 Good Practice Recommendations The service users daily records should clearly describe what action has been taken on a shift by shift basis to meet the assessed needs of the care plan. Nutritional assessments should be completed for all service users. In the event of the unavailability of formal abuse training the manager should ensure that all staff are made aware of the different forms of abuse and of their duty under the homes Whistleblowing policy. Jenkin House DS0000006192.V277606.R01.S.doc Version 5.1 Page 18 4 OP38 Manual handling training should be delivered to staff by a person qualified to do so. Jenkin House DS0000006192.V277606.R01.S.doc Version 5.1 Page 19 Commission for Social Care Inspection Brighouse Area Office Park View House Woodvale Office Park Woodvale Road Brighouse HD6 4AB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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