CARE HOME ADULTS 18-65
Jenkin Lodge New Road Ingleton North Yorkshire LA6 3JL Lead Inspector
Mrs Maggie Coxon Unannounced Inspection 11th January 2006 10:00 Jenkin Lodge DS0000007910.V275432.R01.S.doc Version 5.1 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 Lodge DS0000007910.V275432.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 Adults 18-65. 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 Lodge DS0000007910.V275432.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Jenkin Lodge Address New Road Ingleton North Yorkshire LA6 3JL 01524 241745 01524 241745 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) St Anne`s Community Services Mrs Margaret Keith Frankland Care Home 5 Category(ies) of Learning disability (5), Learning disability over registration, with number 65 years of age (5) of places Jenkin Lodge DS0000007910.V275432.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Registered for five service users with learning disabilities, some or all of whom may also have physical disabilities. 29th June 2005 Date of last inspection Brief Description of the Service: Jenkin Lodge is a care home registered by St Annes Community Services to provide personal care and accommodation for up to five adults with learning disabilities. The home consists of a detached, purpose built bungalow situated on a busy road on the outskirts of the village of Ingleton, in the Yorkshire Dales. The village is within walking distance of the home and has a wide range of public amenities including shops, churches and pubs. All of the five bedrooms are for single accommodation, none of which has en-suite facilities. The home has a large, well-maintained garden surrounding the property and there is an area of hard standing for parking to the front. There is level access to the home. Jenkin Lodge DS0000007910.V275432.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was the second to be undertaken between April 2005 and March 2006. It was done on 11th January 2006, at a time when all of the people living in the home would be present. It took 2.25 hours plus 1 hour’s preparation time. Any key standards not assessed during this inspection have been assessed at the last inspection and reported on in the subsequently published report. Discussions were held with the four people currently living in the home and with all of the care staff on duty. A number of records and most areas of the home, including bedrooms and shared areas, were seen. What the service does well: What has improved since the last inspection?
The social interaction of several of the residents with others has increased markedly due to staff doing individually designed interactive work with them, staff having been provided with training in personal interaction. There were examples of residents making more choices in their daily lives. This progress is also directly linked to an increase in day staffing hours, which allows staff to have 1 to 1 time with individuals on a regular basis. Other benefits of the increase in staffing levels are that residents are now accessing more activities and have been able, in several cases, to improve their daily living skills. The home has been presented with a Good Hygiene Award by Craven District Council. Two bedrooms have been completely redecorated and one resident is, with support from staff, decorating one wall in his room with a mural. New garden furniture and a water feature have been purchased. Jenkin Lodge DS0000007910.V275432.R01.S.doc Version 5.1 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. Jenkin Lodge DS0000007910.V275432.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Jenkin Lodge DS0000007910.V275432.R01.S.doc Version 5.1 Page 8 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None. EVIDENCE: Jenkin Lodge DS0000007910.V275432.R01.S.doc Version 5.1 Page 9 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 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 and 8. People living in the home make as many decisions about their personal lives and about the day-to-day running of the home as possible. EVIDENCE: All staff have recently been given training on intensive interaction and this, along with them having more time due to increased staffing hours, has enabled them to greatly improve their communication with the residents and to be better skilled at encouraging individuals to socialize more and become more confident about making decisions. This has been particularly true in the case of two residents who now make many more choices in their daily lives. Staff also said that one of these individuals had recently socialized very well with other guests during a recent holiday and had, in their view, enjoyed the experience himself more than on similar occasions in the past. Jenkin Lodge DS0000007910.V275432.R01.S.doc Version 5.1 Page 10 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,14 and 17. Residents are as involved as much as possible in their local community. They enjoy a range of social and educational opportunities and enjoy a wide choice of home cooked, good quality food. EVIDENCE: The number and range of activities enjoyed by the residents has improved markedly since the last inspection because staffing hours have been increased. This allows staff time to do 1 to 1 work with residents as well as supporting individuals in group activities. One resident now enjoys weekly swimming sessions and is, with assistance, decorating one of his bedroom walls with a mural. Two attend educational courses at a local college and each has trips out in the local community with an APS assistant. On the day of the inspection one resident went out with a staff member for his lunch, a second had an trip out with his APS supporter and the other two were attending an evening social club. Residents enjoy a very relaxed lifestyle in the home and are consulted about menu planning. The meals provided are well balanced and nutritious and staff prepared a hearty lunch during the visit.
Jenkin Lodge DS0000007910.V275432.R01.S.doc Version 5.1 Page 11 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 20. Residents’ personal and health care needs are fully met. EVIDENCE: None of the residents is able to take their own medication. There is a monitored dosage system in operation, which is securely stored. Medication administration records are well maintained and all staff have undertaken appropriate medication training. A recent medication error was discussed and appropriate measures have been taken to minimise any such future occurrence. Jenkin Lodge DS0000007910.V275432.R01.S.doc Version 5.1 Page 12 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 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 and 23. Residents’ concerns are appropriately dealt with and their interests are safeguarded. EVIDENCE: There is a comprehensive complaints procedure in operation that is available in various formats and is made available to anyone who wishes to see it. Whilst it is unlikely that any of the residents would use the formal procedure, each can make any dissatisfaction known to staff, several individuals are now able to do this more clearly and confidently than previously. Staff attempt to address any issues promptly and appropriately and have developed very good relationships with the residents with whom they communicate extremely well. No complaints have been made to the home or to the C.S.C.I. within the last twelve months. Comprehensive adult protection policies are in place and all staff have adult protection training initially as part of their induction and foundation training then as part of their NVQ and St Annes Community Services provide a rolling in-house training programme. Staff have a good understanding of the procedure to be followed in the event of or following an allegation of abuse having taken place. Jenkin Lodge DS0000007910.V275432.R01.S.doc Version 5.1 Page 13 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,27,28,29 and 30. The standard of the environment is good and provides residents with a comfortable and clean home in which to live. Whilst the environment is in the main safe, one aspect of storage could compromise the safety of the residents. EVIDENCE: The home is well maintained, is pleasantly decorated and furnished throughout and is kept very clean. At present however several boxes of paperwork and a bed are stored in the room containing the hot water tank and which is next door to the laundry, which contains the hot water boiler. These storage arrangements could present a fire risk and alternative arrangements should be made as soon as possible. All five bedrooms are for single accommodation and are of a suitable size. They are all very pleasantly decorated and furnished in line with the taste of the individual concerned. There are two bathrooms, one with an assisted bath and the second with a walk in shower. Appropriate aids and adaptations, including ceiling tracking, are fitted throughout the home and there is level access to the home. New furniture and equipment have been installed in the garden.
Jenkin Lodge DS0000007910.V275432.R01.S.doc Version 5.1 Page 14 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,33 and 34. The residents receive a good standard of care from a highly skilled and motivated staff team. EVIDENCE: Appropriate recruitment procedures are being followed thereby safeguarding the wellbeing of residents. These procedures include the carrying out of all required checks on new staff. A recently appointed residential care officer has completed the induction, foundation and LDAF training and is soon to enrol to undertake a NVQ. The remaining care staff are working hard towards achieving NVQs in care to level 2 or above. Two of the nine support workers have now completed their awards and two more are currently undertaking theirs. An additional 18 care staffing hours have been allocated to the home. There has also been a reshuffle within the staff team resulting in a full time vacancy, which has been advertized. These additional hours are being worked by existing staff until the post is filled. As previously mentioned this increase has greatly improved the quality of life for all four residents currently living at Jenkin Lodge. All staff are receiving regular formal supervision and appraisal.
Jenkin Lodge DS0000007910.V275432.R01.S.doc Version 5.1 Page 15 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 39 and 42. The residents benefit from a well managed home in which their needs and wishes are put first. The fire safety system could however be improved. EVIDENCE: St Anne’s Community Services has a quality assurance and monitoring system that includes regular unannounced inspections of the service by a service manager. The reports from these inspections are fed back into the overall quality assurance system. A new mini plan is developed annually for the home, based on the objectives set out in the new organizational business plan. This sets out the objectives to be achieved in the forthcoming year and is aimed at further improving the residents’ quality of life. It has previously been recommended that this system be further developed to include ascertaining the views of individuals in the community who have contact with home. Staff said that discussions have been held with some relatives and that the registered manager is planning to implement a system for surveying the several groups of people concerned with the home. Some discussion was held about this.
Jenkin Lodge DS0000007910.V275432.R01.S.doc Version 5.1 Page 16 Whilst the organization had previously undertaken a check of the hot water storage system in respect of the prevention of Legionella and had identified that hot water stored in the home is done so at less than the required 60° Celsius, staff were not aware whether or not this issue has been addressed. The only other health and safety concern noted is as previously described the storage of some items within the home with regard to fire safety. Discussions were held with staff as to finding alternative storage arrangements for the item of furniture and paperwork concerned. All other health and safety systems are well maintained and procedures appropriately followed. No further concerns were noted. Jenkin Lodge DS0000007910.V275432.R01.S.doc Version 5.1 Page 17 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 X 2 X 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 1 25 3 26 X 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 X 32 2 33 3 34 3 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X 3 3 X X LIFESTYLES Standard No Score 11 X 12 3 13 X 14 3 15 X 16 X 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X 3 X X X 2 X X 1 X Jenkin Lodge DS0000007910.V275432.R01.S.doc Version 5.1 Page 18 No. Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA24 YA42 Regulation 23 Requirement Alternative, suitable arrangements should be made for the storage of flammable materials to minimise the risk of fire in the home. Timescale for action 13/02/06 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. Refer to Standard YA32 YA39 Good Practice Recommendations A minimum of 50 of care staff should be qualified to NVQ level 2 or above. The views of families, friends, advocates and other people involved with the home, in respect of the quality of services, should be ascertained and incorporated into the quality assurance system currently in operation. Hot water should be stored at a temperature that safeguards against Legionella (at a minimum of 60°C). 3. YA42 Jenkin Lodge DS0000007910.V275432.R01.S.doc Version 5.1 Page 19 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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