Inspection on 22/06/05 for Jessie Place

This inspection was carried out on 22nd June 2005.

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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 7 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Jessie Place 26/11/07

Jessie Place 29/06/06

Jessie Place 28/01/06

Jessie Place 04/10/04

Jessie Place 05/04/04

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

CARE HOME ADULTS 18-65 JESSIE PLACE 39 Stanthorpe Road Streatham London SW16 2DZ Lead Inspector Lynne Field Unannounced 22 June 2005, 10:00 th 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 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 Stationary 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. JESSIE PLACE G52-G02 S22737 Jessie V233547 220605 Stage 4 UIV.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service JESSIE PLACE Address 39 Stanthorpe Road , Streatham, SW16 2DZ Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 0208-769-3591 Jane`s House Limited Mr Raja Manikam Paramal Care Home 6 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (6) of places JESSIE PLACE G52-G02 S22737 Jessie V233547 220605 Stage 4 UIV.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 4th October 2004 Brief Description of the Service: Jessie Place is a large semi-detached house in a residential area. It is within a few minutes walking distance from a main shopping area, which has full community facilities and public transport links. It is a privately owned home, registered since November 1999, which provides long-term residential care for people with mental health problems. The home is registered for 6 service users, who are accommodated in six single bedrooms, one with an en-suite bathroom. There are three communal areas, one of which is a large conservatory with steps leading down to a large landscaped back garden and there is a front garden area that has been converted for parking use. The staff team is small, but fairly stable and experienced with this service user group. The home is not designed to cater for people with physical disabilities, although wheelchair users would have access to the ground floor, which has one bedroom, a toilet and all the communal areas. The home aims to encourage service users to take part in daily activities and to reach their optimum level of functioning, with current service users attending a variety of regular daily activities outside the home. JESSIE PLACE G52-G02 S22737 Jessie V233547 220605 Stage 4 UIV.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over four hours on 22nd June 2005. The registered manager was on annual leave on the day of the inspection and for that period of time, the home was being managed by the registered provider,s son, who is the registered manager of one of the other homes in the group. A tour of the premises took place, care records and financial records were inspected. One member of staff was on duty. Four of the six service users were spoken with. The interaction between the service users and the staff on duty and the support that staff provided with some activities was observed. What the service does well: What has improved since the last inspection? What they could do better: Care plans, risk assessments and record keeping relating to service users needs to improve. JESSIE PLACE G52-G02 S22737 Jessie V233547 220605 Stage 4 UIV.doc Version 1.30 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. JESSIE PLACE G52-G02 S22737 Jessie V233547 220605 Stage 4 UIV.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection JESSIE PLACE G52-G02 S22737 Jessie V233547 220605 Stage 4 UIV.doc Version 1.30 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 standard(s) 2,3,4,5 The Statement of Purpose and Service Users, Guide contains the required information service users need to help them make a decision about coming to live at the home. Prospective service users’ needs and aspirations are assessed, so that a service tailored to their needs is provided. EVIDENCE: The Statement of Purpose and Service Users, Guide used by the home has been reviewed and brought up to date. There have not been any recent admissions. However, files seen by the inspector had appropriate referral and assessment information in place. At the last inspection of 4th October 2004, the registered provider had stated that prospective service users would always be invited for trial visits before moving in. This would usually be for a weekend or two days during the week. New service users would have a three-month trial period, which would be reviewed at a meeting involving the care manager, service user, service users family and the home before a placement is made permanent. Family and friends of prospective service users would also welcome to visit the home if they wish. JESSIE PLACE G52-G02 S22737 Jessie V233547 220605 Stage 4 UIV.doc Version 1.30 Page 9 Contracts were observed to be in place on service user’s files and were signed by the registered manager and service user where appropriate. JESSIE PLACE G52-G02 S22737 Jessie V233547 220605 Stage 4 UIV.doc Version 1.30 Page 10 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 standard(s) 6,7,9 Paperwork relating to care planning and important events in service users lives was incomplete. Important events were not fully documented, nor were related actions or decisions. Risk-taking by service users, or risks presented by their behaviour, was not properly assessed or documented. Care plans and risk assessments must be up dated. EVIDENCE: Four care plans were inspected over. No clear care plans were in place. There were no records of reviews or care planning meetings that were reported to have taken place apart from one social functioning assessment had taken place. The inspector was most concerned about how the home assessed and managed risks taken by service users as there were no clear details of how JESSIE PLACE G52-G02 S22737 Jessie V233547 220605 Stage 4 UIV.doc Version 1.30 Page 11 risks can be minimised. These need to be reviewed with all the relevant people involved with the service users and actions agreed. A record of medical appointments was recorded but the reason for the appointment and the outcome were very brief. JESSIE PLACE G52-G02 S22737 Jessie V233547 220605 Stage 4 UIV.doc Version 1.30 Page 12 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 standard(s) 11,12,13,14,15,16,17 Service users are encouraged to develop independent skills and interests as well as access the community with the support of staff when required. EVIDENCE: Service users said they were encouraged to help with the routine tasks of the home, which gave them some opportunities to develop a range of daily living skills. To ensure there are sufficient numbers of staff to enable service users to be supported to develop domestic and social skills, the home has appointed an activities coordinator to work in conjunction with support staff. The activities co-ordinator also supports service users to attend local activities such as going to the Library or leisure facilities at the leisure centre. JESSIE PLACE G52-G02 S22737 Jessie V233547 220605 Stage 4 UIV.doc Version 1.30 Page 13 At a previous inspection the registered provider told the inspector that service users enjoyed attending local church services of their choice. The service users said they still enjoyed going to the local church. One service user continues to attend the Effra Day Centre twice a week. Records and verbal reports from staff and service users further provided evidence that service users participate fully in the local community. Service users confirmed that they were supported to maintain contact with family and friends and showed photographs and letters to the Inspector. Service users are able to come and go at the home freely and have keys to the front door as well as their own bedrooms. Records of meals are kept in the kitchen. Sometimes individuals buy and cook their own food as well as having the choice of having the option of a group prepared meal, which is also recorded on the menu. JESSIE PLACE G52-G02 S22737 Jessie V233547 220605 Stage 4 UIV.doc Version 1.30 Page 14 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 standard(s) 18,19 There is no consistent care planning or recording system in place to adequately provide staff with the information needed to satisfactorily meet service user’s needs. EVIDENCE: Some of the service users require prompting to complete their personal care. The inspector observed interaction between staff and service users, which was respectful and appropriate. Each service user is registered with the GP of their choice and Community Psychiatric Nurses (CPNs) visit regularly to work with the service users and support the staff. As stated in the last inspection report, there is evidence on files of health care checks that have been undertaken, but these were very brief, consisted of a record of when a service user had attended an appointment with no outcome recorded. JESSIE PLACE G52-G02 S22737 Jessie V233547 220605 Stage 4 UIV.doc Version 1.30 Page 15 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 standard(s) 23 The home must review how it keeps and records all service users financial transactions to ensure service users are protected from possible financial abuse. EVIDENCE: Service users financial records were inspected and several accounting errors were found. These were discussed with the locum manager and the member of staff concerned. The inspector was told one service user is sending money and giving money to her family, but there is no written agreement to this effect on her file. A requirement has been made in this report about this. JESSIE PLACE G52-G02 S22737 Jessie V233547 220605 Stage 4 UIV.doc Version 1.30 Page 16 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 standard(s) 24,25,27,28,30 The standard of décor within the home is good providing the service users with a homely place to live. There has been no change in the bathing facilities, which are not adequate for the five service users to share. The provider must consider installing en-suite facilities to meet the service users individual needs. EVIDENCE: JESSIE PLACE G52-G02 S22737 Jessie V233547 220605 Stage 4 UIV.doc Version 1.30 Page 17 The home is a three-storey building. It is comfortable and homely and was clean and tidy on the day of the inspection. There is a large garden at the back of the house. The home is fairly well maintained but some areas such as the bathroom and stairs are now shabby. All service users have single bedrooms with one bedroom being en suite. Service users showed the inspector their bedrooms and they were furnished adequately and service users had individualised them with personal items. There is one bathroom and a separate toilet on the first floor and a toilet on the ground floor. Five people share the bathroom which does not meet the national minimum standards. The registered provider has told the inspector at past inspections they were considering the viability of installing en-suites in other service user bedrooms. This still needs to be done. There is a large comfortable lounge, which leads into a small conservatory, which is used as a smoking room. The kitchen has a large dining area, that has a large table where the service users eat their meals. A small paved patio and garden with grass and borders is to the rear of the home. The home provides care for people who have problems with their mental health but are ambulant so there are no adaptations or disability equipment in the home. The laundry facilities are located outside in a shed set up for this purpose and from where food is prepared and eaten. JESSIE PLACE G52-G02 S22737 Jessie V233547 220605 Stage 4 UIV.doc Version 1.30 Page 18 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32,35,36 A number of staff are working towards NVQ 2 & 3. However, other essential areas of training based on the needs of service users, is required. An assessment of the training needs of the whole staff team is also needed. EVIDENCE: The inspector was unable to view staff files as the registered manager was away on annual leave. The member of staff spoken to said they had supervision every two months but records were not inspected to confirm this. At the previous inspection the inspector was told all staff are working towards NVQs. A requirement was made for staff to have training related to the service user group living at the home. Discussions the inspector had with staff indicated that staff had not had training in working with service users who have enduring mental health problems or training in communication, record keeping, the recording of complaints, accidents and incidents. Training at the home needs to be better planned and organised in order to ensure that it is based on the needs of the service users and an assessment of the skills/deficits of the whole staff team. This will ensure that staff are able to meet the needs of service users. JESSIE PLACE G52-G02 S22737 Jessie V233547 220605 Stage 4 UIV.doc Version 1.30 Page 19 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 42, 43 Procedures regarding service users money do not properly safeguard service users financial interests. The provider’s handling of service users money and the failure to share vital information with the care manager do not indicate that the home is run in the best interests of service users. The health, safety and welfare of service users and staff are generally promoted and protected within the home. EVIDENCE: Service users said they felt comfortable in the home and staff treated them with respect and listened to them. Staff and service users made it is clear that the home is managed in a positive and open way. JESSIE PLACE G52-G02 S22737 Jessie V233547 220605 Stage 4 UIV.doc Version 1.30 Page 20 The home manages the personal allowances for four of the service users. The financial records and service users money were examined. The system leaves the service users potentially open to abuse and needs to be rectified. The registered provider must ensure that financial systems are reviewed in order to ensure that service users’ financial interests are safeguarded. See Standard 23. Throughout the tour of the home and inspection of all checks, certificates and health and safety monitoring it was shown that the home is ensuring as far as possible the health and welfare of the service users. JESSIE PLACE G52-G02 S22737 Jessie V233547 220605 Stage 4 UIV.doc Version 1.30 Page 21 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 3 3 3 Standard No 22 23 ENVIRONMENT Score x 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 2 x 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 x 2 3 x 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score x 2 x x 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 JESSIE PLACE Score 2 2 x x Standard No 37 38 39 40 41 42 43 Score x x x x x 2 3 G52-G02 S22737 Jessie V233547 220605 Stage 4 UIV.doc Version 1.30 Page 22 Yes 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 YA6 YA7 Regulation 15(1)(b) Requirement The registered person must ensure that service users care plans are kept under review in sufficent detail to provide clear guidance to staff on actions to be taken to meet their health and welfare needs. The registered person must ensure the risk assessments are in sufficent detail to provide clear guidance to staff on actions to be taken to meet their health and welfare needs. The registered person must ensure that accurate records are kept of all incoming and outgoing payments made on behalf of service users in the home. The registered person must review how the home can provide sufficent numbers of lavatories, baths and showers with the view to meeting the minimum standards with regard to the number and needs of the service users. The registered person must ensure staff working in the home have training appropriate to the work they perform. Timescale for action 01/12/05 2. YA9 13(4)(b) & (c) 01/12/05 3. YA23 YA42 17 (2) Schedule 4 para. 9 01/12/05 4. YA27 23(2)(J) 15/01/06 5. YA32 18(1)(c)(i ) 15/01/06 JESSIE PLACE G52-G02 S22737 Jessie V233547 220605 Stage 4 UIV.doc Version 1.30 Page 23 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. Refer to Standard Good Practice Recommendations JESSIE PLACE G52-G02 S22737 Jessie V233547 220605 Stage 4 UIV.doc Version 1.30 Page 24 Commission for Social Care Inspection 46 Loman St Southwark SE1 0EH 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 JESSIE PLACE G52-G02 S22737 Jessie V233547 220605 Stage 4 UIV.doc Version 1.30 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. 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