Inspection on 15/09/05 for Jonathan House

This inspection was carried out on 15th September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Jonathan House 08/11/06

Jonathan House 19/03/06

Jonathan House 18/03/05

Jonathan House 16/10/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Jonathan House 19 Bayswater Avenue Westbury Park Bristol BS6 7NN Lead Inspector Paula Cordell Announced 15 September 2005 09:30 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. Jonathan House D56_D05_S26539_Johnathan House_V241141_150905_Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Jonathan House Address 19 Bayswater Avenue Westbury Park Bristol BS6 7NN 0117 9736361 0117 9736361 info@freewaystrust.co.uk Freeways Trust Ltd 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) Miss Shelley Ann Holvey Care Home for Younger Adults 8 Category(ies) of LD Learning disability for 8 registration, with number of places Jonathan House D56_D05_S26539_Johnathan House_V241141_150905_Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: May accommodate up to 8 persons, aged 18 - 64 years, requiring personal care. Date of last inspection 18th March 2005 Unannounced Brief Description of the Service: Jonathan House is operated by Freeways Trust Limited and is registered with the Commission for Social Care Inspection to provide accomodation and personal care for up to eight persons aged between 18 and 64 years, who have a learning disability. The home aims to support individuals to lead as independent a lifestyle as they wish and as is achieiveable within a community setting. Jonathan House is a mature three storey terraced house that is situated in a residential area in the North of Bristol and it blends in well with the immediate environment. There are eight single bedrooms over three floors and the stairs are the sole means of access to each floor. This home would not be suitable to individuals with mobility issues as the lounge is on the first floor. It is close to local amenities including shops, a cinema, local bus routes, a church and a large common land the Downs, which is used for a variety of recreational purposes. There is a newly appointed manager Ms Brownell. Ms Brownell has been working in the home for one month. She is the process of submitting an application to the Commission for Social Care Inspection to become the registered manager of Jonathan House. Jonathan House D56_D05_S26539_Johnathan House_V241141_150905_Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection. The purpose of the visit was to review the progress to the requirements and recommendations from the unannounced visit in March 2005. The home has demonstrated compliance to most or is working towards the requirements and recommendations from the previous inspection. The outstanding requirement relates to the replacement of two bedroom carpets. There have been no additional visits during this period. The home has been keeping the Commission for Social Care Inspection informed of incidents that affect the wellbeing of the individuals living at Jonathan House and the provider has sent monthly appraisals of the service. This information was used to plan the inspection process. The inspection was conducted over 5.5 hours. The inspector had an opportunity to meet with two of the seven residents, two members of staff, and the manager. The methodology used during this inspection included viewing care records and other relevant documents required of a care home and a tour of the home. Residents were actively encouraged to participate in the process by the staff on duty. The inspector received one professional and four residents completed questionnaires on the service provided by Jonathon House. The inspector would like to take this opportunity to thank the staff and the residents for their welcome and their assistance in the inspection progress. What the service does well: Jonathan House provides a service that is tailored to the individual, with a high level of resident involvement. From conversations with the residents it was evident that they viewed Jonathan House as their home and spoke positively about the relationships they had built both in the home and the local community. The home accesses support from other professionals in the planning of the care of the individuals complimenting the skills of the team. The home was able to demonstrate how they were meeting the changing needs of individuals and promoting individuals’ health and wellbeing. The home has recently supported an individual with a terminal illness. It was evident that the individual remained the focus throughout. Jonathan House D56_D05_S26539_Johnathan House_V241141_150905_Stage 4.doc Version 1.40 Page 6 A community nurse complimented the home “on their ability to cope and meet the changing needs of the residents and that the staff were receptive to advice and kept her fully informed. This is good practice. Resident involvement was promoted in all aspects of running of the home and an open culture of communication was promoted. Residents stated that the manager and the staff team were good at listening and supporting them in their chosen goals. What has improved since the last inspection? What they could do better: The home must develop a refurbishment and maintenance programme for the home, including timescales, so that this can be monitored at future inspections. Carpets in bedroom 6 and 8 must be replaced within one month. This was an outstanding requirement from the inspection in March 2005 and the timescale has been extended to enable the home to demonstrate compliance. A resident must be protected by adequate fire doors. The home must seek the advice from the fire officer on whether a self-closure would be suitable for the individual’s bedroom door to protect them in the event of a fire. Jonathan House D56_D05_S26539_Johnathan House_V241141_150905_Stage 4.doc Version 1.40 Page 7 The home must be able to demonstrate that there is a current certificate of insurance held in the home. There are three recommendations from this inspection, which would be seen as good practice: Residents would be more protected if there were a second staff signature where residents are unable to sign for financial transactions. The manager would benefit from attending a course on abuse to enable this to be cascaded to staff for example the train the trainer course on abuse. Residents would benefit from having the bathrooms included on the refurbishment programme, as they are looking dated. 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. Jonathan House D56_D05_S26539_Johnathan House_V241141_150905_Stage 4.doc Version 1.40 Page 8 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 Jonathan House D56_D05_S26539_Johnathan House_V241141_150905_Stage 4.doc Version 1.40 Page 9 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) 1, 2, 3, 4, 5 Residents have sufficient information to enable them to make a choice on whether to move to the home. The home is meeting the changing needs of the residents. Prospective residents needs are assessed prior to moving to the home. EVIDENCE: The new manager has updated and reviewed the statement of purpose. This meets with the National Minimum Standards. The manager stated that a further review is planned to include a new member of staff and to include the bedroom sizes. Residents had discussed the revised statement of purpose at a recent resident meeting and had made suggestions on what should be included. This is good practice. The Service User guide was available to individuals and formed part of the welcome pack. It was pleasing to see that symbols and pictures had been used to enable all residents in the home to understand the information. Information was available on the assessment process in the statement of purpose and a policy was available to guide staff. The manager demonstrated a good understanding of the process and described how she had been involved in the assessment of new residents in her previous role as a deputy in another Freeways Home. It was evident that the residents would be involved in the process and their views sought on who should move to the home. Jonathan House D56_D05_S26539_Johnathan House_V241141_150905_Stage 4.doc Version 1.40 Page 10 The manager stated that visits to the home would be tailored to the individual and form part of the assessment process. The home has one vacancy. Care records included assessments completed by the home and the placing authority. The certificate of registration requires amendment to remove the variation for the one named individual who is over the age of 65 years of age and to remove the name of the previous manager. The inspector was informed of this information prior to the inspection. The inspector saw many examples of the staff team demonstrating the capacity to meet the residents’ specialised needs. There was evidence that the Community Learning Disability Team including the consultant psychiatrist was supporting the home, staff and the individuals. This is seen as good practice and demonstrated a multi-disciplinary approach to the care of the individuals. Contracts were seen on individuals’ files and met with the legislation. These were updated annually to include the changes to the fees. This is good practice. These clearly stated what was not included in the fee and any additional costs. Residents contribute part of their disability living allowance to the running costs of the vehicle. Residents (where able) had signed the contracts. Jonathan House D56_D05_S26539_Johnathan House_V241141_150905_Stage 4.doc Version 1.40 Page 11 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, 8, 9, 10 Residents are involved in the planning of their monthly goals and making decisions that directly affect their lifestyles. Jonathan House encourages residents to be as independent as possible. EVIDENCE: A random selection of care files were viewed. The inspector saw that reviews were held regularly involving individuals living in the home. It was evident that the individual was the focus of the plan and goals were based on the inspirations of the individual. Goals were set monthly with the individual and the key worker and progress was recorded. A concern was raised with the manager in that the plans of care were not measurable and broken down into clear statements on how the support was to be given and by who. This would enable the individual and the key worker to fully review the service being delivered based on the plan of care drawn up by the placing authority. The manager stated that this was being addressed both in her role as manager and by the organisation. This will be followed up at the next inspection. Jonathan House D56_D05_S26539_Johnathan House_V241141_150905_Stage 4.doc Version 1.40 Page 12 There was no pen picture of the individual to give the reader a reflection of who the person was, a brief history and their interests. However, it was evident that staff and the manager had a good understanding of the individuals living in the home. Residents told the inspector that they make choices on a day-to-day basis on how they want to spend their time from the time they get up to the time they go to bed. Residents stated that they are involved in the planning of the care and confirmed their involvement in the monthly meetings that they have with their key worker. A resident described how they were involved in the choosing of the colour scheme for their bedroom and the choices that had been given to them on destinations for their annual holiday. It was evident that this was an informed choice. They described how they were saving for future holidays and how important and enjoyable the holidays were. Residents’ meetings continue to take place in the home where residents have the opportunity to discuss a variety of matters including the day to day running of the home. An agenda was set and it was pleasing to note that residents were encouraged to add to this should they wish. This continues to be good practice in this home. A resident showed the inspector the rules of the home, stating that all the residents had been involved in writing up the rules. It was evident that they were happy to follow them as it made the house a “better” place to live. The rules were no different from any other shared living accommodation and the focus was respect for each other. Records were held securely. Residents had signed their plans of care, reviews and risk assessments. Staff on duty confirmed this information at the time of the inspection. They also displayed their own awareness for confidentiality when discussing residents. Jonathan House D56_D05_S26539_Johnathan House_V241141_150905_Stage 4.doc Version 1.40 Page 13 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 Residents lead active and independent lifestyles and are encouraged to maintain contact with friends and family. EVIDENCE: Residents confirmed that they are encouraged to be as independent as possible. A resident described how all the residents have household chores to complete and that these are discussed and reviewed at house meetings. It was evident that this individual felt valued and enjoyed the responsibility. All residents access the community independently of staff, information was included in the risk assessment. The manager stated that these will be reviewed and where required will include further information demonstrating the level of independence. A resident told the inspector that they carry a mobile phone to enable them to contact the home in the event of an emergency. Jonathan House D56_D05_S26539_Johnathan House_V241141_150905_Stage 4.doc Version 1.40 Page 14 Timetables indicated that the residents are offered a structured timetable that is tailored to the individual based on choice. Residents told the inspector that they were supported to attend college, work placements, Leigh Court day centre (part of Freeways), and other relevant placements. There was a notice board about local events such as Seymour’s Disco and trips to the theatre. A resident stated that they had recently been to the pub for a meal and told the inspector about the weekly in-house dart session organised by the home and residents from other Freeways Homes are invited to participate. Care records included information about friends and family and how to contact them and significant dates like birthdays. Residents stated that they are supported to use the telephone, write letters and make arrangements to visit their relatives. Residents confirmed that they could have relatives and friends visit them in the home. The home maintains a record of visitors to the home. Residents confirmed that they continue to have one day a week where their key worker (named member of staff) supports them with their household chores including laundry and the cleaning of their room plus planning an activity of their choice. It was evident that residents enjoyed the support given them. One resident told the inspector that over the last couple of weeks staff have been involved in supporting an individual who had been ill but now they were looking forward to returning to the gym with staff. It was evident that the staff working on the day of the inspection was supporting this. Positive communication between residents and staff was observed. The atmosphere in the home was relaxed, welcoming and homely. Members of the household confirmed that they have their own bedroom door key. Two residents showed the inspector their bedrooms and it was evident that they were proud of their own private space, which was filled with personal effects, a music centre and television and decorated reflecting their personal taste. Residents stated that the food was good and choice was available to them. The lunchtime meal, which consisted of a selection of filled rolls and crisps, was relaxed with staff members joining in. Residents confirmed that they could make snacks and drinks throughout the day. Jonathan House D56_D05_S26539_Johnathan House_V241141_150905_Stage 4.doc Version 1.40 Page 15 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, 20, 21 Residents’ health and personal care needs are being met. The home operates a robust medication system ensuring the safety of the residents. EVIDENCE: Care plans clearly documented the personal and health care needs of the residents. Systems for monitoring an individual’s wellbeing were in place and concerns about health were quickly addressed. Residents had access to other health professionals including a GP, optician, chiropody, dentist and the community learning disability team. There was evidence in the form of letters from consultant psychiatrists that they were involved in reviewing the mental health states of individuals. The monthly key worker report included health monitoring and developing an action plan. Residents clearly had their own style of dress, which was tailored to their individual preference and was noted to be age appropriate. Residents stated that they are supported to go shopping for their own clothes and toiletries. Residents evidently took pride in their appearance. Information in care records demonstrated that the home was accessing support and guidance from other professionals ensuring a multi-disciplinary approach. This is good practice. Jonathan House D56_D05_S26539_Johnathan House_V241141_150905_Stage 4.doc Version 1.40 Page 16 The home has a key worker system. The residents and the staff confirmed this. This was described in the statement of purpose and the service user guide. The home has robust procedures and practices on the administration of medication, including a comprehensive induction and training package for staff. Systems were in place to ensure the protection of the individuals living in the home. Care files included an assessment of the ability to self medicate. This is good practice. Where residents self medicate lockable storage is provided in their bedrooms for this purpose. The pharmacist had completed an inspection of the medication system and all was satisfactory. The home is informing the Commission for Social Care Inspection of events that affect the well being of the residents in respect of regulation 37. This was in response to a requirement from the last inspection. The home has a policy to guide staff through the procedure in the event of a death of a resident. Care files did not include the views on what support an individual would like in the event of an illness or death. This will be discussed at the next inspection. The home has recently experienced a death of a resident. It was evident that the individual had been the focus of the care. The home had liaised with other professionals in ensuring that the individual was comfortable leading up to their death including the palliative care services. The home had increased the staffing to meet the changing needs of the individual including waking night staff. This is good practice. Residents told the inspector about the funeral and how they were involved in the arrangements. The manager stated how the home was accessing a psychologist to support individuals through the bereavement process. This is good practice. The home has demonstrated that they are meeting the standards relating to personal care and healthcare. Jonathan House D56_D05_S26539_Johnathan House_V241141_150905_Stage 4.doc Version 1.40 Page 17 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) 22, 23 Jonathan House has robust systems for complaints and protection. However, the manager would benefit from attending a course on train the trainer on abuse. EVIDENCE: The home has a complaint procedure available to residents. This included symbols, clearly described the process and the people they could contact within the organisation and the role of the Commission for Social Care Inspection. The home has a record of complaints detailing the nature of the complaint, the action taken to rectify the concern and the outcome. This is in response to a requirement from the last inspection. The home has had no complaints since the last inspection. It was noticed that residents’ views are sought at residents’ meetings and at care reviews. Residents spoken with during this inspection had a good understanding of the complaint procedure and stated that they would discuss with their key worker or the manager if they were concerned about any issue in the home. Residents were aware of the role of the inspector and had been informed of the announced inspection. This had been discussed at a recent resident meeting. The home has a policy on abuse and a copy of the Bristol City Councils “No Secrets” was displayed on the notice board. The manager stated that it is her responsibility to train staff on abuse. It was apparent that the manager had not attended the Train the trainer course on abuse. This would be advisable to enable her to fulfil this role. The manager stated that all staff receive training on abuse during their induction as part of the Learning Disability Award Framework. Jonathan House D56_D05_S26539_Johnathan House_V241141_150905_Stage 4.doc Version 1.40 Page 18 The home has a whistle blowing policy. All staff and residents were aware of the senior management structure of Freeways and people that they could contact if concerns were raised about the home. A random selection of finances were checked. Monies held in the home accounted with records. There were individual plans relating to support needs of the individuals in respect of their finances. Individuals have their bank accounts and there was a record of all transactions and evidence that personal allowances and benefits were being paid to the individuals. The home has recently had an internal audit. There were three recommendations for the home to investigate a discrepancy of 2p for one individual, to ensure that the records of the bank accounts are updated on a regular basis and that the home ensures that there is a record of all money taken out of the home in the form of a petty cash slip. The manager confirmed that the appropriate action has been taken. The inspector noted that all but one of the residents is able to sign for their money. All expenditure should be supported by two staff signatures in the absence of a resident. Jonathan House D56_D05_S26539_Johnathan House_V241141_150905_Stage 4.doc Version 1.40 Page 19 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, 26, 27, 28, 29, 30 Jonathan House provides a safe and homely environment for the residents. However, the home has failed to replace two bedroom carpets and residents would benefit from a planned refurbishment plan that can be monitored and reviewed. EVIDENCE: Jonathan House is in keeping with the local neighbourhood and is close to local amenities including shops, a church, and a cinema and is a short walk from the “Downs” a large common. The manager stated that the property manager has been requested to visit the home to assess future works to the home. At the last inspection in March 2005 the home was discussing with Freeways a refurbishment plan to include the updating of the bathrooms and the redecoration of the bedrooms. As yet this has not been undertaken or a planned date made available. The Commission of Social Care Inspection must be sent a copy of the plan for refurbishment with timescales to enable this to be monitored. Jonathan House D56_D05_S26539_Johnathan House_V241141_150905_Stage 4.doc Version 1.40 Page 20 There are two outstanding requirements relating to the replacement of the carpets in two of the bedrooms. This has been extended to enable the home to demonstrate compliance. The manager stated that quotes have been obtained and the residents have chosen the colour but this was put on hold due to the illness of one of the residents. Where timescales cannot be met the home must take advice from the inspector. Since the last inspection the external plaster and the guttering has been painted and repaired. This was in response to a requirement from the last inspection and the home has demonstrated compliance. All bedrooms are single. These were furnished to a satisfactory standard and residents had evidently chosen the décor to suit their personal taste. There was evidence in all rooms of residents’ hobbies, activities and personal effects such as books, photographs, videos and ornaments. Two of the bedrooms are due to be decorated but the manager could not confirm a date. One has been outstanding since March 2005. This must be included in the plan of refurbishment, with a realistic timescale. The manager stated that the delay in the refurbishment of the bedrooms was due to one of the residents having a terminal illness and their subsequent death meant there has been a delay in responding to this requirement relating to the decoration of the bedrooms. Communal areas were homely and comfortably furnished. The lounge doubles up as the sleep in facility for staff. A resident and the manager stated that this does not hinder residents who wish to stay up late and a television is available in the dining area, which is situated on the ground floor. Residents have access to two bathrooms, one on the ground floor and a separate toilet on the first floor. Whilst this was adequate for the needs of the residents, the bathrooms, including the flooring, were looking dated. There were areas of concern relating to the cleaning, including the fridge and a resident’s bedroom. This was rectified at the time of the inspection. The home in all other areas was clean and free from odour. The manager stated that care staff and the residents are responsible for the cleaning of the home. There were sufficient facilities to wash clothes. The laundry facility is accessed via the kitchen. The manager stated that residents are fully involved in the laundering of their clothes and that washing is brought down once all food preparation is completed and in closed baskets. The inspector was informed the home has a risk assessment stating the procedure to follow. Jonathan House D56_D05_S26539_Johnathan House_V241141_150905_Stage 4.doc Version 1.40 Page 21 Since the last inspection the home has had a new heating system installed, the manager stated that this is now adequate to heat and provide hot water for all residents living in the home. This is in response to a requirement from the last inspection and the home has demonstrated compliance. However, it has to be noted that the heating was not on at the time of the inspection due to the time of the year. Jonathan House D56_D05_S26539_Johnathan House_V241141_150905_Stage 4.doc Version 1.40 Page 22 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, 33, 35 Residents have sufficient and competent staff to meet their care needs. There is a good rolling programme of training available to the staff team. EVIDENCE: The home is adequately staffed to meet the needs of the residents as described in the statement of purpose. The manager stated that there is always two staff working in the home in the morning, evenings and weekends. This is reduced to one during the day on Tuesday, Wednesday and a Friday as the majority of residents are either working or at their day placements. The manager stated that this is reviewed if residents are on holiday and are all in the home, then staffing is increased to two staff. It was evident from talking with the manager that staffing is reviewed in light of changing needs and increased if an individual is unwell or requires additional support. This is good practice. The manager stated that the home uses regular bank staff to cover the shortfall due to staff holidays or absences. The manager stated that a new member of staff is planning to start at the end of the month. It was evident from the duty rota and talking with residents that there has been a high level of staff sickness. The manager described how this was being investigated and the procedures that were being followed to support staff. Jonathan House D56_D05_S26539_Johnathan House_V241141_150905_Stage 4.doc Version 1.40 Page 23 Recruitment records were not seen on this occasion. All staff presently working in the home have worked there for a number of years. The manager stated that she is planning to introduce more involvement of residents in the recruitment of staff including the interview process and the formulation of the questions. This will be followed up at the next inspection, as this would be seen as good practice. A team of five staff excluding the manager supports residents. Two of the staff are in the process of completing an NVQ (National Vocational Qualification) at level 3 in care with a third planning to commence once they have completed the Learning Disability Award Framework. The home is working towards the government target that 50 of the workforce will have an NVQ in care. An external assessor supports the home. From talking with the manager who has only been in post for one month it was evident that she was putting in place systems for supporting and supervising staff. This has included a review of the staff training and the systems already in place. In the last month the manager was able to demonstrate she had supervised three staff and that a staff meeting was planned for the following week. Records demonstrated that there was a rolling programme of health and safety training and that further training was being explored for the team on mental health, autism, person centred planning and specific training for individual team members relating to management and the supervision of staff. This will be followed up at the next inspection. Jonathan House D56_D05_S26539_Johnathan House_V241141_150905_Stage 4.doc Version 1.40 Page 24 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) 39, 41, 42 The home has a new manager who demonstrated a good understanding of the needs of the residents. EVIDENCE: Ms Brownell is the manager of the home. She has been in post for the last four weeks. She has yet to submit an application to the Commission for Social Care Inspection to enable her to become the registered manager. It was agreed that this would be sent to the CSCI within seven days. Ms Brownell has worked for Freeways Trust for a number of years and was able to demonstrate that she has had two years management experience. Ms Brownell has completed an NVQ (National Vocational Qualification) at level 4 in care and is in the process of completing the Registered Managers Award. Ms Brownell has the necessary requirements as set down by the National Minimum Standards to apply to become the registered manager. Jonathan House D56_D05_S26539_Johnathan House_V241141_150905_Stage 4.doc Version 1.40 Page 25 Ms Brownell demonstrated a good understanding of the residents living in Jonathan House and has formulated a plan on what needs to be addressed to ensure that the home runs smoothly and meets the National Minimum Standards. A resident spoke positively about the support and the open approach of Ms Brownell. Quality assurance was discussed with the manager who is part of a Freeways Trust Quality Audit Review Working Party. Views are being sought from residents across the trust on the service being provided. The manager stated that this information would inform the business plan. This will be further discussed at the next inspection. It was evident that the manager has completed an appraisal of the service including individual care reviews, record keeping, supervision and an audit of the training of staff and has developed an action plan. It was evident through discussion with the manager that this has been shared with her senior manager. She stated that this is being monitored at supervisions and the monthly provider visits in respect of Regulation 26. Records were held securely and found to be current and up to date. Residents had signed records where relevant. There was no current certificate of insurance displayed in the home. From discussions with staff and staff training records it was evident that there is a rolling programme of health and safety training including manual handling, fire, food hygiene and first aid. The home has guidance on infection control and policies to ensure the safety and well being of residents and staff. The manager stated that she was unable to find information relating to COSSH and has requested this information from Freeways and other managers in respect of the Data Sheets for chemicals hazardous to health. This will be followed up at the next inspection. Risk assessments were in place demonstrating that there were safe guidelines for staff and residents on a number of activities that are undertaken in the home and the community. These had been kept under review. Fire records were current demonstrating that staff attend periodic training and drills as prescribed by the fire officer and checks were being completed on the fire equipment. However, one of the bedroom doors on the ground floor was being propped open. Advice must be sought from the fire officer and a self closure fitted to ensure the safety of the residents in the event of a fire. Jonathan House D56_D05_S26539_Johnathan House_V241141_150905_Stage 4.doc Version 1.40 Page 26 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 3 3 3 3 3 Standard No 22 23 ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 2 2 3 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 x Standard No 31 32 33 34 35 36 Score x 3 3 x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Jonathan House Score 3 3 3 3 Standard No 37 38 39 40 41 42 43 Score x x 3 x 3 3 x D56_D05_S26539_Johnathan House_V241141_150905_Stage 4.doc Version 1.40 Page 27 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. 2. Standard 26 24 Regulation 23 (2) (b),16 (2) (c) 23 (2) (b), 24 (1) 23 (4) (c)(i) Requirement Timescale for action 15/10/05 3. 42 4. 43 25 (2) (e) For the carpets in Room 6 and 8 to be replaced (Outstanding requirement 30th June 2005). For the home to develop a 15/10/05 programme of refurbishment and to include timescales. A copy to be sent to the Commission for Social Care Inspection. Fire doors must remain closed 15/10/05 unless fitted with a self-closure on the event of a fire. The home must seek advice from the fire officer on self-closures for the ground floor bedroom (Rm 1). The home must display a current 16/10/05 certificate of insurance. 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 23 23 Good Practice Recommendations Where a resident is unable to sign for financial transactions this should be supported by two staff signatures. The manager should attend a train the trainer course in abuse to enable her to be assessed as competent to cascade this to the staff team. D56_D05_S26539_Johnathan House_V241141_150905_Stage 4.doc Version 1.40 Page 28 Jonathan House 3. 27 The bathrooms to be included on the programme of refurbishment. Jonathan House D56_D05_S26539_Johnathan House_V241141_150905_Stage 4.doc Version 1.40 Page 29 Commission for Social Care Inspection 300 Aztec West Almondsbury South Glos BS32 4RG 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 Jonathan House D56_D05_S26539_Johnathan House_V241141_150905_Stage 4.doc Version 1.40 Page 30 - 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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