Inspection on 19/03/06 for Jonathan House

This inspection was carried out on 19th March 2006.

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 found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Jonathan House 08/11/06

Jonathan House 15/09/05

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 Karen Walker Unannounced Inspection 19th March 2006 09:30 Jonathan House DS0000026539.V273681.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 Jonathan House DS0000026539.V273681.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. Jonathan House DS0000026539.V273681.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Jonathan House Address 19 Bayswater Avenue Westbury Park Bristol BS6 7NN 0117 9736361 0117 9736361 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) Freeways Trust Ltd Helen Rachel Brownwll Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Jonathan House DS0000026539.V273681.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. May accommodate up to 8 persons, aged 18 - 64 years, requiring personal care. 15th September 2005 Date of last inspection 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 accommodation 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 achievable 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. The manager has successfully gone through the registration process with the Commission for Social Care Inspection. Jonathan House DS0000026539.V273681.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out on a Sunday. The purpose of the visit was to review the progress of the requirements and recommendations made at the previous inspection visit and to assess the standards that were omitted last time. The home has demonstrated compliance to most or is working towards the requirements and recommendations from the previous inspection. 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. Time was spent chatting to residents both individually and as a group to ascertain their thoughts and feelings on life in the home and their goals and aspirations in general. One resident said, “of course I like living here, I do a lot of things with my key-worker”. Staff members were available to provide information on the management of the home and on care provision. One staff member said, “ there is an open door approach to management and we have a good team of staff”. Records were examined including care planning folders, risk assessments and health care notes, policies and procedures and daily records. 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. This was evidenced through observations made, speaking to residents and through the examination of care records. 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. Jonathan House DS0000026539.V273681.R01.S.doc Version 5.1 Page 6 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. One resident said, “ we have meetings and every body listens to you”. A staff member commented, “There is a lot of communication at Jonathon House and staff meetings take place on a regular basis”. What has improved since the last inspection? 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. Jonathan House DS0000026539.V273681.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 Jonathan House DS0000026539.V273681.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): X EVIDENCE: All of the above standards were assessed and met at the last inspection and have not been reassessed on this occasion. However it was noted that residents have copies of the service user guide for the home and have up to date contracts. Jonathan House DS0000026539.V273681.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): 6,9 Residents are aware of their assessed and changing needs and have input into reviews. Residents are supported to take risks as part of an independent lifestyle. EVIDENCE: A random selection of care folders were viewed and residents spoken with. Permission was gained from three residents to view their essential lifestyle plans and their associated risk assessments. It was noted that reviews take place on a monthly basis with the involvement of the resident. All records were well written and individually focused maintaining respect at all times. There were positive reactive strategies in place that supported staff and the individual with the management of a behaviour that may be seen as challenging. The strategy plan included details on how the behaviour may be exhibited, indicators that the behaviour may be imminent, what immediate response is most helpful, any actions that should be avoided and how to monitor what is happening. Jonathan House DS0000026539.V273681.R01.S.doc Version 5.1 Page 10 An incident was observed where a staff member successfully diffused a potentially challenging behaviour; she reacted in a supportive yet confident, firm way. The incident was discussed and it was evident that this staff member was aware of the recorded needs of the resident group. 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. One resident said, “I like the meetings we can discuss anything we want”. Risk assessments were examined for those residents that were ‘case tracked’ and it was noted that these were individualised and related to their everyday lives. Jonathan House DS0000026539.V273681.R01.S.doc Version 5.1 Page 11 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): 17 Residents are offered a healthy diet and have input into menu planning and food preparation. EVIDENCE: Standards 11-16 were fully assessed at the last inspection and have not been reassessed. The lunchtime meal was observed and residents said, “the foods nice, I get to chose what I want, I like meat”. “I help with the cooking and I’m making cakes today with a staff member”. “This meal was very nice”. The menu plan was examined and the meals are varied, incorporating individual choices, likes and dislikes. Jonathan House DS0000026539.V273681.R01.S.doc Version 5.1 Page 12 The fridge contained foods that were labelled and dated, and was clean and tidy. Signs on the wall helped residents to remember to wear the appropriate clothing in the kitchen and to comply with hygiene rules. Jonathan House DS0000026539.V273681.R01.S.doc Version 5.1 Page 13 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): 18,19 Residents are supported with personal care in a way in which they prefer and they are confident that their health care needs will be adequately assessed and met. 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. Jonathan House DS0000026539.V273681.R01.S.doc Version 5.1 Page 14 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. 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 demonstrated that they are meeting the standards relating to personal care and healthcare. Jonathan House DS0000026539.V273681.R01.S.doc Version 5.1 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 the following standard(s): X EVIDENCE: These standards were assessed at the last inspection and have not been reassessed. A recommendation that the manager attend a ‘training for trainers’ course to enable her to cascade protection training to her staff was not followed up in the absence of the manager on the day of this inspection. Jonathan House DS0000026539.V273681.R01.S.doc Version 5.1 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 the following standard(s): 25,30 Residents live in a comfortable environment. Although bedrooms meet the needs and lifestyle preferences of individuals they will benefit from regular deep cleaning and the removal of unwanted furniture. EVIDENCE: Two residents were happy to show the inspector their bedrooms. These were individualised and suited to needs and preferences. All bedrooms are single. These were furnished to a satisfactory standard and residents had evidently chosen the décor to suit their personal taste. However one bedroom was cluttered and in need of cleaning. There was a chair turned upside down in the room and the resident said this was due to be taken away. It is a requirement to remove the unwanted chair as this could prove to be a health and safety issue. The home itself would benefit from a deep cleaning routine on a regular basis and the carpets were in need of vacuuming on the stairs and landing. There were no unpleasant smells or cause for concern. Jonathan House DS0000026539.V273681.R01.S.doc Version 5.1 Page 17 A letter has been received by the CSCI detailing the plans for the ongoing maintenance works. Bedrooms will be decorated in May 2006 along with the bathrooms. One resident confirmed that he had a new bedroom carpet and a staff member thought that another carpet for a second room was on order. The inspector for the home will follow up requirements made concerning the environment at a later date as timescales for compliance have been extended. Jonathan House DS0000026539.V273681.R01.S.doc Version 5.1 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 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): 31,34,36 Residents have the benefit of a well-supervised staff team who are aware of their roles and responsibilities in the home. Residents’ benefit from a robust recruitment system backed up by the organisational policies and procedures in place. EVIDENCE: Whilst staffing records were unavailable for inspection in the manager’s absence a staff member explained the recruitment process. She confirmed a Criminal Bureau Record Check (CRB) check was sought in respect of her as was 2 references before she began employment. She is currently undertaking her LADAF with a view to commencing a National Vocational Qualification (NVQ). Staff members are aware of their roles and responsibilities within the home and one staff member said, “ responsibilities are pretty evenly delegated”. She added, “ I am aware of my skill limitations and if in doubt would ask. I have been appropriately supervised and supported through a difficult time. Staff members are supported at a frequency individual to them”. This is commendable and demonstrates a meeting of individualised staff needs. Various training sessions were confirmed including health and safety and first aid. Jonathan House DS0000026539.V273681.R01.S.doc Version 5.1 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 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): 38,40,43 Residents’ benefit from a sound management approach to the home and a motivated staff team provide additional support. Resident’s rights and best interests are safeguarded by the homes policies and procedures that are accessible to all staff and residents. EVIDENCE: It was noted that the fire doors were closed. This was required at the last inspection. A second requirement was made to ensure the certificate of insurance was on display. This was also met. Staff members and residents were happy with the management approach to the home and service provision. One staff member said, “ I am aware of the management structure of the organisation and it is clearly displayed on the office wall”. Jonathan House DS0000026539.V273681.R01.S.doc Version 5.1 Page 20 A resident said, “ I get on with the manager, she’s nice and the rest of the staff, I can complain to the manager and my key-worker”. Staff had access to 3 folders of policies and procedures and one staff member explained the process for reading new policies which must be signed as read. This is good practice. There is an emergency board in the office which details various policies including the missing person policy, accident and incident, emergency contacts, complaints, safe bathing, risk assessments and reactive strategies for dealing with behaviours that may be challenging. Records show that regular regulation 26 visits take place. These are carried out by the provider on an unannounced basis and are used to ascertain the quality of service provision. The Commission for Social Care Inspection is informed of any incidents affecting the well being of residents in the form of regulation 37 notifications. Jonathan House DS0000026539.V273681.R01.S.doc Version 5.1 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for 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 X 23 X ENVIRONMENT Standard No Score 24 X 25 2 26 X 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 3 32 X 33 X 34 3 35 X 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 X X 3 X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 X 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 X X X 3 X 3 X X 3 Jonathan House DS0000026539.V273681.R01.S.doc Version 5.1 Page 22 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 YA25 Regulation 13(4)(a) Timescale for action Remove the unwanted chair from 03/04/06 one of the bedrooms on the top floor. Requirement 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 YA30 YA6 Good Practice Recommendations Regularly ‘deep clean’ the home. Remove and archive outdated resident records/monthly reviews. 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