Inspection on 21/06/07 for Joseph House

This inspection was carried out on 21st June 2007.

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

Joseph House 19/06/09

Joseph House 03/07/06

Joseph House 24/01/06

Joseph House 23/06/05

Joseph House 28/02/05

Joseph House 06/01/05

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOMES FOR OLDER PEOPLE Joseph House The Old Rectory Reedham Norwich Norfolk NR13 3TZ Lead Inspector Andy Green Unannounced Inspection 21st June 2007 11:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Joseph House DS0000027295.V344261.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Joseph House DS0000027295.V344261.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Joseph House Address The Old Rectory Reedham Norwich Norfolk NR13 3TZ 01493 700580 01493 700994 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) Joseph House (Reedham) Ltd Mrs Beverley Mary Terry Care Home 35 Category(ies) of Learning disability (35), Learning disability over registration, with number 65 years of age (35) of places Joseph House DS0000027295.V344261.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The total number of people accommodated must at no time exceed 35. Any person must, on admission, be at least 45 years of age. One person, named in the Commission’s records and less than 45 years of age, can be accommodated. 3rd July 2006 Date of last inspection Brief Description of the Service: Joseph House is a care home currently registered to provide personal care and accommodation to 35 elderly adults with learning disabilities. The home is privately owned and has been run by the same proprietors for a considerable period of time. The service, located in the village of Reedham, approximately 20 miles from Norwich, is a large period house, which has been extended. Joseph House is on a no through road so there is little passing traffic and stands in large grounds. There is off-road parking. There are also two other small units providing accommodation adjacent to the main house. The home has a total of 21 single bedrooms, most of which are en-suite, and 7 shared rooms, all of which have en-suite facilities. The main house has accommodation on the ground and first floors, which residents can also access by the lift. Charges for living at the home range from £330 to £884 per person per week, There are additional charges for hairdressing, chiropody, newspapers and magazines, outings and personal spending. The home ensures that CSCI inspection reports are made available to residents or their representatives. Joseph House DS0000027295.V344261.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Andy Green, Regulation Inspector, undertook this key unannounced inspection on 21st June 2007. The inspector met with the manager, one of the providers, care staff and residents. A number of documents were inspected including care plans, staff files, training records and health & safety records. A tour of the premises and grounds was also undertaken. What the service does well: What has improved since the last inspection? What they could do better: Maintenance of the premises needs to be ongoing to ensure that work is completed in the agreed timescales. Records of emergency light testing needs to be implemented to ensure that residents are protected from potential harm. Joseph House DS0000027295.V344261.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Joseph House DS0000027295.V344261.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Joseph House DS0000027295.V344261.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3, 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents have their needs assessed and can be sure these will be addressed, before they move into the home. EVIDENCE: The manager stated that she and one of the senior carers carry out assessments for prospective residents. The home completes an assessment form to ensure that health and social care needs are recorded and can be adequately met. There were 27 residents living in the home on the day of inspection. The assessment information for a recent admission was seen and evidenced that a good range of information had been collected before the person moved into the home. The manager stated that prospective residents and their relatives are able to make visits to the home prior to admission. The home does not provide intermediate care. Joseph House DS0000027295.V344261.R01.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are treated with respect and receive personal care to meet their assessed needs. EVIDENCE: The care plans of three residents were inspected and they contained detailed and appropriate information. The care plans are now presented in a more professional and accessible manner with clearer guidelines for staff to ensure that the care and support needs of each resident can be appropriately provided. Information included a personal profile, likes and dislikes, mobility monitoring, weight charts, goals and aspirations, behaviour monitoring, ‘key-worker talk time’, support and personal care needs including guidelines for the delivery of care. Records of visits made by healthcare professionals were also included. Each care plan is now in a more person centred format, which gives a more holistic approach to care and incorporates the resident’s views, choices and preferences as much as possible. Joseph House DS0000027295.V344261.R01.S.doc Version 5.2 Page 10 The manager stated that there is commitment from all care staff to ensure that these improvements are maintained. Regular reviews of care plans take place and include any updates or changes in care. This was evidenced in the care plans seen during the inspection. Daily notes are kept up to date by care staff and evidence of this was seen during the inspection. Interactions observed between staff and residents were appropriate, and residents spoken to confirmed that staff supported them in a friendly and appropriate manner. Comment cards received by CSCI also confirmed this to be the case. There is screening provided in shared rooms. The glazed panels in bedroom doors have been screened to provide more privacy, as required at the last inspection. There is a risk assessment procedure in place to ensure that residents are protected from harm both within the home and when accessing the community. Each resident has a key worker to ensure that care is consistently delivered to meet individual needs. Discussions with residents is evidenced in the “time to talk” sheet in the care plans. Staff members spoken to during the inspection confirmed that they are involved in the care planning process. Medication records were inspected and they were accurate and up to date. The manager stated that a local pharmacist is available provided training in the home. Comment cards received from residents, relatives and healthcare professionals were mainly positive about the care and support provided in the home. One comment card did however raise some concerns about whether the home could meet all of the complex needs that residents may present. Feedback from comment cards was given to the manager. Joseph House DS0000027295.V344261.R01.S.doc Version 5.2 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents have access to a range of social and recreational opportunities. EVIDENCE: There are a range of activities provided for residents. The goal setting sheets in each of the resident’s care plans provide some details of individual activities that are undertaken. It is recommended that there is a weekly programme sheet included in care plans showing details specific activities undertaken. There are two activities co-ordinators who consult with residents to devise individual and group activities. These include art groups, music therapy, visits from the hairdresser, aromatherapy, quizzes, bingo, singing, pub lunches, local village fetes, cinema trips and visits to the local animal park. Paid musical entertainers also visit throughout the year. Two residents also attend local day services and three residents attend local colleges. Regular daytrips are organised to local seaside resorts and holidays are planned for four residents in Yarmouth and for four residents in Skegness in July. Residents confirmed this during the inspection. Joseph House DS0000027295.V344261.R01.S.doc Version 5.2 Page 12 Residents benefit from a varied menu in the home and continue to receive a choice of meals to meet their dietary needs and preferences. Residents spoken to confirmed that the standard of meals were of good quality with choices offered to the menu for the day. Drinks and snacks were available during the day. Residents continue to be involved in the shopping and preparation of food where possible. Joseph House DS0000027295.V344261.R01.S.doc Version 5.2 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 , 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a satisfactory complaints process to ensure that residents and their representatives are able to raise concerns and have them dealt with appropriately. EVIDENCE: The home’s complaints procedure ensures that all concerns are fully investigated and actioned appropriately. There have been no complaints raised with the home since the last inspection. CSCI has also not received any complaints since the last inspection. The home ensures that adult protection issues are dealt with in line with local authority policies to help ensure that service users are protected from potential abuse. Care staff confirmed that they receive appropriate training to ensure they are aware POVA procedures and was also evidenced in the home’s training records. Joseph House DS0000027295.V344261.R01.S.doc Version 5.2 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 23, 26. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There has been some refurbishment, but attention is needed to maintenance and redecoration as previously reported. EVIDENCE: Refurbishment of the home is underway to address concerns raised during the last inspection. Timescales for maintenance requirements have not yet elapsed, but there are good signs that work has commenced. The manager stated that planned decoration / refurbishments to downstairs areas are planned including replacing carpets, dining chairs and furnishings. Decoration to the first floor is underway with redecoration of corridors and new carpets have been laid. Standards regarding the environment will be assessed at the next inspection of the home to more accurately gauge improvements that have been made. Joseph House DS0000027295.V344261.R01.S.doc Version 5.2 Page 15 Water temperature recording has improved since the last inspection and records are being maintained. There is also a monthly repairs and maintenance book to repairs/maintenance issues. Bathrooms were clean and tidy and free from any resident’s personal items as outlined in the last report. A new seat and shelf has been installed in the shower room. The heating problems identified in the last report have now been remedied. Valves to covered radiators have been made accessible. A trolley has been purchased since the last inspection so that items of crockery etc. can be satisfactorily removed from bedrooms. Cleaning and other hazardous substances were observed to be kept in a locked cupboard. Unused light fittings identified at the last inspection have been removed. The notice board in the corridor did not give details of residents but displayed the fact that a number of healthcare professionals were visiting the home. Five bedrooms were seen and they were furnished and personalised to meet individual residents preferences and wishes. The glazed door panels have been screened to provide more privacy for residents. The manager stated that an audit of bed linen had been undertaken and that any worn items had been replaced with new bedding. Of the bedrooms seen, bedding appeared to be of good quality. The star locks to bedrooms (apart from three) have been replaced with Yale locks. There was evidence of letters from three relatives stating that they preferred star locks remaining on their relative’s bedroom doors. Agreements with residents regarding the locking/keeping keys for bedrooms were evidenced in care plans. It was noted that the corrugated roofing near to the annexe needs to be cleaned. The grounds of the home are well maintained so that residents to sit and enjoy their surroundings. There is a variety of seating near to the front of the home with picnic tables and parasols. The home was generally clean and free from odours. Joseph House DS0000027295.V344261.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Improvements have been made to recruitment practices to ensure that adequate checks are made before employment commences. EVIDENCE: Four care staff files were seen and they contained appropriate information apart from adequate numbers of references, which had been highlighted at the last inspection. The manager however has taken steps to improve the recruitment procedures and she is currently processing two applications. She stated that two references and POVA/CRB checks would need to be received before any commencement of employment. There was evidence of satisfactory POVA/CRB checks in staff files. Staff training in the home continues to be well co-ordinated and a programme is in place ensuring that mandatory and client specific training is delivered. Refreshers and regular updates continue to be organised throughout the year. NVQ training is also in place for care staff and managers to meet expected nationally agreed standards. Four members of care staff spoken stated that they had received a variety of training in the home including induction, moving & handling, fire safety, first aid, food hygiene, infection control, moving and handling, medication administration, health & safety, POVA, challenging behaviour and NVQ training. Joseph House DS0000027295.V344261.R01.S.doc Version 5.2 Page 17 Care staff spoken to confirmed that they felt well supported by the manager and that they were encouraged to be involved in the development of the service. Two posts are currently being recruited to and any shortfalls in care hours are being met by the use of bank/agency staff. There were sufficient staff on duty to meet the needs of residents. Joseph House DS0000027295.V344261.R01.S.doc Version 5.2 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36, 37, 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the home. The manager is experienced and provides supportive leadership and guidance to staff to ensure that service users receive good quality care. EVIDENCE: The manager has obtained her Registered Managers Award, and participates in other training with the remainder of the staff team. She is also working towards a diploma in psychology and also participates in sessions in local schools regarding care principles. Staff supervision had previously been infrequent but records evidenced improvement in this area. The manager is fully aware that regular supervision of staff needs to be maintained so that staff are adequately monitored on at least 6 occasions during the year. Joseph House DS0000027295.V344261.R01.S.doc Version 5.2 Page 19 The records of personal money held for two residents were inspected and found to be accurate. Servicing and maintenance records were checked. There were adequate weekly fire alarm tests but the provider keeps them on his laptop computer and there fore there are no signatures to evidence that they have been carried out. It was agreed with the provider that he should print out copies and that a signature column added. He agreed to action this. There was no evidence that monthly emergency lighting testing is being carried out. Again the provider has agreed to implement a recording sheet to deal with this. Consequently a requirement will be made regarding emergency lighting tests. A fire risk assessment is now in police following recommendations from the fire officer’s visit in April 2007. PAT testing is carried out annually and the recent servicing records for the lift and two hoists were seen. Joseph House DS0000027295.V344261.R01.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 2 X X 3 X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 2 3 Joseph House DS0000027295.V344261.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? no STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP19 Regulation 23(2) Requirement Timescale for action 31/12/07 3 OP37 17(2) Schedule 4(14) The Registered Persons must ensure that all parts of the house are well maintained, i.e. damage is repaired and areas that require it are redecorated. The timescale for this requirement has not yet expired. Records must be maintained 30/07/07 regarding the testing of emergency lighting in the home 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 OP7 Good Practice Recommendations It is recommended that there is a weekly programme sheet included in care plans showing details of specific activities undertaken by each resident. 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