CARE HOMES FOR OLDER PEOPLE
Jubilee Court Care Home Nabbs Lane Hucknall Nottingham NG15 6HB Lead Inspector
Richard Ramsden Unannounced Inspection 20th October 2005 9:45 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 Jubilee Court Care Home DS0000043200.V260241.R01.S.doc Version 5.0 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. Jubilee Court Care Home DS0000043200.V260241.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Jubilee Court Care Home Address Nabbs Lane Hucknall Nottingham NG15 6HB 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) 0115 983 4630 0115 983 4640 Nottinghamshire County Council Mrs Colleen Russell Care Home 60 Category(ies) of Dementia (30), Dementia - over 65 years of age registration, with number (30), Old age, not falling within any other of places category (60), Physical disability (5) Jubilee Court Care Home DS0000043200.V260241.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 3. Out of the total number of beds (60), there will be 30 beds for DE 55 and over and/or DE(E) Out of the total number of beds (60), 5 may be used for PD 55 and over Service Users shall be within category OP Date of last inspection 1st March 2005 Brief Description of the Service: Jubilee Court is a purpose-built care home for up to 60 older people some of whom may have dementia. The home is owned and managed by Nottinghamshire County Council Social Services. The accommodation is provided on two floors with two shaft lifts to assist independent access. The home is divided into four units each with kitchen, dining room, sitting room and assisted bathing facilities. All bedrooms are for single occupancy and have ensuite facilities. One of the units is dedicated to provide respite care. There are pleasant well-maintained gardens, which are accessible to all residents. Jubilee Court Care Home DS0000043200.V260241.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. One Inspector completed this and announced inspection over one day it took approximately 6 hours. It included the inspection of care and of the records, a discussion with three residents and five members of staff including three team leaders. A partial tour of the building was also completed. What the service does well: What has improved since the last inspection?
The registered person is now ensuring that appropriate sections of the Criminal Records Bureau checks are being completed before staff commence employment.
Jubilee Court Care Home DS0000043200.V260241.R01.S.doc Version 5.0 Page 6 The records of controlled medication were checked and were being acceptabley in maintained at the time of this inspection. From the records checked it was evident that staff are ensuring that they observe and take appropriate action when a resident has had an accident. 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. Jubilee Court Care Home DS0000043200.V260241.R01.S.doc Version 5.0 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 Jubilee Court Care Home DS0000043200.V260241.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,6. The literature supplied to prospective residents does not contain sufficient information to enable them to make an informed decision as to whether the home will meet their individual needs. Jubilee Court no longer provides intermediate care. EVIDENCE: The home provides a ‘Welcome Pack’ for all residents however this does not include the qualifications and experience of staff or the resident’s views of the home. The literature also needs to be updated to show that the Commission for Social Care Inspection has replaced the National Care Standards Commission as the organisation responsible for registering and monitoring standards within the home. This information needs to be included to ensure that prospective residents have sufficient information to enable them to make an informed decision about whether the home will meet their needs. The inspector was informed that the homes manager has updated the literature supplied prospective residents however this was not available for inspection.
Jubilee Court Care Home DS0000043200.V260241.R01.S.doc Version 5.0 Page 9 The inspector was informed that the home no longer provides Intermediate Care and that this unit is now used to provide respite care. Jubilee Court Care Home DS0000043200.V260241.R01.S.doc Version 5.0 Page 10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 8,9,10. The home is ensuring that resident’s health care needs are fully met. Improvements must be made in the way in which the home administers medication to ensure that the system is safe for the residents. Residents are treated with respect and their right to privacy is upheld. EVIDENCE: The health care records of two of the residents were checked as part of this inspection. The records showed that appropriate referrals had been made to health care professionals. The two residents accident records were also assessed, appropriate treatment had been provided and the records showed that where necessary staff had monitored the residents health and emotional state following the accidents. (This is good practice). The residents spoken with confirmed that they are very satisfied with the way in which medical care is provided. One person stated that their health has improved considerably since they moved into Jubilee Court. Jubilee Court Care Home DS0000043200.V260241.R01.S.doc Version 5.0 Page 11 The medication Administration on Windsor Unit was assessed as part of this inspection. The medication Administration records did not have a photograph of individual residents attached. It is important that photographs are attached to the Administration records as this helps the person administering medication to ensure that it is given to the correct resident. The senior staff was advised that there should be no gaps in the medication Administration records, if for any reason, medication is not given to the resident for whom it is prescribed, an explanation must be provided. The use of codes is acceptable for this purpose. It is considered good practice to encourage people to remain independent and continue administer their own medication however there health and safety and the health and safety of the other residents can be compromised if appropriate risk assessments are not completed. Staff are recording the temperature in the room in which medication is stored on a daily basis. (This is good practice). The temperature must also be recorded in any bedroom where medication is stored, if the medication states in must be stored below 25°C. The homes controlled medication were checked at random and had been well maintained. All of the residents spoken with during the inspection said that staff are always friendly and respectful and that they ensure that their privacy and dignity is maintained at all times. The observed interaction between staff and residents was of a very good standard. Jubilee Court Care Home DS0000043200.V260241.R01.S.doc Version 5.0 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,14. Residents are provided with a good range of activities and entertainment, which matches their expectations and preferences. People are encouraged to exercise choice and control over their lives. EVIDENCE: There were posters advertising the various events and activities displayed in each unit and in the main entrance hall. (This is considered good practice). Two of the three residents spoken with during the inspection said that they are very satisfied within the level of activities and entertainment provided by the home. One person confirmed that the home does provide activities but that she chooses not to participate, as she prefers to socialise with her relatives and friends. All service users are offered the opportunity to manage their own finances as part of the formal review process. (This is considered good practice). The literature provided to prospective residents and their families gives comprehensive information on how to contact external agents such as advocates. Jubilee Court Care Home DS0000043200.V260241.R01.S.doc Version 5.0 Page 13 All of the residents spoken with during the inspection confirmed that they had been able to bring personal pictures, ornaments and small items of furniture to personalise their bedrooms. Jubilee Court Care Home DS0000043200.V260241.R01.S.doc Version 5.0 Page 14 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 The home implements policies and procedures to protect service users from abuse. EVIDENCE: The home has an appropriate Whistle Blowing Policy and a copy of the local Protection of Vulnerable Adults Procedure. The inspector was informed that all staff completes Basic training in adult protection as part of their TOPS training course. There have been no allegations of abuse in the home and none of the staff have been referred to the P.O.V.A list. The residents spoken with confirmed that staff are always friendly and helpful and that if they had any problems they believe the senior staff would resolve them promptly. Jubilee Court Care Home DS0000043200.V260241.R01.S.doc Version 5.0 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 23,26. The service users bedrooms do meet their individual needs. The home was clean and there were no offensive odours at the time of this inspection. EVIDENCE: Three residents bedrooms are viewed as part of this inspection. The rooms were spacious well decorated and comfortably furnished. Each bedroom had been personalised with photographs, ornaments and small items of furniture. All of the residents spoken with said that they are very happy with their bedrooms and that the home is always kept very clean and tidy. The premises were clean, hygienic and free from offensive odours and the home has appropriate policies and procedures to control the spread of infection.
Jubilee Court Care Home DS0000043200.V260241.R01.S.doc Version 5.0 Page 16 The main laundry is well equipped, the floor finishers are impermeable and the wall finishes are readily cleanable. It is recommended that the relevant sections of the homes infection control policies be displayed in the laundry. There is a small second laundry situated on the first floor. At the time of the inspection there was no lock on this laundry door and washing powder and fabric conditioner had been left unattended in this room. This is potentially putting residents health and safety at risk. These substances were removed at the time of inspection. Jubilee Court Care Home DS0000043200.V260241.R01.S.doc Version 5.0 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 28,29,30. The staff group have sufficient experience and training to meet the assessed needs of the residents. Two satisfactory written references need to be obtained for each member of staff before they commenced employment, to ensure that residents are protected. EVIDENCE: The inspector was informed that five members of staff have completed NVQ level 2 and that seven members of staff have completed their NVQ level 3. The home was able to demonstrate a commitment to professional training with a significant number of additional staff currently completing their NVQ training. (This is considered good practice). The records of the two most recently recruited members of care staff were assessed as part of this inspection. The records contain all the required information except for written references. The homes employment checklist indicated that written references had been received but these were not available at the time of inspection. The team leader stated that new members of staff always worked under the supervision of an experience staff member. They initially complete an inhouse induction and they are enrolled on their TOPS induction programme as soon as the course becomes available. The member of staff spoken with
Jubilee Court Care Home DS0000043200.V260241.R01.S.doc Version 5.0 Page 18 during this inspection confirmed that she would be commencing her tops induction training in the near future. Jubilee Court Care Home DS0000043200.V260241.R01.S.doc Version 5.0 Page 19 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 35,38. The administration of resident’s finances does not ensure that their financial interests are safeguarded. Some Health & Safety issues need to be addressed to ensure the safety & welfare of residents. EVIDENCE: At the time of inspection the records of items handed in for safekeeping could not be located. It is important that this information is available at all times as people may wish to leave the home and take their belongings with them. The records of resident’s finances were checked at random and two were satisfactory. However the records showed that one resident should have had £16 in the safe and the money was missing. Someone had left a note stating that the money was missing and that they assumed that it had been returned
Jubilee Court Care Home DS0000043200.V260241.R01.S.doc Version 5.0 Page 20 to the resident when she was discharged from the home. However as previously stated the records showed that money should still have been in the safe and no investigation had been completed even though the resident had been discharged in June 2005. Issues in relation to safe working practices were assessed at random and were maintained to a good standard. The inspector was informed that there are no issues outstanding from the fire officers last visit. The homes Fire records have been maintained to a good standard. Legionella risk assessments have been completed and water tests are carried out on a regular basis. As previously stated washing powder and fabric conditioner was left unattended in the first floor laundry. These hazardous substances must be stored safely when a member of staff is not used them. There must be a qualified first aider on duty at all times. Jubilee Court Care Home DS0000043200.V260241.R01.S.doc Version 5.0 Page 21 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 2 X X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 3 9 1 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 X X X X 4 X X 3 STAFFING Standard No Score 27 X 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X 2 X X 2 Jubilee Court Care Home DS0000043200.V260241.R01.S.doc Version 5.0 Page 22 Are there any outstanding requirements from the last inspection? Yes 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 OP1 Regulation 4 Requirement It is required that the literature supplied to prospective residents contains: a) The staff qualifications and experience. b) The resident’s views of the home. c) Details of the commission for social care inspection. (Previous timescale of 21/04/05 not met) It is required that: a) A photograph of each resident is attached to their medication Administration records. b) The temperature must be recorded each day in every bedroom where medication is stored, if the medication states it must be stored below 25°C. c) Individual risk assessments must be completed and regularly reviewed with all residents who wish to administer their own medication. d) Medication Administration records are signed each time the medication is given to the resident. If for any reason the medication is not given an
DS0000043200.V260241.R01.S.doc Timescale for action 05/12/05 2 OP9 13 20/10/05 Jubilee Court Care Home Version 5.0 Page 23 3 OP29 19 4 OP35 17 (9) explanation must be provided. The use of codes is acceptable for this purpose. It is required that two satisfactory written references are obtained for every member of staff prior to them commencing employment. A copy of the references must be kept in the home, available for inspection at all times. It is required that: a) The registered person investigates what has happened to the money, which was missing from the safe at the time of inspection. b) That the records of items handed in for safekeeping are accessible for inspection at all times. It is required that there is a qualified first aider on duty at all times. It is required that hazardous substances are stored securely at all times, 20/10/05 20/10/05 5 6 OP38 OP38 13 13 05/12/05 20/10/05 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 OP26 Good Practice Recommendations It is recommended that the relevant sections of the homes Infection Control Policy be displayed in the laundry areas. Jubilee Court Care Home DS0000043200.V260241.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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