Inspection on 19/04/05 for Jubilee House

This inspection was carried out on 19th April 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Jubilee House 21/05/08

Jubilee House 06/08/07

Jubilee House 06/06/06

Jubilee House 25/10/05

Jubilee House 20/10/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Jubilee House Bronshill Road Torquay Devon TQ1 3HA Lead Inspector Stella Lindsay Announced 19 April 2005 th The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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 House D54-D07 S61444 Jubilee House V210724 190405 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Jubilee House Address Bronshill Road, Torquay, Devon, TQ1 3HA 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) 01132392957 ADL Plc Mrs Eileen Grace Pope Care Home 28 Category(ies) of Old age, not falling within any other category registration, with number (28) of places Jubilee House D54-D07 S61444 Jubilee House V210724 190405 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th October 2004 Brief Description of the Service: Jubilee House provides care for up to 28 people over the age of 65. It is a detached property, set in an accessible garden, with mature trees, close to Toquay town centre. All accommodation is in single rooms, 15 of which have an en suite toilet. There are two bathrooms and an accessible shower. There are some small steps and a slope on the upper floor, but the shaft lift is one side of the building, and the stair lift the other end, to give access to all parts of the building. There is a lounge, a dining room and a bright sun lounge. Jubilee House D54-D07 S61444 Jubilee House V210724 190405 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was an Announced Inspection, and took place between 10am and 6.30pm on a Tuesday in April. It included a partial tour of the premises, and examination of care records, staff files, health and safety records and the medication system. There were 27 people in residence at the time, and one resident in hospital. As well as discussion with the Registered Manager, the inspector spoke with 11 residents, one visiting relative, and five staff members, and thanks all for their time. In addition, four relatives returned questionnaires to the CSCI. What the service does well: What has improved since the last inspection? What they could do better: The Management should provide sufficient toilets for residents close to the lounge and dining areas. The Management should put into practice plans they have for up-grading the remaining bedrooms so that all residents will have their own en suite toilet. Jubilee House D54-D07 S61444 Jubilee House V210724 190405 Stage 4.doc Version 1.30 Page 6 A suitable place for cleaning commode pots should be provided. All residents should have access to a telephone in a private place. 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 House D54-D07 S61444 Jubilee House V210724 190405 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Jubilee House D54-D07 S61444 Jubilee House V210724 190405 Stage 4.doc Version 1.30 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 standard(s) 1,3 and 5 Jubilee House has carefully prepared information available for prospective residents and their representatives. They are clear when showing people the facilities about the considerable difference between the custom built bedrooms in the new wing, and other rooms which are awaiting refurbishment. The Registered Manager takes care to assess a person’s care needs, so that accommodation is offered appropriately, and staff are prepared. EVIDENCE: The Statement of Purpose and Service users’ Guide has been produced containing all information required by the regulations, and has been updated very recently. The only discrepancy seen was in the summary of facilities- the 2 baths with hoists, plus accessible shower, shared by 28 residents equate to just over 1;9 (rather than less than 1;7). Also, a way should be found of representing residents’ views. The Home has a format for gathering information which has been completed with care by the Registered Manager. Information had also been received from the Mental Health team, from the prospective residents, and from relatives. The Registered Manager had gathered sufficient information on which to base her judgement that a service could suitably be offered at Jubilee House. Jubilee House D54-D07 S61444 Jubilee House V210724 190405 Stage 4.doc Version 1.30 Page 9 Prospective residents are welcome to visit, but have not always done so. The Registered Manager has visited people in hospital, and expects to meet them in order to complete the assessment of their care needs. Jubilee House D54-D07 S61444 Jubilee House V210724 190405 Stage 4.doc Version 1.30 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 standard(s) 7,9, and 10 The Registered Manager has developed an effective system for ensuring that good care is provided, and staff are up-dated frequently on the changing needs of the residents. The medication is carefully managed, to promote good health. EVIDENCE: The care plans examined were detailed and up to date. A baseline assessment was completed on the first day of residence, so that any progress or deterioration in health or well-being could be noticed. The plans included moving and handling plans, continence assessments, a falls risk assessment, Occupational Therapist assessment and records of provision of equipment, pressure area assessment, nutritional needs assessment and monthly weight check, if people agree. Care staff meet to up-date the care records each morning, which ensures that observations are shared and care is given consistently. A Senior Carer checks all care plans each month. The medication was seen to be administered, recorded, and stored properly, including Controlled Drugs if necessary. Seven staff, including Night Carers and Senior Carers, are booked for a distance learning course in the safe handling of medicines. Jubilee House D54-D07 S61444 Jubilee House V210724 190405 Stage 4.doc Version 1.30 Page 11 Staff were seen to treat residents with respect at all times. One resident said the staff are ‘very, very good and treat us all as equals’. All have their own room. Some have installed their own telephone lines. The pay phone is not in a private place, and is on the same line as the office phone. Relocation of the telephone is included in the Home’s refurbishment schedule. Jubilee House D54-D07 S61444 Jubilee House V210724 190405 Stage 4.doc Version 1.30 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 standard(s) 12,14,15 Daily routines are effective in maintaining personal care and other household services, and sufficiently flexible to accommodate residents, except when staffing levels drop. The meals are good, with some choice available. EVIDENCE: Breakfast is served in the dining room at 9am, unless a resident particularly wants it in their room. Residents said they were happy with the arrangements for their bathing. One resident said they are happy to have help with a shower once a week, and manage to wash themselves on the other days. One said he generally has help to shave at about 8.30am, which suits him, but if there are only three carers, it sometimes gets left till 11 or 12 o’clock. Individuals’ own hairdressers and chiropodists attend them in the Home. One said they are happy to be able to wander about the house and garden. Entertainments are provided, but not activities arranged for individuals, with some exceptions. Two residents are regularly taken to a shop or bank. There have been group outings in the past – the latest being a trip to see the Christmas lights. The Registered Manager stated that she intends to start these again when there is a full complement of staff. Lunch was roast beef on the day of the inspection. The meat was served sliced on hot plates. There was a choice of vegetables brought round on a trolley. Jubilee House D54-D07 S61444 Jubilee House V210724 190405 Stage 4.doc Version 1.30 Page 13 Some residents said they thought these could be hotter. The Registered Manager stated that a hot trolley has been made available by ADL, and is awaiting delivery. The gravy was delicious, but some residents felt they would prefer to serve themselves from a small jug on the table. One resident who needed to have her food blended said that it was tasty. For sweet, a trolley came round and people could choose any combination of tinned or fresh fruit, Bakewell Tart, custard &/or cream. Some residents knew that it was going to be roast beef – they said they had been told during the morning by the cook when she came to take their order for tea. More people did not know, they may have forgotten. It might help to have the day’s menu up on a notice board. Choice is offered at tea time, and the alternatives eaten are recorded, which is good practice and can provide useful information if residents become ill. Jubilee House D54-D07 S61444 Jubilee House V210724 190405 Stage 4.doc Version 1.30 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 standard(s) 16 Residents generally know about the complaints procedure, and feel able to speak to the Manager about anything they are worried about. She is an effective manager, and has been able to sort out difficulties which come within her sphere of responsibility. EVIDENCE: The Complaints Policy is displayed in the office window, the dining room notice board, all bedroom doors and is included in the Service Users’ Guide. Complaints forms are available in the entrance hall. The CSCI has not received any complaints about Jubilee House since May 2004. Residents said they find the Manager to be approachable. Staff received training on Awareness of Adult Abuse on the day before the inspection. Jubilee House D54-D07 S61444 Jubilee House V210724 190405 Stage 4.doc Version 1.30 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 standard(s) 19,20,21,22 & 26 The new and refurbished parts of the house are well designed, attractive and comfortable to live in. The shortfalls in the remaining part of the building cause difficulties for some residents. The Service Providers have plans for refurbishment. EVIDENCE: Residents who occupy rooms in the new wing expressed satisfaction with their accommodation. There is enough room for mobility aids, and they have an en suite toilet. Some residents occupying rooms in the older part of the building said they had to use a commode because there was not a toilet close enough. Management have stated that refurbishment is due to take place soon, which will bring all rooms up to standard, but a Reviewed Refurbishment Schedule supplied to the CSCI did not include this work, or the building of an extra toilet on the ground floor, close to the lounges. This addition is of prime importance, as there are queues for the only close toilet, particularly before and after meals, which can cause distress and the fear of humiliation. Jubilee House D54-D07 S61444 Jubilee House V210724 190405 Stage 4.doc Version 1.30 Page 16 The ground floor and the garden have level surfaces and easy to get around. The first floor is not entirely flat. The shaft lift accesses one end of the top floor, close to the new bedrooms, and the stair lift takes you to the older part of the building. The Sun Lounge still feels bright and new. It is accessed through the lounge and through the dining room. A battery powered bath seat has been fitted to the bathroom on the first floor, giving the choice of a bath closer to many bedrooms. The schedule of refurbishment includes redecorating and re-tiling both bathrooms. A suitable place for cleaning commode pots is still needed. Equipment to aid mobility and independence has been issued to residents following Occupational Therapist assessment. A survey of the premises as a whole is still outstanding. It could be beneficial to take professional advice before embarking on the major refurbishment of the remaining bedrooms. Other plans recorded include a general up-grade of the entrance hall; resurfacing of the front driveway; work to rectify the problems with the heating system; and a refurbishment of the dining room. Jubilee House D54-D07 S61444 Jubilee House V210724 190405 Stage 4.doc Version 1.30 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28,29 and 30 Enough care staff are employed to provide good personal care, carefully organised and up dated. Problems have arisen if the level of care needed or staff available changes. Jubilee House has a sound recruitment system, to ensure that new staff are trustworthy and reliable. A thorough induction programme is in place, and staff are engaged in a range of training to assure safe working practices, and to achieve their NVQs. EVIDENCE: Care staff reported that they can meet everyone’s needs in good time if four carers are on duty. All residents seen had their appearance cared for, and said that if they used the call-bell, attention would come quickly. As reported in Standard 12, one said that personal care that was expected around 8.30am is sometimes not given until 11 or 12o’clock if only three care staff are on duty. The Registered Manager when on duty works as one of the four between 8 and 10am, to maintain contact with residents and observe staff while working alongside them. There are plans to appoint an administrator to cover office duties, but until this is satisfactorily in place the levels of care staff drop when the manager is necessarily called away. Staff said that when only three carers are on duty they do not have time to talk, and if a resident is ill they struggle to keep up with all tasks. One of the relatives who replied to the CSCI questionnaire said they do not think there are always enough staff on duty. Jubilee House D54-D07 S61444 Jubilee House V210724 190405 Stage 4.doc Version 1.30 Page 18 From 4 – 6pm the number of staff has been dropped to three, as a tea-time cook has been appointed. The Manager stated that the cook has been sanctioned to work later required, for instance if the delivery of medications has not been completed by 6pm. The Manager is continuing with her efforts to recruit staff. Three care staff have gained their NVQ2. All three Senior Carers are working towards NVQ3. Six more care staff are working towards NVQ2. This is excellent progress towards achieving a qualified workforce. A thorough induction training programme has been used, in order to prepare new staff to work safely and with the right attitude. The Manager has produced a training matrix which shows that most staff are up to date with Moving and Handling and COSHH training, vital to assure safe working with residents. Five staff are qualified First Aiders, and four more are booked to receive this training. Three care staff, the cook and the Manager have the Food Hygiene certificate. This should be made available for all staff who serve and prepare food, and a training session has been booked for 05/08/05. Staff should be offered training in awareness of the needs of people with specific conditions which affect the residents, for example stroke, and the promotion of independence. Jubilee House D54-D07 S61444 Jubilee House V210724 190405 Stage 4.doc Version 1.30 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,35,36 and 38 The Registered Manager is well qualified, experienced and competent to run this home. Steps have been taken to improve communication within the organisation. Staff were working together well as a team. Documentation is very good, and safe systems of work are in place. EVIDENCE: The Manager is qualified in the management of care, health and safety, and is close to completing her NVQ4 in Care and the Registered Managers’ Award. She said she had been given a new and more appropriate Job Description, but the only one available related to a Nursing Home. There have been unresolved differences of opinion between the staff and the Service Providers. A Consultant has been engaged by ADL. She chaired a staff meeting in February, and she has been carrying out the monthly visits on behalf of ADL. Reports were given to the inspector at the inspection, but should be sent to the CSCI. She has been assisting the Manager by providing Jubilee House D54-D07 S61444 Jubilee House V210724 190405 Stage 4.doc Version 1.30 Page 20 supervision for some staff. They said they have found this supportive, and have felt able to discuss concerns. One staff member said that there had in the past been a steering group, which had been useful for sorting out practical problems, and might be considered again. Following a training session booked for 09/05/05, there will be a qualified First Aider on duty at all times. Fire training was delivered on 18/04/05, and all staff took part, over three sessions. A new firm have been engaged to service the fire precaution system. Their check took place on 16/11/04, and they have informed ADL of work needed to maintain a safe and secure system. A survey has been done with regard to the risk from Legionella, and ADL have been informed of the work needed to reduce or eliminate the risk of Legionella from Jubilee House’s water system. Jubilee House D54-D07 S61444 Jubilee House V210724 190405 Stage 4.doc Version 1.30 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 3 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 x 14 3 15 3 COMPLAINTS AND PROTECTION 2 3 2 2 x x x 2 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x 3 3 x x 3 3 x 3 Jubilee House D54-D07 S61444 Jubilee House V210724 190405 Stage 4.doc Version 1.30 Page 22 yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP21 Regulation 23 Requirement Sufficient toilets must be provided for residents, close to lounge and dining areas. Previous timescale - 30/11/04. A suitable place for cleaning commode pots must be provided. Previous time scale 30/11/04 Timescale for action 31/08/05 2. OP26 23 31/08/05 3. 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 OP22 Good Practice Recommendations The Registered Provider should arrange for an assessment of the premises and facilities to be made by a suitably qualified person in respect of disability equipment and environmental adaptations. All residents should be able to use a telephone in privacy. The menu of the day should be displayed. Reports of the monthly visits by the Registered Provider should be sent to the CSCI. 2. 3. 4. 5. OP10 OP15 OP31 Jubilee House D54-D07 S61444 Jubilee House V210724 190405 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Jubilee House D54-D07 S61444 Jubilee House V210724 190405 Stage 4.doc Version 1.30 Page 24 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!