Inspection on 11/01/06 for Jubilee House Jonquil Close

This inspection was carried out on 11th January 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 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Jubilee House Jonquil Close 02/10/08

Jubilee House Jonquil Close 24/05/06

Jubilee House Jonquil Close 30/06/05

Jubilee House Jonquil Close 14/02/05

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 HOME ADULTS 18-65 Jubilee House Jonquil Close 29 Jonquil Close Panshanger Welwyn Garden City Herts AL7 3HX Lead Inspector Mr Tom Cooper Unannounced Inspection 11th January 2006 3:00 Jubilee House Jonquil Close DS0000062294.V278037.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 Jubilee House Jonquil Close DS0000062294.V278037.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. Jubilee House Jonquil Close DS0000062294.V278037.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Jubilee House Jonquil Close Address 29 Jonquil Close Panshanger Welwyn Garden City Herts AL7 3HX 01707 391113 01707 394022 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) Jubilee House Care Trust Limited Michael John O`Connell Care Home 6 Category(ies) of Learning disability (6), Physical disability (6) registration, with number of places Jubilee House Jonquil Close DS0000062294.V278037.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 30th June 2005 Brief Description of the Service: Jubilee House, Jonquil Close, is a 6-bedded purpose-built bungalow for high dependency service users. Services are offered to younger adults with a learning disability, and those with an additional physical disability. The home is situated in a residential area of Welwyn Garden City and the town centre, with its wide range of facilities, is about a mile away. The property is leased through a housing association. There is ample car parking for the home and a minibus is provided for the service users to facilitate outings. Jubilee House Jonquil Close DS0000062294.V278037.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the second unannounced inspection for the current inspection year and took place on a weekday afternoon. The main focus of the inspection was to evaluate the service users’ experience of living in the home and to check compliance with the statutory requirements made at the last inspection. In addition to observing the service users and staff working with them, discussions were held with the acting manager and members of staff on duty. Only limited communication was possible with the service users due to the nature of their disabilities. Documentation checked included the statement of purpose and service user’s guide, six service users’ care plans, medication records, the complaints procedure and investigation records. A tour was made of part of the premises. A very pleasant and calm atmosphere was found in the home. The service users appeared relaxed and happy and were being well cared for by committed and appropriately trained staff. What the service does well: Staff and service users enjoy positive relationships between based on mutual respect. Staff have a good understanding of the complex needs of the service users. Service users’ care plans provide clear details of individual needs and the action to be taken to meet them. The home has well established relationships with community-based healthcare services including an occupational therapist. Staff feel well supported, receiving regular individual supervision at which work issues are discussed and training needs identified. The home was purpose built to provide a suitable environment for service users with high complex needs and physical disabilities. Equipment and aids are available to facilitate movement as well as an impressive sensory room, which provides a valuable additional communal space and a wheelchairaccessible garden with a large summerhouse. All service users have single bedrooms providing ample private living space, decorated to reflect their individual personalities. Sound procedures are followed for the handling and administration of medication. The home has a suitable complaints procedure that ensures matters raised are properly investigated. Jubilee House Jonquil Close DS0000062294.V278037.R01.S.doc Version 5.1 Page 6 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. Jubilee House Jonquil Close DS0000062294.V278037.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 Jubilee House Jonquil Close DS0000062294.V278037.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): 1, 2, 4 & 5 Information is available to prospective service users and their relatives about the philosophy of care and operation of the home including the arrangements in place to meet individual needs. Assessments are carried out to ensure that the home would be suitable and all relevant information on any prospective service user’s needs and aspirations is available prior to admission. Before deciding on admission, prospective service users have the opportunity to visit the home to experience the atmosphere and evaluate the care services on offer. Each service user has a contract detailing the terms and conditions of occupancy. EVIDENCE: The home has a statement of purpose and service user’s guide that contain the required information to meet the standard. The manager has recently updated both documents to reflect changes in the home. There have been no new admissions since the last inspection. However the manager stated that any new admissions would be subject to a thorough assessment made by the referring agency, supplemented by that carried out Jubilee House Jonquil Close DS0000062294.V278037.R01.S.doc Version 5.1 Page 9 by senior staff and this would form the basis of the initial care plan. A series of familiarisation visits would be arranged prior to admission. Examples of occupancy contracts were seen on service users’ files. Jubilee House Jonquil Close DS0000062294.V278037.R01.S.doc Version 5.1 Page 10 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 Service users’ individual needs and comprehensive risk assessments are detailed in their care plans and personal files. These documents enable staff to work consistently to provide the care required. Staff observe and communicate with service users and help them make decisions for themselves. Service users are supported to take responsibly assessed risks in order to maximise their opportunities for stimulation and fulfilment. EVIDENCE: Care plans for all six service users were examined. These had been recently updated and contained clear and concise details of the needs of each individual, covering personal care, medical health, mobility, eating and drinking, communications, activities and leisure, behaviour, cultural and spiritual elements. Due to the limited communications abilities of the service users, the manager had sent copies of the draft care plans to representatives outside the home capable of advocating on their behalf in order to secure a Jubilee House Jonquil Close DS0000062294.V278037.R01.S.doc Version 5.1 Page 11 measure of consensus on the contents. The home holds service user meetings, however staff mainly learn about individual preferences through daily observations of body language, facial expression and other behavioural indicators. The home is linked to an external advocacy group and referrals have been made. This demonstrates the home’s commitment to expanding the service users’ influence over their lives. Risk assessments have been completed for a wide range of situations. These and the activities referred to in the care plans indicate that staff support service users to take sensibly evaluated risks as part of a reasonably independent lifestyle. Jubilee House Jonquil Close DS0000062294.V278037.R01.S.doc Version 5.1 Page 12 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): 13, 14, 17 Staff support service users to access community facilities and act as full members of society. Service users take part in appropriate leisure activities. Service users contribute to menu planning, have a healthy diet and enjoy sociable mealtimes. EVIDENCE: Staff support and encourage all service users to maintain and develop social, emotional, communication and independent living skills. Staff have a good knowledge of the service users’ personal preferences and their preferred activities are documented in their care plans. Work is currently proceeding to involve the service users more in decision making regarding their lifestyles, although because of their limited communications abilities, inevitably staff often take the lead in suggesting activities. A board displaying pictures of suitable activities was being put up in the lounge to help service users participate more in decision making about activities they would like to do. Jubilee House Jonquil Close DS0000062294.V278037.R01.S.doc Version 5.1 Page 13 The home is centrally located within a short distance of local shops and community amenities. The home has the use of a minibus and allocated drivers to facilitate service users going on outings. During the inspection staff and were observed interact with service users in a very natural way. The home provides a four-week rolling menu, which staff devise taking into account the service users’ expressed and observed preferences as well as specialist dietary advice. A record is maintained of foods eaten. During the inspection the service users took their evening meal together, supported by three staff in a gentle and positive way. Various dishes were presented to one service user who was not feeling well, to encourage him to eat a reasonable amount. Jubilee House Jonquil Close DS0000062294.V278037.R01.S.doc Version 5.1 Page 14 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, 20, 21 Staff care for the service users with sensitivity and respect and constantly monitor their condition. Service users receive competent personal and healthcare from staff, by reference to clear documentation of their needs. This ensures that their health and welfare are safeguarded. The home operates sound medication procedures that protect service users’ interests. The manager should discuss issues such as ageing, illness and death with service users and/or their representatives so that staff have the information to act in accordance with individual requirements and expectations. EVIDENCE: Staff were observed dealing with service users in a sympathetic and caring manner, showing great respect for individual preferences and dignity. Personal and healthcare needs are clearly and concisely documented in the care plans. Staff support service users with all aspects of their physical and emotional care Advice is sought as appropriate from specialists such as community nurses, consultants, GPs, dentists, opticians and dieticians etc. An additional benefit to Jubilee House Jonquil Close DS0000062294.V278037.R01.S.doc Version 5.1 Page 15 service users is the keyworker system that is used to provide extra one to one support. Medication is supplied in a blister pack system and is securely stored in a locked cabinet in the kitchen. At present none of the service users selfmanages medication. Sound procedures are operated for the administration and recording of medication. No mistakes were found in recording or storage during a spot check. All staff who handle medication have been trained in accordance with company policy. The manager should tactfully discuss issues such as ageing, illness and death with service users and/or their representatives to ensure that staff are aware of individual requirements and expectations and can act accordingly should difficult situations arise. Details should be maintained on file so all staff can access this information if necessary. Jubilee House Jonquil Close DS0000062294.V278037.R01.S.doc Version 5.1 Page 16 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): 22, 23 The home has an adequate complaints procedure designed to ensure the proper response to any matters raised by service users or (more likely) their representatives. Robust policies, procedures and training are in place to ensure service users are protected and safe. EVIDENCE: The home has a satisfactory complaint procedure in place that is available to all residents and their representatives and contains the required information on how to complain. One formal complaint had been received in the home since the last inspection. This had been investigated promptly and responded to by the Direct Services Manager, with details recorded of the action to be taken to resolve the issue. The documentation had been updated since the last inspection with the current details of the Hertfordshire office of the CSCI, should a complainant wish to refer a matter to the Commission. Jubilee House has a ‘whistle blowing’ policy that all staff are aware of. This provides a framework for reporting concerns and suspicions of abuse, including passing on concerns to the CSCI and is designed to protect service users. The subject is covered during the induction of new staff and staff spoken with had a fair understanding of the principles of adult protection. A copy of the Hertfordshire inter-agency adult protection guidelines is kept in the office. Jubilee House Jonquil Close DS0000062294.V278037.R01.S.doc Version 5.1 Page 17 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): 24, 30 The home provides a comfortable, homely and safe domestic environment, suitable for the service users’ needs. Staff maintain good standards of cleanliness and hygiene. EVIDENCE: The building is spacious and airy, with single bedrooms and adequate communal space in a number of different rooms. There is also an impressive sensory room, equipped with numerous devices to provide a very attractive facility for sensory stimulation, relaxation and leisure. Décor and furnishings in all areas seen were domestic and of good quality. Specialist equipment is provided such as tailor made wheelchairs, assisted bathing facilities and hoists. The kitchen is showing signs of age but is adequate apart from the worktop which has a worn out laminate surface. This represents a food hygiene risk and must be replaced. It is again recommended that the whole kitchen be refitted to complement the standards in the rest of the premises. An annual redecoration plan is followed. All areas seen were clean and tidy, producing an attractive domestic environment for the service users. Jubilee House Jonquil Close DS0000062294.V278037.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, 33, 34, 36 Staff understand and support the home’s aims and their roles in delivering the service promised in the statement of purpose. Sufficient experienced and competent support workers are provided who are appropriately trained to meet the service users’ needs. The company provides regular relevant training for staff that ensures they are well equipped to assist service users to lead safe and fulfilled lives in accordance with the home’s statement of purpose. Staff are well supported and supervised by senior colleagues to deliver consistent care for the service users. EVIDENCE: Each member of staff has a clear and well-defined role evidenced by clear and concise job descriptions and person specifications. Staff spoken with had a clear understanding of the purpose of the home and their responsibilities in achieving them. Staff indicated that mandatory training in first aid, fire safety, food hygiene, moving and handling etc was ongoing and kept up to date by Jubilee House Jonquil Close DS0000062294.V278037.R01.S.doc Version 5.1 Page 19 reference to a training plan for each year. Some staff have NVQ qualifications, with at least one support worker due to start the NVQ2 course in the new year. The manager stated that there were usually three staff on duty to care for the service users during the day shifts, with one person awake and one sleeping-in at night. Records were available to support this. These staffing levels are adequate to meet the needs of the current group. Although the core team had been reduced to four persons the manager felt that staffing was stable at present due to the availability of several high calibre bank staff, mostly student nurses, who worked regularly in the home and knew the residents, the philosophy of care and the routines well. This promoted good consistency of care from day to day. The company follows rigorous recruitment policies. One personnel file was examined and this contained the information required, including two references, CRB and identity information. Minuted staff meetings take place regularly within the home as well as individual supervision sessions. Evidence was seen of the frequency of supervisions occurring. Each member of staff also has an annual appraisal. Staff spoken with said they felt well supported by senior colleagues and rated teamwork and communications in the team as good. Jubilee House Jonquil Close DS0000062294.V278037.R01.S.doc Version 5.1 Page 20 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): 37, 38, 39, 42 The manager is experienced and qualified to run the service in accordance with the aims outlined in the statement of purpose. He provides calm and effective leadership, with good support from senior colleagues. This ensures the home is run for the benefit of the service users. At present there is no quality monitoring process beyond the monthly proprietor’s representative’s visits. A formal quality monitoring system must be introduced that involves canvassing the views of service users, their representatives and other interested parties on the quality of the care provided. The information gathered must be taken into account when planning improvements to the service. All records seen were well maintained and up to date. The home is safe to live and work in, with systems for effective health and safety management in place. Jubilee House Jonquil Close DS0000062294.V278037.R01.S.doc Version 5.1 Page 21 EVIDENCE: The manager has long experience of social care and is well qualified to run the service. He provides strong leadership to the team and staff spoken with said that he was effective and approachable. Staff spoken with also said that they were encouraged to contribute ideas for improving the running of the home. Service users seemed very happy with the home and relaxed and at ease with staff, who were clearly caring and confident in relating to them. The manager stated that the company was planning to implement a quality monitoring system in the current year but this had not yet been approved by head office. Therefore the previous requirement on this point remains outstanding. Some discussion was held about how to contact the various interested parties who could contribute opinions on the quality of the service provided. Jubilee House should consider their views when planning improvements to the service. It is also worth noting that quality assurance will be an essential part of care home providers’ self-assessment obligations in the future. Care plans and medication records were detailed, accurate and up to date. It has previously been established that health and safety matters in the home are covered by a full range of risk assessments. Apart from the hygiene issue presented by the worn kitchen worktop described earlier in this report, no health and safety problems were noted and the home appeared to be safe for service users and staff. Jubilee House Jonquil Close DS0000062294.V278037.R01.S.doc Version 5.1 Page 22 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 3 2 3 3 X 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 X 36 3 CONDUCT AND MANAGEMExNT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 x LIFESTYLES Standard No Score 11 X 12 X 13 3 14 3 15 X 16 X 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 2 3 3 2 X 3 2 x Jubilee House Jonquil Close DS0000062294.V278037.R01.S.doc Version 5.1 Page 23 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 YA39 Regulation 24 Requirement The home must ensure that there is an effective quality monitoring system based on seeking the views of the service users, their representatives and other stakeholders, for the purpose of reviewing and improving the quality of care provided at the home. The worn kitchen worktop must be replaced to preserve hygienic conditions. Timescale for action 01/04/06 2. YA30YA42 13(3) & 16(2)(j) 01/06/06 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 YA21 Good Practice Recommendations The manager should discuss issues such as ageing, illness and death with service users and/or their representatives so that individual requirements and expectations can be recorded and met by staff. It is recommended that the kitchen be refitted and modernised to ensure standards of basic infection control are maintained. DS0000062294.V278037.R01.S.doc Version 5.1 Page 24 2. YA42 Jubilee House Jonquil Close Commission for Social Care Inspection Hertfordshire Area Office Mercury House 1 Broadwater Road Welwyn Garden City Hertfordshire AL7 3BQ 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. 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