Inspection on 19/06/07 for Jubilee Nursing Home

This inspection was carried out on 19th 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

Jubilee Nursing Home 06/06/06

Jubilee Nursing Home 31/08/05

Jubilee Nursing Home 30/03/05

Jubilee Nursing Home 29/11/04

Jubilee Nursing Home 18/03/04

Similar services:

Turret Villa Retirement Home

Moor House

Mendip House

Beaconsfield Court Care Home

Little Sisters Of The Poor

Manor House

Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

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

CARE HOMES FOR OLDER PEOPLE Jubilee Nursing Home Thornhill Crescent Sunderland SR2 7AD Lead Inspector Mr Tom Moody Key Unannounced Inspection 19th June 2007 10:00 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 Nursing Home DS0000018198.V340366.R02.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. Jubilee Nursing Home DS0000018198.V340366.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Jubilee Nursing Home Address Thornhill Crescent Sunderland SR2 7AD 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) 0191 565 2727 0191 565 4734 Jubilee Home (Sunderland) Limited Mrs Carol Trueman Care Home 35 Category(ies) of Old age, not falling within any other category registration, with number (35), Physical disability (1), Physical disability of places over 65 years of age (4) Jubilee Nursing Home DS0000018198.V340366.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The one specific service user under the age of 65 will relate to the current service user only. 6th June 2006 Date of last inspection Brief Description of the Service: Jubilee Care Home is a purpose built three-storey building, which can provide nursing and personal care for up to 40 older people. It is of traditional brick build design and has an ample size car park to the rear of the building. There are large lounges, a separate smoking lounge and a dining room on the ground floor with bedrooms on the first and second floors. On the ground floor there is a pleasant conservatory at the front of the building, which has level access into the garden area. The Home offers both single and double bedrooms, with the majority having en-suite facilities. The Home is very close to the city centre of Sunderland and benefits from being near the shopping centre, library and the transport network. There is a large park close to the Home as well as local tourist attractions. Jubilee Nursing Home DS0000018198.V340366.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and carried out by one inspector. The deputy manager was present throughout the inspection due to the manager attending training. Before the inspection, self-assessment information had been submitted by the manager that gave the inspector up to date information about the home. The inspector toured the home and looked at bedrooms, communal facilities and service areas. Also during the day, the inspector spoke to residents, visitors and members of staff. A number of records were examined including three residents care plans and related documentation plus some staff files and training records. What the service does well: What has improved since the last inspection? There have been some refurbishment and redecoration. Jubilee Nursing Home DS0000018198.V340366.R02.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. Jubilee Nursing Home DS0000018198.V340366.R02.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 Jubilee Nursing Home DS0000018198.V340366.R02.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): Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. Service users entering the home have some of their needs accurately assessed by social care and health service staff. The home makes it’s own assessment in addition to this. Most service users and their family have the opportunity to visit the home before they come to stay, unless there are exceptional circumstances, and accurate information is availale about the home. This allows them to make an informed choice about their stay. EVIDENCE: The providers self-assessment stated:The home has excellent links with both Social Services & the NHS funding team, prior to admission in depth, comprehensive reports are obtained. These along with our own pre admission assessment policy ensures that all prospective service users are given information about the home and are re assured that their needs can be fully met. Private funded clients receive the same pre admission assessment which meets standard 3.3. The home has a satisfactory service user’s guide that provides a good level of information to service users in an easily understood format. It contains the Jubilee Nursing Home DS0000018198.V340366.R02.S.doc Version 5.2 Page 9 necessary information about the staff and manager of the home. The manager stated that service users can visit the home and all potential service users are provided with a service users guide. The deputy also stated that service users have contracts. Examples were seen in service users records. Service user’s visitors confirmed they had been given information about the home before their relative went there and they were happy with the way staff communicated with them. The deputy confirmed that the placing authority did their own assessment and that the home did their own assessment of needs independent to this. Records contained both assessments and this provided a comprehensive picture of service users needs, including social, spiritual and aspirational needs. Jubilee Nursing Home DS0000018198.V340366.R02.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgment has been made from evidence gathered both during and before the visit to this service. Care plans had good information in relation to healthcare needs and demonstrate that the home is meeting all of service user’s healthcare needs. The care that was observed was good. The home’s medication systems are being adhered to and service users are protected by as safe system of medication that is properly operated by staff. EVIDENCE: The providers self-assessment stated :We have comprehensively assessed working care plans that instruct all levels of staff on how to look after residents and to ensure that all their assessed needs are met. We have always encouraged our service users to remain with their existing GP, where this is not possible, choice has been offered. Individualised Care Plans are comprehensive, of good quality and reviewed monthly by the trained staff. Our service users have access to outside health professionals of their choice. Jubilee Nursing Home DS0000018198.V340366.R02.S.doc Version 5.2 Page 11 Our system for storage and administration of medicines is robust and all aspects from ordering to actual administartion to residents is checked regularly. In Jubilee trained nurses are responsible for administration and recording of medication. Staff respect residents and strive to maintain their dignity by always asking and consulting with them about their preferences plus ensuring that all personal care is given in privacy. Observation of the care given on the day of the site visit confirmed this. Staff were seen to talk respectfully to service users and listened attentively to what they said. Staff knocked before entering service users rooms and gave support in a way that was unhurried and focussed on the individual they were dealing with. One relative remarked how the home staff had spotted a small lesion on her mothers face and made sure she was referred to the dermatology department at the local hospital. Care plans for some service users were examined. They were well written and contained all the information necessary to ensure service user’s needs are met. This includes nutritional assessments, information on pressure damage risk and moving and handling. The care plans indicate the involvement of clinical specialists. There were good risk assessments documented and evidence that this was carried out in practice. The home has appropriate policies, and practice to ensure service users receive their medication in a safe way. Observation of the administration and storage indicated this was good and in line with policies. The Medicine Administrations Records that were seen by the inspector were accurate and well kept. The deputy states relationships with the local GP practice is good. Jubilee Nursing Home DS0000018198.V340366.R02.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgment has been made from evidence gathered both during and before the visit to this service. The service users can make full use of all of the homes facilities and show signs of having their own interests and possessions. There is evidence of visitors involvement in service users care and recreation. Service users enjoy an appetizing selection of meals in well-decorated and pleasant surroundings. All of this indicates most service users needs and preferences are being met by the home and that they have choice and control over many areas of their lives. EVIDENCE: The providers self-assessment stated:We offer flexibility with all things where ever possible. Visiting is open to suit individuals and meals are available to visitors to enable them to visit for longer periods if they so choose. This also enables families to celebrate special occassions enabling our service users to maintain strong family ties. Meals are nutritious and well presented and they get positive comments from both service users and visitors. A choice of menu is available at each meal. We have no fixed rising times and breakfast is served fropm 8.30 - 11.30. Service users retire at their request. We encourage service users to personlise their rooms to enhance the homely feeling Jubilee Nursing Home DS0000018198.V340366.R02.S.doc Version 5.2 Page 13 During the visit I found that the activities co-ordinator keeps records to show the type of activities that have taken place. Service users confirmed they took part in a variety of activities, Service user’s bedrooms reflect their personal tastes and contain items that reflect the individuality of the occupant. Visiting relatives were made welcome and had a good relationship with staff members. There is a good assessment of social needs in service users care plans. It is evident from these documents that the service users families are able to contribute to the social care assessment. Service users were seen to be talking to each other as well as the staff. Service users told the inspector, “ We’re looked after very well” and “the staff are very good.” One member of staff spoke of taking service users out of the home into the surrounding area for “trips out”. Kitchen staff were enthusiastic and said that care staff ascertain service user’s menu choices. The menus are based on traditional home cooked meals appropriate to the age and culture of the service users. The meal that was served was appetising and well presented. Tables were set with a range of condiments and table clothes. Water jugs and glasses were on each table. Staff were seen to support service users, who needed help, in a sympathetic and relaxed way. This support was always unhurried and focussed on the individual. Relatives spoke of the home being, “Fabulous, Mam is really well looked after” and said things like, “ I’m happy with the care Mam receives.” Service users indicated the food was of a good standard and to their personal taste. Comments such as, “It’s very good, I couldn’t fault it ” were typical. Jubilee Nursing Home DS0000018198.V340366.R02.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgment has been made from evidence gathered both during and before the visit to this service. Service users and relatives are comfortable about raising issues with staff and the manager. They are sure that issues will be dealt with appropriately by the manager. Staff have had training and have a good awareness of protection issues. The local authoritys strategy, the managers ethical approach and the company’s policy should combine to protect service users from abuse. EVIDENCE: The providers self-assessment stated that the manager and her staff are always available and are approachable, so problems are dealt with promptly. The complaints policy is prominently displayed, robust and easy to follow. Complaints are dealt with quickly and residents and relatives can feel confident that their concerns are taken seriously and acted upon . Staff are trained in safeguarding vulnerable adults. During the site visit I found that the home has suitable policies. The complaints procedure is available and is displayed in the home. This gives clear information about how, and who complaints can be made to. The information is also in the Service Users Guide. Jubilee Nursing Home DS0000018198.V340366.R02.S.doc Version 5.2 Page 15 There were few complaints recorded and the deputy spoke of dealing with potential problems by having a good level of contact with relatives and service users. Staff receive training in this area and the local authority have a robust adult protection strategy that the staff are aware of. Jubilee Nursing Home DS0000018198.V340366.R02.S.doc Version 5.2 Page 16 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): Quality in this outcome area is good. This judgment has been made from evidence gathered both during and before the visit to this service. The home is generally clean, tidy, but there are some exceptions to this. It is generally maintained but some defects were noted. Bedrooms are well furnished with service user’s possessions and are generally suited to their needs. The home has aids and adaptations, but the size and design of some facilities may not make them suitable to meet all service users needs and safeguard staff. EVIDENCE: The providers self-assessment stated that:Jubilee is a purpose built building - it is easiuly accessible. Our latest fire inspection produced no remedial actions. We provide a homely atmosphere in which service users can personalise their own rooms to encourage ownership. Jubilee Nursing Home DS0000018198.V340366.R02.S.doc Version 5.2 Page 17 Extensive planned maintenance allows us to maintain and improve the interior of the home and gardens. During the site visit I found that although the home was purpose built this was some years ago and the building is showing it’s age both in design and maintenance. The exterior paintwork has deteriorated and unless remedial work is carried out it is likely that the fabric of the external woodwork will suffer. The home present a pleasant environment and service users rooms are homely and contain personal items. However, the home also has some defects. Doorways to toilets are only standard width. In spite of their being labelled as suitable for disabled access a number do not have a clear opening width of 800mm and the internal space is unlikely to meet disabled standards. One of the showers are only accessed by service users stepping into a raised tray. This is also not suitable access for disabled or high dependency service users. The shower on the first floor had a broken rail although this was addressed, on the day, by the maintenance man. This room also smelled of dampness and it may be that the ventilation is not adequate. There were no unpleasant smells anywhere else in the home and it was generally well lit and ventilated. The water at one sink was not hot and the mixer valve may need some adjustment. If this is so, all of them should be checked regularly. Although most of the home is clean and tidy there were some areas of concern. Several empty rooms had dust on the window-sills and torn wallpaper. There was a urinal and toilet brush wedged behind the waste pipe in one room, and no one had attempted to move this for some time. The kitchen was well maintained and tidy. Food preparation areas were clean but odd corners of the floor were marked and there was dust on some surfaces such as the fire extinguisher. The kitchen staff did address this as soon as it was pointed out. The home has good equipment and adjustable beds were seen, however the scales have been broken for some time and these should be replaced because of the importance of monitoring service user’s weight. It does seem that the staff provide good care but the environment could be improved to make their tasks easier. Jubilee Nursing Home DS0000018198.V340366.R02.S.doc Version 5.2 Page 18 Jubilee Nursing Home DS0000018198.V340366.R02.S.doc Version 5.2 Page 19 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): Quality in this outcome area is good. This judgment has been made from evidence gathered both during and before the visit to this service. The number of staff on duty was sufficient to meet service users care needs. The homes recruitment policy and practice safeguards service users. Training is provided and is evident in all practice. EVIDENCE: The providers self-assessment stated:Excellent training programme with a dedicated trainer in house with the back up of our training department - TIC Our staff are long serving, work as a team and provide consistency of care we have over 50 NVQ level 2 or above (actually 64 ) Well established robust recruitment policy and procedures ensure that appropriate staff are appointed. At the time of my site visit I found that the staff records confirmed that all necessary recruitment checks are carried out. Staff who were spoken to stated that they received a good level of support from the company to complete nvq training and other in service training. The training records of the each staff member is recorded on a “matrix” type sheet Jubilee Nursing Home DS0000018198.V340366.R02.S.doc Version 5.2 Page 20 and it is easy to ensure staff remain updated in mandatory training such as moving and handling. At the time of the visit staff were able to meet service user’s needs and call bells were answered promptly. Jubilee Nursing Home DS0000018198.V340366.R02.S.doc Version 5.2 Page 21 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): Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. The manager is experienced and the home is well managed. The manager is professional in her approach, and is generally supported by the provider. Service users will benefit from the way the home is managed. EVIDENCE: The providers self-assessment stated that:The manager has worked at the home for 15 years with 1 break to gain management experience. She has 6 years experience as a manager and 5 as a deputy. She is supported in her role by a comprehensive well developed quality assurance system that includes rigorous audit processes. Regular checks of the fabric of the home, lifting equipment are recorded and audited regularly. We have an active Health &Safety Committee in the home Jubilee Nursing Home DS0000018198.V340366.R02.S.doc Version 5.2 Page 22 Residents finances are protected by policies and procedures to ensure that they are protected from financial abuse. These are subjected to regular audit. At the time of my site visit I found that the manager was not present due to attending training. The Deputy Manager is also an experienced Registered General Nurse (RGN) and supports the management functions of the Home. Discussions with staff indicate that they have a good awareness of health and safety issues and confirms that they receive training in this area. Staff are enthusiastic and well motivated. Quality monitoring systems are in place and are well designed. Service monitoring includes resident questionnaires, residents meetings, staff meetings. Audits of health and safety, falls, catering and accidents are monitored. The Deputy Manager confirmed that the Provider’ senior managers make regular visits to the Home. Service users and their relatives spoke of having confidence in both the staff and the manger of the home. Jubilee Nursing Home DS0000018198.V340366.R02.S.doc Version 5.2 Page 23 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 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 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 3 2 2 3 3 3 3 2 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X 3 3 3 X 3 3 3 Jubilee Nursing Home DS0000018198.V340366.R02.S.doc Version 5.2 Page 24 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 2 Standard OP21 OP21 Regulation 23(2)(j) 23(2)(J) Requirement Timescale for action 30/09/07 Toilets must be of a design that is accessible to disabled and wheelchair users. The number of assisted bathing 30/09/07 facilities must not fall below the number stated in regulations and the design must be suitable for all service users. All parts of the home must be kept clean. Showers, bathrooms and toilets must have adequate ventilation. 31/08/07 31/08/07 3 4 OP26 OP25 13 (3) 16(1) (k) 23 (2) (p) 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 OP21 Good Practice Recommendations It is recommended that the home seek the advice of the local disabled access officer about the design and provision of toilet and bathing facilities. Jubilee Nursing Home DS0000018198.V340366.R02.S.doc Version 5.2 Page 25 Commission for Social Care Inspection South Shields Area Office 4th Floor St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Nursing Home DS0000018198.V340366.R02.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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