Inspection on 14/07/05 for Juniper House

This inspection was carried out on 14th July 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

Juniper House 16/09/08

Juniper House 25/07/07

Juniper House 06/03/07

Juniper House 19/01/06

Juniper House 11/02/05

Juniper House 20/07/04

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 Juniper House 159 Strathmore Avenue Luton Bedfordshire LU1 3QR Lead Inspector Ansuya Chudasama Announced 14 July 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. Juniper House I51 S15013 Juniper House V231376 140705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Juniper House Address 159 Strathmore Avenue Luton Bedfordshire LU1 3QR 01582 756851 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) Mrs Audrey Greer Mrs Audrey Greer Care Home 3 Category(ies) of LD registration, with number of places Juniper House I51 S15013 Juniper House V231376 140705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 11.2.05 Brief Description of the Service: Juniper House is a small home for three service users with learning disabilities. The home was owned and managed by Mrs Audrey Greer. A small staff team are employed and work closely with service users. The home is situated in a residential of Luton, close to shops and other amenities. The building is a detached house with four single bedrooms. The ground floor has a lounge, dining room and the kitchen with washing machine. An enclosed garden with a patio was accessed from the kitchen. Juniper House I51 S15013 Juniper House V231376 140705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This Announced inspection took place over 6 hours. The manager/owner, Mrs Audrey Greer was present at the inspection. The inspection comprised of a tour of the bedrooms, bathing facilities and the communal areas of the home, care tracking in relation to two service users and conversations with all the service users, a family of a service user, and one member of staff and the manager. What the service does well: What has improved since the last inspection? What they could do better: Juniper House I51 S15013 Juniper House V231376 140705 Stage 4.doc Version 1.40 Page 6 The registered person must fit washbasins in all bedrooms has a requirement that needs to be completed by year 2007. The risks assessments needed reviewing. The staff must at all times sign the medication sheets when giving out medication. The manager had discussed this with all the staff in their meetings. The bathroom door needed attention, as it was difficult to lock. The home must undertake new CRB checks for all new staff. The manager had started undertaking this process. 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. Juniper House I51 S15013 Juniper House V231376 140705 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Juniper House I51 S15013 Juniper House V231376 140705 Stage 4.doc Version 1.40 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 standard(s) 1,2,3,4,5. Perspective service users, their families and representatives were provided with information, and trial visits to help them make an informed choice to accept the placement. EVIDENCE: The home had a statement of purpose and a service users’ guide. The guide was very good, and in pictorial format. This information was also available on audiotape. The service users’ and their families had visited the home prior to admission. Service users also had trial settling in period to find out if they wanted to stay at the home. The manager had also visited the service users in their own homes to tell them about the services they offered, and to find out more information about the service users needs. The home did not admit service users who’s needs they could not meet. The home had not admitted any new service users to the home for a long time. All service users’ had a contract with the home. Juniper House I51 S15013 Juniper House V231376 140705 Stage 4.doc Version 1.40 Page 9 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 standard(s) 6,7,8,9,10 Service users’ care plans inspected showed that their needs were being met by the home. EVIDENCE: All service users had care plans and these were reviewed on a regular basis. The Plans had information on how service users were helped to manage their personal care, social and their health care needs. The home involved service users, their families and other professionals in reviewing the care needs of the service users. The manager stated that they encouraged service users to make decisions about how they wanted to be cared at the home. This practice was observed on the day of the inspection. The service users spoken to stated that the staff helped them with personal care and took them shopping. The staff supported service users by undertaking risk assessments to promote their independence. The service users were also informed and provided with advice and information to minimise these risks. Some of the risk assessments needed reviewing and the manager stated that she was going to undertake this task this month. The staff spoken to were aware of the service users risks. Juniper House I51 S15013 Juniper House V231376 140705 Stage 4.doc Version 1.40 Page 10 The manager involved the advocacy services to help service users to complete the person centred planning and service user comment forms about living at the home. The financial records of one service user was examined in detail and showed that these were well maintained. The staff supported the service user to manage their money. Juniper House I51 S15013 Juniper House V231376 140705 Stage 4.doc Version 1.40 Page 11 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 standard(s) 11,12,13,14,15,16,17. Service users’ participated in a variety of activities in the community and in the home. EVIDENCE: The service users attended college and day care centres. Those spoken to stated that they enjoyed this. Service users also had set days at the home to work on their independent living skills. On the day of the inspection, one service user baked a cake with supervision from staff. Another service user went out shopping with a member of staff. The service users stated that they went to the seaside, cinema, and to the pub. Service users also helped with housing keeping chores, cooking, and did art work. The manager stated that when the college was closed during the summer months, the service users went out with staff and undertook different activities. Service users were also encouraged to maintain their hobbies by staff, and this was confirmed by talking to them. The manager held service users meetings to listen to their views and issues on health and safety activities and holidays were also discussed. The service users told the inspector that they were excited, as they were soon to go on a holiday to Cornwall. A service users family visited the inspector and stated that she was happy with the home and with the care that Juniper House I51 S15013 Juniper House V231376 140705 Stage 4.doc Version 1.40 Page 12 was provided by staff. It was also stated that the staff kept the family informed of the service users progress. One of the service users informed the inspector that she wanted to leave and this was being dealt by the home and the funding agency. The service users spoken to stated that the food was very good. The manager stated that she was also in the process of changing some of the menus and have them displayed in pictorial format. Juniper House I51 S15013 Juniper House V231376 140705 Stage 4.doc Version 1.40 Page 13 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 standard(s) 18,19,20,21 Service users’ personal and health care needs were being met by the home. EVIDENCE: Service users’ care plans seen showed that the staff helped them to meet their personal care needs. All service users choose their own clothes and observation showed that they were dressed appropriately. One service user showed the inspector some clothes that she had bought for her holiday. The medical records seen showed that health professional’s appointments were well maintained. The home had a medication policy and records were well maintained. Service users’ medication was also reviewed regularly and all staff who gave out medication had received training in this. The Mars sheets looked at showed that there were two occasions when these had not been signed by staff. Information on service users burial arrangements was available. The manager stated that service users were able to stay at the home as long as they were able to meet their needs. Juniper House I51 S15013 Juniper House V231376 140705 Stage 4.doc Version 1.40 Page 14 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 standard(s) 22,23 The home had policies and procedures in place to protect service users from abuse. EVIDENCE: The home had a complaints policy and the staff were aware of this. Service users spoken to stated that they knew who to speak to if they were unhappy. A family member spoken to stated that she would speak to staff if she had any concerns. The staff spoken to stated that they understood the needs of the service users well. They gave many examples of how they would know if any service users were unhappy. The staff used makaton sign language and verbal communication to communicate with one service user. The manager and staff were aware of the adult abuse policy and they had reported two incidents to Social services and these were dealt with appropriately. The service users money checked was well recorded and correct at the time of the inspection. Juniper House I51 S15013 Juniper House V231376 140705 Stage 4.doc Version 1.40 Page 15 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 standard(s) 24,25,26,27,28,30. Service users live in a homely and safe environment. EVIDENCE: The premises were clean and homely and met the needs of the service users. The premises were accessible to all the service users. The lounge, dining room, and the passage way had been decorated, and the service users picked the colour of the carpet. The bathroom had a new shower but the door was a bit difficult to close. The manager was aware of this and was going to get this sorted, and have the bathroom decorated. All service users’ rooms seen were individualised to meet their needs, and all the service users said that they liked their rooms. The home had an attractive garden and on the day of the inspection the service users had a party in the garden. Juniper House I51 S15013 Juniper House V231376 140705 Stage 4.doc Version 1.40 Page 16 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,34,35,36 Service users benefit from well supported and competent care staff. EVIDENCE: The home was fully staffed. The manager stated that the staff were very caring and this was confirmed by talking to service users. The staff files inspected had most of the information required. However three staff had CRB checks that were recent but these had been undertaken at their previous employment. Some of these staff were also still working at these jobs. The manager stated that she had sent off CRB checks for these staff and had not realised that she needed to have a new CRB check. The staff files and those spoken to stated that they had completed all mandatory training. All new staff had also completed the induction training. One member of staff was undertaking NVQ level 3, another staff was completing the foundation in NVQ level 2, and one staff had completed NVQ level 2. The staff stated that they had staff meetings every month and supervision every two months. The staffing ratio to service users was met. The staff team reflected the gender composition of service users. The staff spoken to stated that they enjoyed working at the home and they worked well as a team. The working environment was described as being homely and happy. Juniper House I51 S15013 Juniper House V231376 140705 Stage 4.doc Version 1.40 Page 17 Juniper House I51 S15013 Juniper House V231376 140705 Stage 4.doc Version 1.40 Page 18 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,38,39,40,41,42. Service users benefited from a well run home. EVIDENCE: The registered manager had many years experience working with the service user group. She had practiced as a nurse. She was undertaking her NVQ level 4 in management and care and due to complete in September 2005. The family member spoken to stated that the home had a homely atmosphere and she was always made to feel welcomed. The member of staff spoken to also stated that the manager was very supportive and approachable. The manager had daily contact with the staff and service users. The Fire officer had visited and this was satisfactory. The manager carried out fire drills with the staff and service users. They also stated that they knew what to do if there was a fire. Risk assessment for the environment was undertaken. The person centred planning questionnaires and comment cards completed with the support of an advocate by service users were very positive. Juniper House I51 S15013 Juniper House V231376 140705 Stage 4.doc Version 1.40 Page 19 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 4 3 3 3 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Juniper House Score 3 3 3 3 Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 3 x I51 S15013 Juniper House V231376 140705 Stage 4.doc Version 1.40 Page 20 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 ya27 Regulation 23 Requirement The registered person must fit was-basins in all bedrooms Timescale for action 1.1.2007 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 Good Practice Recommendations Juniper House I51 S15013 Juniper House V231376 140705 Stage 4.doc Version 1.40 Page 21 Commission for Social Care Inspection Clifton House Goldington Road Bedford MK40 3NF 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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