Inspection on 16/08/05 for Miriam Kaplowitch House Care Home

This inspection was carried out on 16th August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Miriam Kaplowitch House Care Home 04/04/08

Miriam Kaplowitch House Care Home 05/04/07

Miriam Kaplowitch House Care Home 31/01/06

Miriam Kaplowitch House Care Home 21/03/05

Miriam Kaplowitch House Care Home 23/12/04

Similar services:

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

Byars Care Home

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

CARE HOMES FOR OLDER PEOPLE Miriam Kaplowitch House Care Home 470 Mansfield Road Sherwood Nottingham NG5 2EL Lead Inspector Meryl Bailey Unannounced 16 August 2005 at 10:00 am 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. Miriam Kaplowitch House Care Home C53 C03 S2212 Miriam Kaplowitch H V245603 160805 Stage 2.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Miriam Kaplowitch House Care Home Address 470 Mansfield Road, Sherwood, Nottingham, NG5 2EL 0115 962 2038 0115 969 2326 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) Nottingham Jewish Housing Association Limited Stephanie Linda Besbrode Care home only (PC) 22 Category(ies) of Old age, not falling within any other category registration, with number (OP 22) of places Miriam Kaplowitch House Care Home C53 C03 S2212 Miriam Kaplowitch H V245603 160805 Stage 2.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st March 2005 Brief Description of the Service: Miriam Kaplowitch House is situated in adapted detached premises in a residential area, but close to shopping areas, all amenities and public transport routes. Accommodation and care is offered to the older members of the Jewish community only. Bedrooms are on two floors with a lift to the upper floor level and a choice of communal areas is provided. All meals are prepared in the Kosher kitchens on the premises. Miriam Kaplowitch House Care Home C53 C03 S2212 Miriam Kaplowitch H V245603 160805 Stage 2.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and conducted by two inspectors (Meryl Bailey and Rob Cooper) during one morning. All current residents were at home and several gave their views about the care provided. Four care staff were seen on duty, but the manager was not present. No visitors were present during this inspection. Four written care plans were examined and medication was checked. Some of the staffing records were also seen. The communal areas of the home, a bathroom and a sample of bedrooms were seen. Lunch was observed. What the service does well: 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. Miriam Kaplowitch House Care Home C53 C03 S2212 Miriam Kaplowitch H V245603 160805 Stage 2.doc Version 1.40 Page 6 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 Miriam Kaplowitch House Care Home C53 C03 S2212 Miriam Kaplowitch H V245603 160805 Stage 2.doc Version 1.40 Page 7 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 and 3 Clear written information about the service is complete, though not readily available to be given to prospective residents. Forms are available for completing assessments. EVIDENCE: The residents’ handbook (Service User Guide) has been reviewed and updated and should now be issued to residents. The full Statement of Purpose is also available. However, staff were unaware of the location of these documents. A copy of the up to date residents handbook should be readily available for staff to hand to any potential residents or families making enquiries about the home. Since the last inspection a format has been prepared for recording preadmission assessments of need, but this was not seen in use as all current residents have been at the home since before the last inspection. Care plans do, though, refer to areas of assessed need (see under Standard 7). For some residents there are pre-admission assessment forms completed by social work staff. Miriam Kaplowitch House Care Home C53 C03 S2212 Miriam Kaplowitch H V245603 160805 Stage 2.doc Version 1.40 Page 8 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, 8, and 9 Care is planned, though a consistent model and format for written plans is not yet in place. More thorough reviewing and updating of plans is required to ensure all needs are met. Health needs are monitored and medication is well organised, though attention must be given to the storage temperature. EVIDENCE: The manager and deputies are responsible for the care plans and three of the four plans examined were stored together in a filing system. Most areas had been superficially reviewed on a monthly basis and there was no evidence of residents being involved in the reviewing process. One care plan selected had recently been seen by a representative of the funding authority and was contained in a new file with additional, but uncompleted paperwork. This new system, when in full use, is more organised and should give staff clear information about residents and how their needs are to be met. Currently, not all changes are reflected in the main plans, though the new system would allow for this. All plans should be reviewed, and amended as necessary. This should be done in consultation with service users or their representatives whenever needs change and on a monthly basis. Staff said that they get instruction from hand over meetings and from the board in the manager’s office, which displays the special needs of “vulnerable residents”. There is a Miriam Kaplowitch House Care Home C53 C03 S2212 Miriam Kaplowitch H V245603 160805 Stage 2.doc Version 1.40 Page 9 risk of breeching confidentiality if this information is displayed when residents and relatives visit the office. Also, written plans are stored on an open shelf in this office (see Standard 37). Accidents are recorded appropriately and there are daily notes of some health needs being monitored and instructions left by General Practitioners and District Nurses are recorded. Some care notes contain pressure risk assessments to assess the risk of pressure sores. There are also turning and fluid charts completed by both day and night staff. Storage for medication has been reorganised. The five senior staff are appropriately trained and are responsible for medication. A refrigerator is available for cold storage of eye drops and the temperature of this is monitored daily. However, the room was very warm on the day of inspection – measured at 26.6°C at 12.30pm. All medication should be stored under 25°C to preserve shelf life and the handyman immediately brought a fan into the room. The window was also opened, but further security is needed if this window is left open. The heating system leaves residual heat in the pipes and this needs attention (see Standard 25). Miriam Kaplowitch House Care Home C53 C03 S2212 Miriam Kaplowitch H V245603 160805 Stage 2.doc Version 1.40 Page 10 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 and 15 Some activities are arranged, but social and recreational needs are not all met. A balanced diet of Kosher food is provided. EVIDENCE: Some residents appeared contented with their lifestyles and others complained of boredom. Several enjoy reading and some like to write. Residents said that there was a visiting speaker once a month and Bingo occasionally on Thursdays. There was also a pianist every two weeks, but no organised activity took place during this inspection. Staff had arranged for one person, cared for in bed, to have the stimulation of music. However, there are others who are unable to find their own entertainment. It is recommended that suitable daily activities be provided, particularly for those with needs relating to dementia. The kitchens are well organised to provide strictly Kosher food. The dining room is adequate for the number of residents and provides a pleasant environment. Lunch was observed and residents were mostly very satisfied with their meal. Three courses were served: Minestrone Soup; Liver with potatoes, fresh beans and carrots; Fruit Pie or fruit and Ice cream. The cook produced a four-week menu, which showed a variation of balanced meals. One person had some discreet help with the meal in the dining room and another resident was fed with a liquidised meal in her room. Miriam Kaplowitch House Care Home C53 C03 S2212 Miriam Kaplowitch H V245603 160805 Stage 2.doc Version 1.40 Page 11 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 have opportunities to express any concerns and are listened to. EVIDENCE: The complaints procedure is included in the revised Residents’ Handbook (Service User Guide). Residents spoken with know who to discuss any concerns with. A recent complaint had been dealt with in writing and discussion between resident and manager. This was not recorded in the complaints book, but the resident stated that the final outcome was satisfactory. There are residents meetings where residents can raise their concerns and the most recent was held on 12th May 2005. Additionally the Chairperson of the Jewish Association visits regularly and speaks individually with residents. Monthly reports are received at the Commission. It is recommended that all concerns, aswell as formal complaints, be recorded in the complaints book with action taken and final outcome. Miriam Kaplowitch House Care Home C53 C03 S2212 Miriam Kaplowitch H V245603 160805 Stage 2.doc Version 1.40 Page 12 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, 21, 25 and 26 Most areas are well maintained and comfortable. Appropriate washing facilities are provided, but the floor of the shower room still needs attention. Heating and ventilation also need some attention, but the home generally maintains a high standard of cleanliness and hygiene. EVIDENCE: Residents said they feel very comfortable in their surroundings. The building and gardens are generally well maintained. There are four separate sitting areas in the home and further seating outside. Every bedroom has an en-suite bathroom. There are toilets close to the communal areas and there is a bathroom on the first floor with a fully accessible walk-in shower facility. The floor of this is non-slip, but appears stained. At the last inspection it was recommended that the providers review this facility and thoroughly clean or replace the flooring. The floor has remained the same and staff have found it impossible to remove the staining. Miriam Kaplowitch House Care Home C53 C03 S2212 Miriam Kaplowitch H V245603 160805 Stage 2.doc Version 1.40 Page 13 It was too warm in some areas of the home. The heating system was such that, though radiators were off, pipes were hot, giving residual heat. Heat was also rising from the hot water cylinders in the basement. Appropriate ventilation and a controllable heating system must be provided and it is recommended that consideration be given to separating the water and central heating systems. The communal areas and corridors were found very clean and odour free with the exception of one small area. This received immediate attention. The laundry area, although small, is well organised with appropriate machines. Miriam Kaplowitch House Care Home C53 C03 S2212 Miriam Kaplowitch H V245603 160805 Stage 2.doc Version 1.40 Page 14 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 and 29 Staff are available in sufficient numbers and are able to meet current needs. New staff are thoroughly checked before commencing employment. EVIDENCE: Staffing rotas show that there are always at least three day care staff on duty and two at night. Residents said that care staff responded quickly to their needs and were very helpful. Manager, cleaners, cooks, administrators, handyman and gardener are all employed in addition to care staff. Staffing records selected at random show that appropriate checks were carried out and references obtained prior to employment. Miriam Kaplowitch House Care Home C53 C03 S2212 Miriam Kaplowitch H V245603 160805 Stage 2.doc Version 1.40 Page 15 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) 37 and 38 Most records are well maintained, but further security is needed for some confidential information. A safe environment is maintained. EVIDENCE: Service users’ financial records are held securely and confidentially in locked filling cabinets with limited access. However, other general information and care plans should be afforded similar security, as they were on an open shelf in the manager’s office. The board showing names of those needing more frequent attention is useful for staff, but visible to anyone visiting the office and it is recommended that this be moved to an area used only by staff to preserve confidentiality. Copies of certificates show that staff are trained in safe working practices. All windows have restricted openings for safety and security and the handyman described systems in place to prevent Legionella. Miriam Kaplowitch House Care Home C53 C03 S2212 Miriam Kaplowitch H V245603 160805 Stage 2.doc Version 1.40 Page 16 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 2 x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 x 14 x 15 3 COMPLAINTS AND PROTECTION 3 x 2 x x x 1 3 STAFFING Standard No Score 27 x 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x x x x x x x x 2 3 Miriam Kaplowitch House Care Home C53 C03 S2212 Miriam Kaplowitch H V245603 160805 Stage 2.doc Version 1.40 Page 17 No 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 OP 1 Regulation 5 Requirement Issue the new Residents Handbook (Service User Guide) to each resident and make a copy available to staff and any prospective resident. Ensure medication is stored at temperatures under 25°C. Provide a suitable controllable heating and ventilation system. Timescale for action 30th September 2005 16th August 2005 30th November 2005 2. 3. OP 9 OP 25 13(2) 23(2)(p) Miriam Kaplowitch House Care Home C53 C03 S2212 Miriam Kaplowitch H V245603 160805 Stage 2.doc Version 1.40 Page 18 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. 2. 3. 4. 5. 6. Refer to Standard OP 1 OP 7 OP 12 OP 16 OP 21 OP 37 Good Practice Recommendations Use the new care planning forms and filing system consistently with all residents. Consult residents when reviewing care plans and revise individual plans as needs change. Provide suitable daily activities, particularly for those with Dementia. Record all concerns, as well as formal complaints, in the complaints book with action taken and final outcomes. Review the use of the walk-in shower facility and replace the flooring. Provide a lockable filing cabinet for care plans and do not display names and needs on a board visible to others. Miriam Kaplowitch House Care Home C53 C03 S2212 Miriam Kaplowitch H V245603 160805 Stage 2.doc Version 1.40 Page 19 Commission for Social Care Inspection Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © 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 Miriam Kaplowitch House Care Home C53 C03 S2212 Miriam Kaplowitch H V245603 160805 Stage 2.doc Version 1.40 Page 20 - 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. 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