Inspection on 31/01/06 for Rachel Mazzier House

This inspection was carried out on 31st 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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Rachel Mazzier House 29/01/07

Rachel Mazzier House 31/08/05

Rachel Mazzier House 04/03/05

Rachel Mazzier House 01/09/04

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

CARE HOME ADULTS 18-65 Rachel Mazzier House 25 Chatsworth Road Brighton East Sussex BN1 5DB Lead Inspector Jenny Blackwell Announced Inspection 31st January 2006 11:00 Rachel Mazzier House DS0000014228.V269809.R01.S.doc Version 5.0 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 Rachel Mazzier House DS0000014228.V269809.R01.S.doc Version 5.0 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. Rachel Mazzier House DS0000014228.V269809.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Rachel Mazzier House Address 25 Chatsworth Road Brighton East Sussex BN1 5DB 01273 564021 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) Sussex Tikvah Ms. Joanne Osbaldiston Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Rachel Mazzier House DS0000014228.V269809.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The number of people accommodated must not exceed 6 The people accommodated will be between the age of 18 and 65 years on admission 31st August 2005 Date of last inspection Brief Description of the Service: Rachel Mazzier is a registered care home providing support for 6 people of the Jewish faith who have a learning disability. The Jewish Charity, Sussex Tikvah, runs the home. The committee includes parents, social workers, services users and other members of the community. Brighton Housing Trust owns the building. Under this arrangement, the Trust is responsible for all external maintenance. It is the responsibility of the charity to provide for the overall care of the 6 service users, internal maintenance and the up keep of the internal fixtures and fittings. The home does not have level access and parking is restricted due to pay and display bays. Rachel Mazzier House DS0000014228.V269809.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. During this summary and report the people who live at the home will be referred to as people/person and the people who work at the home as staff or by their job title. The people who live at the home, some of the staff team and the manager were present during the inspection. Time was spent with four of the people who live at the home. Three relatives/visitors comment cards were received and six comment cards from people who use the service. The recommendation made from the inspection in August 2005 was checked to see if it had been met. The manager produced evidence to show that the recommendation had been met. The people who live at the home and the staff were helpful throughout the inspection and contributed to the report where possible. What the service does well: The home is set up and run to enable the people who live there as much independence from the staff as possible. Each person is able and expected to contribute to the daily running of the home. The people meet regularly to work out who would be doing what task throughout the week and discuss any issues. The home has a contract with the terms and conditions of residency in place for all of the people living at the home. One was viewed for one person. The staff had made an effort to make the document accessible to the people by translating some of the written words into symbols. The individual had signed the contract. The six comment cards received back form the people all indicated that they were happy with the staff, the levels of privacy at the home, the food and feeling safe. One comment card filled in by a relative stated that the relative was very happy at the home. She said she felt safe and supported and appreciated the better care and low turnover of staff compared to her previous home. Another person’s comments said that “ Rachel Mazzier Home gives excellent service to residents and visitors and have only praise at the highest level for the manager and her supporting team, who exercise very good standards at all times.” Another comment card filled in by a relative said, “The care and atmosphere of this home is very good.” Rachel Mazzier House DS0000014228.V269809.R01.S.doc Version 5.0 Page 6 The staff spoken to were able to demonstrate knowledge of each person support needs to practice their faith. The staff had been supported by the organisation to attend training and awareness days about the Jewish faith. 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. Rachel Mazzier House DS0000014228.V269809.R01.S.doc Version 5.0 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 Rachel Mazzier House DS0000014228.V269809.R01.S.doc Version 5.0 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): 2,3,4 and 5 Prospective people to the home had their needs assessed and their aspirations were reviewed regularly. Opportunity to test drive the home was available to suitable referred people. Contracts provided each person with information about residency. EVIDENCE: Brighton and Hove City Council fund three of the people live at Rachel Mazzier House, Camden one person and Hillingdon another and one person is privately funded. The placing authorities ensure that the people have had placement reviews. The home also ensures that they undertake six monthly reviews with each person and their families and friends. The information is held in the persons care plan. Annual goals are set with the people to ensure they are achieving their aspirations. The people who live at the home have done so for some time. The last person moved to the home over a year ago. She planned the move with her family and the home. Overnight stays and visits were arranged and time was spent getting to know the other people living at the home. The manager said that the home could currently only support people who were fairly independent as the staff ratio were low. This arrangement was well documented by the organisation and staff so any person referred to the home would be given this information prior to visiting. Rachel Mazzier House DS0000014228.V269809.R01.S.doc Version 5.0 Page 9 The home has a contract with the terms and conditions of residency in place for all of the people living at the home. One was viewed for one person. The staff had made an effort to make the document accessible to the people by translating some of the written words into symbols. The individual had signed the contract. Rachel Mazzier House DS0000014228.V269809.R01.S.doc Version 5.0 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): 6-10 The individual plans contained information that reflected the interest support needs and goals of the people. Each person made decisions about their lives and contributed to the running of the home. This was supported by appropriate risk assessments by the individuals in conjunction with the staff. Records were stored securely and were available to the people at all times. EVIDENCE: Each person had an individual plan with detailed information about their interests support needs and health care support. Each person signed some sections such as the short-term goals. This showed that the staff where aware that the individuals needed to be at the centre of their support planning and in agreement to the type of support they received. The manager showed a new file that had been put together as a quick reference tool for staff. It had a section for each person that contained daily guidelines about their support for example how someone preferred to have their personal care. In addition there were signed agreements about group living such as cleaning up after themselves. Some of these agreements were spoken about with two of the people who live at the home. They explained why the agreements were in place and how they had been agreed either at the residents meeting or with their keyworkers. Rachel Mazzier House DS0000014228.V269809.R01.S.doc Version 5.0 Page 11 The staff ensured that people where in a position to make decisions about their lives. The home needs to run with as much participation from each person as possible. Often there is only one staff on shift with the six people. So the people decide about the food they will buy and the menus they would write. Activities and social events are arranged to ensure each person does not have an effect on another’s plans. The people talked about the meetings they have at the house to decide what would be happening during the week. Decisions where taken about who will prepare the meals and do the household shopping. The people also had an understanding of the organisation function and how it was set up. One person talked about a committee member of Sussex Tikvah who visits the home. The staff support the individuals to take measured risks in all aspects of their lives. A process of risk assessments was used to ensure that the individuals had an independent life style. Recently a person had an accident whilst out and the manager and staff had reassessed the risk to the person going out unsupported. The information about the people was stored safely and staff understood the need for confidentiality when dealing with people’s information. Evidence was seen in each person’s records of their active involvement of contributing to them. Rachel Mazzier House DS0000014228.V269809.R01.S.doc Version 5.0 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): 12,13 and 14 The staff were committed in supporting each person with their interest. Personalised activity information was in place for each individual. Each person was actively engaged in his or her local community. EVIDENCE: The people continue to engage in their preferred activities. On the day of the inspection one person had returned to the home in the afternoon after volunteering in the Jubilee Library, he went one day a week in the morning. He said he was particularly enjoying his work at the library as he enjoyed working with books. Other people who live at the home attend days at organised day services locally. Another person was continuing her volunteering in an older persons home. Everyone had opportunities to access community facilities and one person in particular was very involved with his local Jewish community. Time was spent with one person who had been spending several months writing his childhood memoirs with a volunteer. With support from the staff and the organisation he had produced a booklet about his childhood. The Rachel Mazzier House DS0000014228.V269809.R01.S.doc Version 5.0 Page 13 person and the inspector read the book and talked about its contents and how he came to put it together. Rachel Mazzier House DS0000014228.V269809.R01.S.doc Version 5.0 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): 19,20 and 21 The people who live at the home are supported to maintain their well-being. They attend community health care appointments and have access to specialist health care provision. . The medication procedures are clear and involved the people at the home. EVIDENCE: The manager also produced some evidence of the staff working closely with psychologist, psychiatrists and the Community Learning Disability Team when developing support methods for particular individuals. The manager demonstrated knowledge about the limitations of the homes ability to support someone who may become particularly unwell either physically or mentally. Recently one person had a significant accident in the community and was receiving additional input from the hospital team after care support. One member of staff said that although the initial arrangements had its difficulties the additional support now worked well. The home encourages service users to administer and control their own medication where possible. One persons risk assessment was viewed. It was Rachel Mazzier House DS0000014228.V269809.R01.S.doc Version 5.0 Page 15 recommended the person and the home reviews the risk assessment and identifies future review dates. The home has comprehensive information on the medications and their side effects and store’s and administers medication appropriately. A check on the medication system found no errors. It was recommended the home counts stock of medications that have a potential to be miss used. Currently the people do not have any issues about ageing. The manager said that the people would be supported to stay at the home if they wished for as long as it was feasible. Rachel Mazzier House DS0000014228.V269809.R01.S.doc Version 5.0 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 and 23 The organisation’s policies and procedures enable the people who live at the home and their representatives the opportunity to raise concerns and make complaints. The staff understood the complaints procedure and the process. The organisation operates within procedures to protect people from abuse. EVIDENCE: The complaints procedure contains the information needed for the people and their representative to make a complaint. The home or the Commission had not received a complaint since the last inspection. The home had produced a new complaints leaflet in response to a suggestion form a person living at the home. The leaflet is easy to understand and has the Commissions contact details. The manager and staff continue to actively protect people from abuse by means of training the staff, encouraging the people to speak up about any concerns they have, and ensuring that they con contact outside support if they needed. Rachel Mazzier House DS0000014228.V269809.R01.S.doc Version 5.0 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): 24,27,28,29 and 30 The home was safe comfortable and homely with sufficient shared spaces and bathroom facilities. The home was kept to a standard that appeared to be how the people liked it. EVIDENCE: The home is comfortable and homely. The people were asked about their views of the home and said they liked the home and the decoration. One person talked about the new downstairs shower room, he said he liked it. The people and staff had also moved a washing machine to the place were the toilet used to be and in the process bought a new washing machine. The shared space in the home was used well. During the inspection the people wee seen to spend time in their rooms and time in the communal areas. The lounge was bright and clean and the area that people sat together to watched T.V in the evenings. The dinning room off the kitchen provides enough space for everyone to eat together if they wished. Generally the people do not use specialist equipment to help with mobility around the house. Although after one persons accident minor adaptation were used to help him with personal support. The home employs a cleaner who comes to the home on weekdays. All the people who live at the home are expected to contribute to the cleaning as well. Rachel Mazzier House DS0000014228.V269809.R01.S.doc Version 5.0 Page 18 The home was very clean and tidy. The communal rooms reflected the tidiness of the people’s own rooms indicating they generally preferred a tidy house. Rachel Mazzier House DS0000014228.V269809.R01.S.doc Version 5.0 Page 19 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 and 36 The staff team were effective and met the support needs of the people who lived at the home. The roles were clear and understood by the people living at the home. The organisation invests in the induction and training of its staff and the manager monitors each staff member through supervisions and staff meetings. EVIDENCE: The manager has worked at the home for many years. The people were very familiar with her and identified her as the manager. The deputy manager also had a noticeable role in the home. As the home runs with usually one staff member working at a time the people appeared to identify easily with all the staff. During discussions with the people they named their keyworkers and the relief staff. They had awareness of one staff being of sick and also the role of the Sussex Tikvah committee members. The staff team were competent individuals, who the manager described as being reliable and able to work on their own initiative. One person was on long term sick but the manager had arranged for the shifts to be covered by relief staff that were known to the people. Staff received regular supervision on a 1:1 basis and attend staff meetings. Time was spent with one member of staff who said she found the manager and the organisation supportive. She described the relationship between the Rachel Mazzier House DS0000014228.V269809.R01.S.doc Version 5.0 Page 20 home’s staff and the committee members as good. Training was readily available from the organisation. The manager said that as the home was a stand alone service the organisation had teamed up with a housing association that supported them with Humana Resources services. The manager reiterated what the staff member had said about the committee members saying that Sussex Tikvah had paid for all staff to be affiliated to an independent staff support service. The organisation provides confidential support and advice to staff about work and personal matters. This was seen by the manager as an example of the organisation concern over the staff’s well being. Rachel Mazzier House DS0000014228.V269809.R01.S.doc Version 5.0 Page 21 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): 38-43 The home was well run and the organisational ethos was reflected in the wider staff team. Policies and procedures were written to serve the best interest of the people. The home was a safe enviorment for the people who live and work in the home. EVIDENCE: As stated previously, the people were able to identify the management structure of the home. The ethos of the home is to ensure that the people who live at the home run the service as much as possible. Strong emphasis is place on group living with each person having responsibilities to contribute in running the home. Individuals were supported to maximise their potential. This was noted through discussion with the people, their care plans and comparing their achievements form the last inspection. The home has a quality assurance system were the people their representatives and the staff are consulted about he home. This information is drawn together by the organisation to gain an understanding of peoples experience of the home. It was required that the home provide the Commission with a copy. Rachel Mazzier House DS0000014228.V269809.R01.S.doc Version 5.0 Page 22 The home has comprehensive policies and procedures that are required to meet the standards. These support the peoples best interest and ensure staff are equipped with the guidance they need to do their work. The manager and staff undertake regular health and safety checks. The manager also ensures that the people who live at the home are familiar with fire evacuation procedures. A staff member has been given the project of setting up a food safety file in preparation for new regulations. The file contains guidance and explanations of good practice. Checklists are in place for the safe storage of food and all staff are trained in food hygiene. The manager described the setting up of the file as a good piece of work by the staff member. Rachel Mazzier House DS0000014228.V269809.R01.S.doc Version 5.0 Page 23 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 X 3 3 3 3 Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 3 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X 3 3 3 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score 3 X 3 X X 3 CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Rachel Mazzier House Score X 3 3 3 Standard No 37 38 39 40 41 42 43 Score X 3 2 3 3 3 3 DS0000014228.V269809.R01.S.doc Version 5.0 Page 24 Are there any outstanding requirements from the last inspection? YES 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(2) Requirement It was required that the home provides the Commission with a copy of the quality assurance report. That the registered person must ensure regulation 26 reports are sent to the commission. Timescale for action 01/06/06 2. YA39 26 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. 2. Refer to Standard YA20 YA20 Good Practice Recommendations It was recommended the home counts stock of medications that have a potential to be misused. It was recommended the person and the home reviews his self-administered medication risk assessment and identifies future review dates. Rachel Mazzier House DS0000014228.V269809.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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 Rachel Mazzier House DS0000014228.V269809.R01.S.doc Version 5.0 Page 26 - 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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