Inspection on 06/11/06 for Rubens House

This inspection was carried out on 6th November 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 but made no statutory requirements on the home.

Other inspections for this house

Rubens House 06/02/06

Rubens House 01/08/05

Rubens House 23/02/05

Rubens House 31/08/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE Rubens House 184 Ballards Lane Finchley London N3 2NB Lead Inspector Margaret Flaws Key Unannounced Inspection 10:00a 6th November 2006 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 Rubens House DS0000010524.V310744.R01.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. Rubens House DS0000010524.V310744.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rubens House Address 184 Ballards Lane Finchley London N3 2NB 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) 020 8349 9879 020 8343 4173 Jewish Care Mrs Kok Ying Idelbi Care Home 51 Category(ies) of Dementia - over 65 years of age (51), Old age, registration, with number not falling within any other category (51) of places Rubens House DS0000010524.V310744.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 6th February 2006 Brief Description of the Service: Rubens House is registered to provide personal care and support for a maximum of 51 older people, some of whom may have dementia. The home is owned and managed by Jewish Care in accordance with Jewish culture and beliefs. Jewish Care operates other care homes in the London area. The building is a large detached four-storey house built in the 1960s. There are two passenger lifts, which serve all floors. The ground floor contains two large dining rooms, two lounges, laundry, kitchen, staff room, an administration area and the managers office. Service users bedrooms are located on the first, second and third floors. There are two double bedrooms, one of which has ensuite facilities. There are 50 single bedrooms, 22 of which have en-suite facilities. All others have a washbasin. There are 14 toilets, 7 assisted bathrooms and 2 showers, located throughout the building. A treatment room, containing the medication cupboard is located on the third floor. There is a parking area at the front of the premises and a large garden at the rear, which is partly paved. A company called Eurest, provides the hotel and maintenance services. However, the manager has considerable management responsibility for these staff. The home is situated on Ballards Lane, a busy trunk road between North and Central Finchley. There is a wide range of shops, pubs and restaurants nearby and there is good access by public transport. The fees for the home are £652 per week. Rubens House DS0000010524.V310744.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over one day. It was undertaken by Inspector Margaret Flaws, as part of the routine schedule of inspections for the home. The Registered Manager, the Care Manager, the Activities Coordinator, the Drama Therapist, the handyman and eight staff of Rubens House were spoken to on the day of the inspection. The inspector also spoke to the Service Manager, who visited during the inspection. The inspector spoke to seven service users and including some who were affected by dementia. Two relatives visited during the inspection and spoke to the inspector. Five service user’ surveys, five relatives’ surveys and one health and social care professionals surveys were returned to CSCI. A tour of the buildings and grounds, inspection of service user’ files, staff records, general home records and policies and procedures formed the basis of the inspection. One new requirement was made on this inspection and one was restated from the last inspection. What the service does well: What has improved since the last inspection? Two requirements were made at the last inspection. One was met: bathroom tiling has been repaired. Rubens House DS0000010524.V310744.R01.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. Rubens House DS0000010524.V310744.R01.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 Rubens House DS0000010524.V310744.R01.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Prospective service users can be confident that the home makes every effort to give them information about the home and how they might feel living there. EVIDENCE: Four care plans were sampled on this inspection. They were all new admissions to the home since the last inspection and contained comprehensive assessments. All referrals are initially assessed by a panel from Jewish Care and a trial visit follows. The prospective service user is then assessed by the Rubens House Care Manager. There were three vacancies on the day of the inspection. Service users surveyed were particularly positive about the pre-admission procedures. They said they were able to visit the home on a trial basis and that the home supports their relatives to assessing whether it will suit their needs. “Every possible bit of help and advice was given, and my daughter reassured that she was doing the best for me”, said one service user. Rubens House DS0000010524.V310744.R01.S.doc Version 5.2 Page 9 The home has had a low number of deaths in the last year and no admissions to hospital accident and emergency departments. Rubens House DS0000010524.V310744.R01.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Service users can be confident that their health, personal and social needs will be set out in a plan of care which is regularly reviewed, and that their healthcare needs will be reviewed. They can also be confident that staff will respect their privacy and treat them respectfully. EVIDENCE: Four service user care plans were sampled. All contained full details of assessment, risk management, goals and actions required. They were regularly reviewed by keyworkers. Good processes of review are in place and adhered to by staff. There is a record in each service user’s file, detailing appointments with G.P.s, chiropodists, and other visiting health professionals. There are also good life histories for service users on file, which provide helpful and accessible holistic summaries of their lives. These life histories are written in the first person and, in some cases, written by the service users. Rubens House DS0000010524.V310744.R01.S.doc Version 5.2 Page 11 The inspector spoke to several service users and spent considerable time sitting in the dementia unit lounge observing interactions between staff and service users. These interactions were sensitively handled. The staff were running an activities session using a sensory machine called a vector machine. The service users appeared to enjoy the sessions and respond to the sensory and tactile elements of the machine. A Community Psychiatric Liaison nurse visits regularly to monitor the dementia care. Staff demonstrated familiarity with the service users and were observed to treat them with respect. Service users confirmed this when interviewed. They also said that staff upheld their privacy when they delivered personal care. Service users surveyed were generally positive about the care they received in the home. For example, “I feel that I am in a safe and kind home. I am gradually feeling at home here – excellent staff, excellent food.” There is a private telephone call box in the foyer for service users and relatives to use. Staff training includes a day and regular updates on ‘The Jewish Way of Life’, to ensure they are taught to understand and respect the cultural practices and beliefs of the service users. Medication arrangements will be inspected by the CSCI Pharmacy Inspector and reported separately. Rubens House DS0000010524.V310744.R01.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is excellent. This judgement has been made from evidence gathered both during and before the visit to this service. The service users benefit from a comprehensive and stimulating activities programme. Their cultural needs are paramount in the home; family involvement is encouraged and the food is of an excellent standard. EVIDENCE: There was ample evidence of a comprehensive activities programme. Service users have constant input into the content and structure of the programme. On the day of the inspection, some service users participated in art therapy sessions, acting workshops, and staff delivered a session in the dementia unit with a sensory machine. The home has regular in-house drama performances, discussion groups and speakers and entertainers coming from outside. There are also programmes of arts and crafts, reminiscence, music, games, as well as individual activities programmes and outings. The home offers hairdressing, beauty therapy and exercise classes, as well as activities tailored for the needs of people with dementia. The Activities Coordinator showed the inspector photographs of activities organised over the last few months. Examples included World Cup Football parties, mad hatter’s tea party, several visits from children in local schools and Rubens House DS0000010524.V310744.R01.S.doc Version 5.2 Page 13 Jewish community groups and a visit from the orthodox community. A regular volunteer described activities that she coordinates, along with another volunteer, including the forthcoming pantomime. The home has a strong volunteer contingent who run and assist with activities and support the service users and care staff. Several service users are over one hundred years old or close to a century. Birthday parties are big occasions in the home and the home also recently celebrated its 40th anniversary with a grand party. The home has a synagogue which is used for Jewish celebrations and a Rabbi visits regularly. Activity timetables are posted on noticeboards throughout the home and documented in service users’ files. All service users spoken to said that they enjoy the activities and the choices offered. One service user was observed to say to a staff member: “you make me laugh – I wouldn’t laugh otherwise”. The drama therapist described how she works with a small group of service users. The sessions include storytelling, physical activities to encourage teamwork and communication. All service users who participate in the drama therapy have dementia and the drama therapist was able to describe how the activities had supported maintaining their wellness. Service users and relatives described regular contact and said that the home’s procedures supported unlimited visiting. Relatives meetings are held regularly and the Deputy Manager said they are well attended. This was confirmed by the minutes. All relatives and service users spoken to were very positive about the home. For example, “we are so lucky to be here – the staff are amazing, kind and so much fun”. The kosher kitchen is run and staffed by Eurest, an independent catering company. The prepared lunch was nutritious, healthy and culturally appropriate. After the meal, the chef spoke to all the service users to check what they thought of the lunch. Service users were all very positive about the food in the home. The menus are varied and offer good choices for the service users. Rubens House DS0000010524.V310744.R01.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Service users are protected by the home’s complaints and adult protection policies and procedures. EVIDENCE: Six complaints were received and appropriately investigated and responded to since the last inspection. The complaints process is publicly available and service users spoken to said they knew how to complain if they wished. Staff training files indicated that all staff have received recent adult protection training. Service users reported that they felt safe in the home. Rubens House DS0000010524.V310744.R01.S.doc Version 5.2 Page 15 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 the following standard(s): 19 and 26 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. The home is of a reasonable standard for the service users to live in, although some parts are beginning to show their age. EVIDENCE: The inspector toured the home with the Deputy Manager. The home is extremely presentable and comfortable. The communal areas are homely and pleasantly decorated, although parts would benefit from a coat of fresh paint. There is a garden to the rear of the building. The bedrooms are well furnished and highly personalised by each service user. All storage furniture is lockable. All rooms, except two doubles, are single. These double rooms are reserved for the use of the two married couples in the home. There are an adequate number of bathrooms and toilet facilities for the service users. These are all appropriately equipped to meet the service users’ needs Rubens House DS0000010524.V310744.R01.S.doc Version 5.2 Page 16 and the equipment is regularly serviced. There are assisted bathrooms and five hoists available throughout the home and staff are trained in their use. The home was clean, hygienic and free from unpleasant odours on the day of the inspection. One report of the fourth floor smelling of urine was not substantiated on the day of the inspection. There is one cleaner dedicated to each floor and there is a cleaning register in each bedroom, so that the service users know when their room has been cleaned (normally daily). Several rooms were inspected and were in good order. One room however had a curtain rail down. It is required that this be replaced. A requirement to repair the tiling and vinyl flooring in an upstairs bathroom has been completed. A kitchenette has been put into the dementia unit to help promote the independence of the service users. The managerial staff described plans for the refurbishment of the reception area. This would incorporate a dementia safety entrance. Rubens House DS0000010524.V310744.R01.S.doc Version 5.2 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28, 29, 30 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Service user benefit from a safely recruited and well trained staff. Changes in the working pattern have preserved current staffing levels. EVIDENCE: An new Administrator has been appointed. There were two staff vacancies at the time of the inspection and appointments have been made. Four staff files were sampled and all pre-employment information was complete and a requirement from the last inspection to ensure that all staff have a photo on file has been met. Staffing levels in the home are appropriate to the care needs of the service user but the Deputy Manager said that they would like to increase the number of night staff per shift to five. Staff receive a systematic and comprehensive induction. The induction includes First Aid, Manual Handling, Health and Safety, Adult Protection, Dementia care, and literacy for those whom need it. Training records were examined. There is an ongoing programme of dementia awareness, run over eight weeks, as well as other statutory and care related training, which all staff attend. Most staff have NVQ2 or NVQ3, or are in the final stages of one of these programmes. Since the last inspection, staff have had training in fire safety, management and communication skills, administration of medication, pressure care, Jewish Rubens House DS0000010524.V310744.R01.S.doc Version 5.2 Page 18 cultural issues, adult protection and first aid. Staff have also been trained in sexuality in older people. The Activities Coordinator is developing her skills in life history work and training staff on how to put this into the careplans, as well as undertaking training in management. Staff have also participated in the dementia development training and music for life training to work help the work more supportively with the rising numbers of people with dementia in the home. Since August 2006, the rota has been changed to a twelve hour shift for all care staff. Staff interviewed said that they were happy with the staffing arrangements and that they were well resourced to do their jobs. They were very positive about the home and its management. Rubens House DS0000010524.V310744.R01.S.doc Version 5.2 Page 19 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,36 and 38 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Service users are supported in a well managed home and protected by their financial and health and safety arrangements. Staff are supported systematically, formally and informally. Some improvements are still needed to the hot water system. EVIDENCE: The management of the home is sound. Both the Registered Manager and Deputy have been in the home for many years and have worked hard to ensure a high standard of care is provided. They support an experienced team of Team Leaders and seniors who are committed to the service users’ wellbeing. The ethos of team work was apparent from the discussions observed during the inspection, along with a healthy climate of debate. The Service Manager was also very positive about the home. The Registered Manager and the Deputy Manager said that it has been hard work during the period when Rubens House DS0000010524.V310744.R01.S.doc Version 5.2 Page 20 the Administrator’s post was vacant but there were no obvious detrimental effects to service users or staff identified during the inspection. Service users’ finances, where handled by the home, are kept safe through the organisation’s policies and procedures which are regularly reviewed. All receive supervision every eight weeks, which is documented in supervision records. The Registered Manager said that they will be increasing the frequency of supervision. Staff have also had training in the principles and practice of supervision. Quality assurance is integral to Jewish Care’s practice. A quality committee operates in the home and the recent survey was positive. Safe working practices are in place throughout the home and these are reinforced by regular staff training and meetings, monthly health and safety inspections and committee meetings and good legislative compliance. Incident and accident records were inspected. These were appropriately recorded and actions taken. Water temperature was checked. The water temperature in the first floor bathroom is still too hot. The boiler mixer has not been replaced, as required at the last two inspections. The requirement is repeated. Fire drills occur monthly and are recorded in detail. Fire safety awareness training is regularly undertaken. The fire safety officer last visited the home in July 2006. Fire equipment had been regularly checked. Gas, electrical, water and equipment certificates were checked and were up to date and in order. The hoists, assisted baths and lifts were recently checked and found to be in order. The home has systems to regularly check water, environmental health and wheelchairs. Rubens House DS0000010524.V310744.R01.S.doc Version 5.2 Page 21 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 X X 3 X X 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 4 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 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 4 X 3 X 3 4 X 2 Rubens House DS0000010524.V310744.R01.S.doc Version 5.2 Page 22 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 OP19 Regulation 13(4) Requirement The Registered Person must ensure that the water temperature in the first floor bathrooms be better regulated. The Registered Person must ensure that a curtain rail is replaced in a service user’s bedroom. Timescale for action 28/02/07 2. OP19 13(4) 28/02/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Rubens House DS0000010524.V310744.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Southgate Area Office Solar House, 1st Floor 282 Chase Road Southgate London N14 6HA 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 Rubens House DS0000010524.V310744.R01.S.doc Version 5.2 Page 24 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!