Inspection on 20/04/05 for Spanish & Portuguese Jews Home For The Aged

This inspection was carried out on 20th April 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Spanish & Portuguese Jews Home... 18/07/07

Spanish & Portuguese Jews Home... 28/11/06

Spanish & Portuguese Jews Home... 07/11/05

Spanish & Portuguese Jews Home... 06/12/04

Spanish & Portuguese Jews Home... 20/04/04

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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 Spanish & Portuguese Jews Home Edinburgh House 36-44 Forty Avenue Wembley HA9 8JP Lead Inspector Julie Schofield Unannounced 20 April 2005 9.30am 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. Spanish & Portuguese Jews Home for the Aged Version 1.10 Page 3 SERVICE INFORMATION Name of service Spanish & Portuguese Jews Home for the Aged Address Edinburgh House 36-44 Forty Avenue Wembley Middlesex HA9 8JP 020 8908 4151 020 8908 3103 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) Ms Christine Gilmore CRH PC 51 Category(ies) of OP 41 registration, with number DE(E) 10 of places Spanish & Portuguese Jews Home for the Aged Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 06 December 2004 Brief Description of the Service: Edinburgh House is a home accommodating up to 51 elderly Jewish residents and provides personal care. It is part of a complex, which includes sheltered housing units and a day centre and is situated on Forty Avenue. This is a busy road linking Wembley Park with East Lane. Transport facilities include bus routes and a nearby underground train station (Wembley Park). The home has a large car park in the grounds and there are garden/patio areas around the building, which are attractive in appearance. The home consists of three floors (ground, first and second) and there are residents bedrooms and toilet/bathing facilities on each floor. There are a number of lounge areas on the ground floor including a large entrance hall that opens into a conservatory and there are residents using each of the communal spaces in the home. One lounge (Sunflower) is for the mentally frail residents. The pink lounge is for the high dependency/very frail residents and is situated on the second floor. The home has a spacious dining room for most of the residents although the Sunflower lounge and the pink lounge have their own dining areas. There are separate meat and milk kitchens, in accordance with dietary laws. There are offices on the ground floor for the manager and other senior staff. There is also a suite of offices on the first floor, which are used by the finance staff. The home has a number of pets. Spanish & Portuguese Jews Home for the Aged Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place on a Wednesday in April 2005 and lasted for 6 hours and 40 minutes. The manager was off duty and the deputy manager and a team leader assisted. Seven residents also spoke with the Inspector. The Inspector would like to thank all who took part in the inspection. Care records were inspected. A partial site inspection took place. At the time of the inspection there were 50 residents living in the home and there was one vacancy. What the service does well: What has improved since the last inspection? Spanish & Portuguese Jews Home for the Aged Version 1.10 Page 6 A change in the use of the communal space in the home has given the more physically frail and high dependency needs residents their own dedicated lounge. The residents are supported by staff assigned to this unit. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Spanish & Portuguese Jews Home for the Aged Version 1.10 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 Standards Statutory Requirements Identified During the Inspection Spanish & Portuguese Jews Home for the Aged Version 1.10 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 standard(s) 3, 4, 6 Prior to admission information is received about the prospective resident and one of the managers carries out an assessment to ensure that the needs of the resident can be met within the home. Residents were satisfied that the service provided respected their religious beliefs. Trained staff support residents with dementia care needs. The home does not provide an intermediate care service. EVIDENCE: The case file of a newly admitted resident who receives funding from the local authority and of a newly admitted resident who is privately funded was inspected. Both files contained a pre-admission assessment that had been carried out by the deputy manager. Where the local authority was involved information had been sent to the home and the hospital had supplied information to the home for the privately funded resident. The Sunflower lounge is for residents with dementia and staff (including staff working in the other lounges in the home) have undertaken training courses on dementia care. The home specifically provides a service for Jewish residents Spanish & Portuguese Jews Home for the Aged Version 1.10 Page 9 and the home honours each Jewish festival and the dietary laws. Residents confirmed that they were satisfied that the care received respected their religious beliefs. Most of the staff team are non-Jewish and they receive training in the Jewish culture and religion. Spanish & Portuguese Jews Home for the Aged Version 1.10 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 standard(s) 7,8,9,10 Residents’ needs are identified in care plans. The changing needs of residents are not recorded and monitoring is hampered by the lack of consistent evaluation of the plans and lack of regular reviews of the placements and care provided. The monitoring of health care checks for residents would be assisted by the completion of the record of appointments with health care professionals form on each individual case file. Residents are supported by staff to take their medication at the times directed and in the doses prescribed by their GP in order to promote their general health. Discreet and caring support is given to residents by staff so that the privacy and dignity of the resident is respected. EVIDENCE: Although each case file inspected contained a care plan the monthly evaluations of the care plans were not up to date. The last entries were made in either January or February 2005. Although there were manual handling care Spanish & Portuguese Jews Home for the Aged Version 1.10 Page 11 plans, 3 of the 4 files did not contain risk assessments. The deputy manager said that risk assessments, including the prevention of falls, were in the process of being prepared. Care plans had not been signed by residents, they were not given a copy of their care plan and regular reviews of the placement have not been undertaken. Although the deputy manager said that regular health checks were available to the residents e.g. appointments with the optician, dentist, chiropodist etc the forms on file for recording appointments with health care professionals had not been completed. One resident has a pressure sore and the home has pressure relief cushions, mattresses etc. Advice is sought from health care professionals when needed e.g. from the incontinence adviser. A record is kept of the weight of residents. Medication was stored securely. Records of the administration of medication were comprehensive and up to date. The home uses a blister pack for the administration of medication and they had been appropriately administered prior to the inspection. A resident said that the staff were very good and that the staff were happy people. Residents said that staff respected their dignity and need for privacy and that staff knock on the bedroom door when they wish to see the resident. During the inspection some of the residents were having a manicure and were choosing the colour of nail polish to be applied. Two of the residents said that they enjoyed having visits from the hairdresser and residents were smart in their appearance. Spanish & Portuguese Jews Home for the Aged Version 1.10 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 standard(s) 12,13,14, 15 Residents are able to take part in a programme of activities inside the home and in activities outside the home, including organised outings, which provide stimulation, interest and enjoyment. This is commendable and residents expressed their satisfaction with these. Residents said that they enjoyed the company of their visitors, who were made welcome by the staff when they visited the home. Residents described Edinburgh House as their home and said that they were able to exercise choice in their daily lives. Residents’ nutritional needs are met through the provision of a diet that is wholesome and varied and which is in accordance with religious and dietary laws. EVIDENCE: During the inspection the activities co-ordinator was on duty and she started the discussion group session taking place in the activities room. After this she said that she would be doing some activities in the Sunflower unit. Residents confirmed that they took part in exercise sessions and a resident said that these helped them to remain active. A physiotherapist was on duty during the inspection. She visits the home twice a week and there were exercise sheets Spanish & Portuguese Jews Home for the Aged Version 1.10 Page 13 on display in each lounge. Residents said that they had taken part in outings arranged by the home and had enjoyed them. The home has its own minibus. One resident was doing some knitting and said that the activities co-ordinator arranged lots of things for them to do. Another resident said that they took part in the flower arranging sessions and put the arrangements in their bedroom. They also enjoyed the painting sessions. A resident said that they were one of a number of residents who went to a day care service. Last year a number of residents had taken part in a holiday to the seaside and the deputy manager said that they hoped to organise another holiday in the summer. A resident said that their family visit them and that they talked to their relatives in their room. They confirmed that their visitors were made welcome by the staff on duty when they arrived at the home. Another resident said that visitors were welcome at any time and that there were no special hours for visits. A resident said that the home was the “best of the best” and that they did what they wanted. They described Edinburgh House as “my home”. They said that they were able to choose whether to take part in activities and sometimes they liked to sit with the cats. Another resident said that was very important to have animals in the home, cats in particular. Residents confirmed that they were able to spend time in their rooms during the day, if they wished. A resident said that they had a key to their bedroom door. A resident said that the food was lovely, that they enjoyed the meals and that they ate everything. They were pleased that fruit was available on a daily basis. Another resident said that the meals were adequate and that there was variety. One resident said that the home served good food and another that it was very good and that they liked the chicken soup with noodles. Although a resident said that the food is good, it was not seasoned enough. Spanish & Portuguese Jews Home for the Aged Version 1.10 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 standard(s) 16,18 A complaints procedure was in place and residents said that they were able to bring any concerns to the attention of the senior staff. Protection of vulnerable adults training for staff contributes towards the safety of residents. Familiarity with the interagency guidelines, produced by the local authority, is also a factor, which contributes towards the safety of residents, and staff must be aware of the book and of where it is kept. EVIDENCE: There is information on display in the home advising residents or relatives how a complaint can be raised. The complaints book was made available and complaints had been recorded. Complaints had been investigated and action taken, where appropriate. The complainant had been advised about the outcome of the investigation. Residents said that if they had any concerns or complaints they could talk to some one in the office. The deputy manager confirmed that staff have received training in respect of the protection of vulnerable adults and that there have been no allegations or incidents of abuse since the last announced inspection. When asked, she said that she was not sure whether the home had a copy of the local authority’s Interagency Guidelines for the Protection of Vulnerable Adults. Spanish & Portuguese Jews Home for the Aged Version 1.10 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 standard(s) 20,26 Residents are able to enjoy a number of comfortably furnished lounge areas and these meet the individual needs of residents. Residents live in a home where standards of cleanliness are high. EVIDENCE: There are lounges in the home that are dedicated to specific groups of residents i.e. the Sunflower lounge for residents with dementia and the Pink lounge for physically frail residents. Other lounge areas include informal seating areas in the conservatory and entrance hall where residents can sit together or sit alone, if they wish. The lounges are comfortably furnished and decorated and new chairs have been purchased. A resident said that there was a homely atmosphere in Edinburgh House. One resident said that they loved flowers and the gardens at Edinburgh House. The gardens are well kept and provide a pleasing view from the windows through all the seasons. Residents praised the overall cleanliness of the home. A resident said that the dining room was hovered after the meal and it was not left to the next day. The location of the laundry is away from where food is prepared or eaten. The Spanish & Portuguese Jews Home for the Aged Version 1.10 Page 16 appliances are commercial ones and the washing machines have sluicing cycles. A charge is made to the resident for dry cleaning, as this is not carried out in the home. A resident said that they were satisfied with the laundry service in the home. Spanish & Portuguese Jews Home for the Aged Version 1.10 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 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) 27,28 Residents are assisted by a staff team with sufficient numbers to meet their needs. Residents praised the caring manner of staff. Residents are assisted by a staff team who undertake vocational training that is competence based and which equips them to provide a service underpinned by a knowledge and understanding of the needs of the residents. EVIDENCE: Residents were complimentary about the staff in the home and one resident said that the people working in the home were charming and that they wanted to help the residents. Each of the 3 main lounges has a number of designated carers per shift and the lounges where residents with dementia and residents with high dependency needs are accommodated have increased staffing ratios. A resident confirmed that they had rung the call alarm bell in their room and that staff answered promptly, unless they were busy elsewhere. Team Leaders and senior managers support the carers and each day there is a named duty officer. Separate domestic and catering staff are employed in the home. The deputy manager confirmed that the programme of NVQ training is ongoing. She said that some staff have satisfactorily completed the level 2 training and that some staff are undertaking level 3 training. Spanish & Portuguese Jews Home for the Aged Version 1.10 Page 18 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) 33 Residents are able to give their views on the running of the home during meetings and during talks with senior staff and to see their ideas put into practice. EVIDENCE: A resident said that they attended the residents’ meetings that were held in the home. They confirmed that residents were able to put forward ideas and suggestions and that these were given a trial. However, the resident said that an idea that they had put forward was tried for one day and then discontinued because it was considered to be too time consuming. Residents were able to name senior staff and confirmed that they walked around the home and talked with residents. During the inspection residents came to the office if they had a question or wanted to discuss a private matter. Spanish & Portuguese Jews Home for the Aged Version 1.10 Page 19 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. Where there is no score against a standard it has not been looked at during this inspection. 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 x x 3 3 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 2 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION x 3 x x x x x 3 STAFFING Standard No Score 27 3 28 2 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 2 x x 3 x x x x x Spanish & Portuguese Jews Home for the Aged Version 1.10 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 OP7 Regulation 13.4 Requirement That a risk assessment, with particular attention to prevention of falls, is included in the care plan of each resident. (Previous timescale of 01 October 2003 not met). That residents receive a copy of their care plan. That the placement and plan of care is reviewed on a regular basis. That a record is kept on the case file of health care appointments. That the home has a copy of the local authoritys Interagency Guidelines for the Protection of Vulnerable Adults. (Previous timescale of 01 August 2004 not met). That 50 of care staff achieve an NVQ level 2 qualification. Timescale for action 01 September 2005 2. 3. 4. 5. OP7 OP7 OP8 OP18 15.2 14.2 13.1 13.6 01 October 2005 01 November 2005 01 September 2005 01 September 2005 6. OP28 18.1 31 December 2005 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. Spanish & Portuguese Jews Home for the Aged Version 1.10 Page 21 No. 1. 2. Refer to Standard OP7 OP7 Good Practice Recommendations That care plans are evaluated by the staff on a monthly basis. That where possible, residents sign their care plans. Spanish & Portuguese Jews Home for the Aged Version 1.10 Page 22 Commission for Social Care Inspection 4th Floor Aspect Gate 166 College Road Harrow HA1 1BH 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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