Inspection on 28/11/06 for Spanish & Portuguese Jews Home For The Aged

This inspection was carried out on 28th November 2006.

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... 07/11/05

Spanish & Portuguese Jews Home... 20/04/05

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

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

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 Spanish & Portuguese Jews Home For The Aged Edinburgh House 36-44 Forty Avenue Wembley Middlesex HA9 8JP Lead Inspector Julie Schofield Key Unannounced Inspection 09:35 28th November, 6 and 7th December 2006 th 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 Spanish & Portuguese Jews Home For The Aged DS0000017448.V319470.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. Spanish & Portuguese Jews Home For The Aged DS0000017448.V319470.R01.S.doc Version 5.2 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 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) Spanish & Portuguese Jews Home for the Aged Ms Christine Gilmore Care Home 51 Category(ies) of Dementia - over 65 years of age (10), Old age, registration, with number not falling within any other category (41) of places Spanish & Portuguese Jews Home For The Aged DS0000017448.V319470.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 7th November 2005 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 DS0000017448.V319470.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over 3 days. The first day in the home consisted of 2 visits. These were from 9.35 am to 12.35 pm and from 1.45 pm to 4.10 pm. On the second day, the 6th December, the inspection consisted of 2 visits. These were from 8.45 am to 12.40 pm and from 2 pm to 3.30 pm. The visit that took place on the 7th December was from 1.55 pm to 4.45 pm. The Inspector would like to thank the manager, the members of staff and the residents who took part in the inspection. Whilst in the home records, files and documents were examined, discussions took place with the manager, staff and individual residents, a tour of the premises was conducted, care practices were observed and the Inspector joined the residents’ discussion group. As part of this unannounced inspection the quality of information given to people about the care home was looked at. People who use services were also spoken to, to see if they could understand this information and how it helped them to make choices. The information included the service user’s guide (sometimes called a brochure or prospectus), statement of terms and conditions (also known as contracts of care) and the complaints procedure. These findings will be used as part of a wider study that CSCI are carrying out about the information that people get about care homes for older people. This report will be published in May 2007. Further information on this can be found on our website www.csci.org.uk. Information regarding the fees charged may be obtained, on request, from the manager of the home. They are also included in the brochure, a copy of which is sent to every person enquiring about a vacancy in the home. What the service does well: Residents spoke well of the service provided in the home and agreed that the standard of care was high. A resident said that staff were genuine and always around. They said that the staff know what everyone requires. They were satisfied with the carers, describing them as “good”. A resident said that she couldn’t have made a better choice and that coming to Edinburgh House was “like coming home, a joy and relief”. Another resident also said that it had been a wise move and that they couldn’t think of a better place to be in than Edinburgh House. A resident described Edinburgh House as “marvellous”. Spanish & Portuguese Jews Home For The Aged DS0000017448.V319470.R01.S.doc Version 5.2 Page 6 The activities offered by the home drew praise from the residents. The coordinator was named by residents and described as a “good liaison officer”. They appreciated regular activities at regular times and the programme of outings was popular. There are opportunities for residents to attend a fellowship club, which takes place outside of Edinburgh House. Residents were pleased that their religious needs were met and that dietary laws were respected. There was a “busy atmosphere” in the home with residents taking an active part in their surroundings. Residents retained a sense of purpose. There was a good rapport between residents and staff and the manager continues to put into practice opportunities for residents and staff to work together in an enjoyable and fun way. What has improved since the last inspection? What they could do better: An immediate Requirements form was issued during the inspection in respect of unsafe recruitment practices. An enhanced CRB disclosure was on file that had been obtained by a previous employer. (A previous inspection had already identified the need for disclosures to be obtained naming Edinburgh House as the employer). Two files lacked 2 satisfactory references each. One file lacked any proof of identity. The home needs to ensure that the care plan and placement are reviewed on a six monthly basis. The monthly progress reviews need to be undertaken, and recorded, on a consistent basis. Decisions regarding the use of cot sides, which restrict the movement of a resident, need to include the involvement of Spanish & Portuguese Jews Home For The Aged DS0000017448.V319470.R01.S.doc Version 5.2 Page 7 the local authority, if they are funding the placement. Medication records need to be up to date and complete. The complaints procedure needs to include up to date details of the current regulatory authority for the home. The record of a complaint must include the date on which the outcome of the investigation is communicated to the complainant. The home needs to meet the target of 50 of carers achieving an NVQ level 2 or 3 qualification. There must be a staff file for each member of staff. The overdue annual quality assurance survey needs to be carried out and must include feedback from residents, relatives, professional visitors to the home and representatives from the placing authorities. Residents’ meetings need to be held on a monthly basis. The overdue testing of the portable electrical appliances needs to be carried out. 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. The summary of this inspection report can be made available in other formats on request. Spanish & Portuguese Jews Home For The Aged DS0000017448.V319470.R01.S.doc Version 5.2 Page 8 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 Spanish & Portuguese Jews Home For The Aged DS0000017448.V319470.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4 Quality in this outcome area is good. Information provided by the home helps residents, and their relatives or friends, to decide whether the service can meet the needs of the resident. Providing a statement of terms and conditions, or contract, clarifies what the resident is entitled to expect from the service. Carrying out an assessment of the resident, prior to admission, ensures that the needs of the resident are identified and that the home is able to determine whether these can be met. Specialist care offered by the home is underpinned by training for the staff team. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Spanish & Portuguese Jews Home For The Aged DS0000017448.V319470.R01.S.doc Version 5.2 Page 10 The statement of purpose and service users’ guides were available for inspection. The brochure, a folder containing several inserts, included a copy of the service user guide. The manager said that a brochure is sent to all people making enquiries about vacancies. The brochure also includes a copy of the complaints procedure and a leaflet containing useful information about the home. Information is included in respect of contacting the regulatory authority. Six residents were asked whether they had received a copy of the service user guide (contained in the brochure). Three of the 6 residents had been admitted to the home within the last 12 months. Only 1 of the residents remembered receiving a copy of the brochure and said that it was comprehensive and helpful. Two residents said that they did not need a brochure as they knew Edinburgh House before an application was made for admission. The finance department notifies all persons responsible for the payment of the fees regarding changes to the cost of care for the residents. Copies of letters sent in respect of the 6 residents who commented on the brochure were available. Each of the 6 residents confirmed that a relative or friend acted on their behalf in respect of financial matters and 2 residents said that this gave them peace of mind. The residents were unaware of any changes to the fees charged. Although there were contracts for the residents that were privately funded and a spot contract between the home and the placing authority, where a local authority funded the placement, none of the 6 residents remembered signing a contract. Most residents indicated that a relative or friend would have dealt with this on their behalf. Much of the information that would be included in a statement of term and conditions is included in the “Information for New Residents” leaflet that is included in the brochure. The remaining information is included in other parts of the brochure. Six files were selected as part of case tracking. Three files belonged to residents that had recently been admitted to the home. Each of these files contained a prospective resident’s assessment portfolio, which a member of staff begins to complete prior to the resident’s admission to the home. A local authority funded one of these 3 residents and a copy of the overview assessment from the local authority was received, prior to the resident’s admission. The assessment portfolio includes information regarding the resident’s health, mobility, ability to self care, prescribed medication, social contact, hobbies, likes and dislikes, continence and behaviour. Each of the 6 residents confirmed that they had been “interviewed” by the deputy manager. A resident whose placement was funded by a local authority said that someone from the social services department had also spoken to them about their need for residential care. The home provides a service for Jewish residents and the home honours each Jewish festival. Meals prepared and served in the home are in accordance with Jewish dietary laws. Most of the staff team are non-Jewish and they receive Spanish & Portuguese Jews Home For The Aged DS0000017448.V319470.R01.S.doc Version 5.2 Page 11 training in the Jewish culture and religion. This specialist training begins during their induction and includes sessions given by an executive member of the committee overseeing the home. Training is then provided on an ongoing basis and a member of the committee gave a talk in November 2006 in respect of death and dying, from a Jewish perspective. There was a record that before Passover a committee member had spoken to staff about religious observances. Within the home there is a dementia care unit and all staff working on this unit have undertaken dementia care training. The home does not provide an intermediate care service. Spanish & Portuguese Jews Home For The Aged DS0000017448.V319470.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10, 11 Overall quality in this outcome area is adequate. Assessing the needs of a resident and identifying these in a care plan enables the resident to receive a service tailored to meet their needs. However responding to changing needs is hampered by the lack of consistent evaluation of the plans and lack of regular reviews of the placements and care provided. The health and well being of residents is promoted through regular health care checks and appointments but decisions taken that limit the movement of residents need to involve all relevant parties. Residents are supported in taking their medication, as prescribed by their GP, in order to maintain their general health and records need to be complete and up to date. Discreet and caring support is given to residents by staff so that the privacy and dignity of the resident is respected. This respect extends to the care given to residents before and after death. This judgement has been made using available evidence including a visit to this service. Spanish & Portuguese Jews Home For The Aged DS0000017448.V319470.R01.S.doc Version 5.2 Page 13 EVIDENCE: Six case files were examined and each contained a care plan assessment, a summary of the resident’s care needs, a manual handling care plan and a risk assessment in respect of falls. Monthly progress reviews of the care plan had not been completed on a regular basis and the most recent progress review for 2 residents had taken place in October while for the other 4 residents the forms were dated August 2006. None of the residents had had a comprehensive review of their care plan and placement within the last 6 months, convened either by the home or by the placing authority. One of the residents in the home has become bed bound has a pressure sore and is receiving care from the district nurse. Pressure mattresses are also provided for residents who are at risk of developing pressure sores. Cot sides are used when the resident is in danger of falling out of bed and although risk assessments undertaken involve the resident and their relatives they lack the involvement of a representative from the funding authority, where the resident is not privately funding the placement. It was noted that one of the case files examined related to a resident where there were concerns about the resident being reluctant to eat. Although residents’ weights are monitored on a monthly basis it had been noted in the monthly review notes that the resident was losing weight. It is recommended that a more regular monitoring be undertaken i.e. weekly. The home encourages residents to maintain their optimum level of mobility and residents confirmed that exercise sessions took place in the home. During the inspection it was noted that dancing to music took place in the large lounge. The monthly progress review forms included a list of health care appointments that had taken place. Appointments included visits by the dentist, optician, chiropodist, community nurse, GP and district nurse. Residents had the opportunity to have a flu vaccine, if they wished. Residents also had access to out patient appointments at local hospitals. The storage of medication was inspected and was satisfactory, this included facilities for controlled drugs. The home uses the blister pack system for administering medication. Although most packs were from Sunday to Saturday one was from Tuesday to Monday and this had resulted in blisters being “popped” out of sequence. All other blisters (including those for controlled drugs) had been appropriately opened, according to the day of the inspection and the time of day when the packs were examined. However, when the records were inspected it was noted that initials were missing from 9 of the boxes on record sheets over the period 3/12 to 5/12. This was brought to the attention of the manager during the inspection. Records for the administration of controlled drugs were up to date and complete. All staff administering medication have received training. Each resident has their own single bedroom and some rooms have an ensuite toilet. A resident that had an ensuite bedroom confirmed that they Spanish & Portuguese Jews Home For The Aged DS0000017448.V319470.R01.S.doc Version 5.2 Page 14 appreciated the additional privacy that this gave. Residents confirmed that if they needed assistance with bathing etc their privacy and dignity were respected. It was noted during the inspection that if a member of staff wished to speak to a resident that was in their room, the member of staff knocked on the bedroom door and waited to be invited in before entering. It was noted when examining residents’ case files that during the admission process the wishes of the resident regarding funeral arrangements are recorded. If the resident is unable to express their wishes, this information is obtained from the relatives. A resident passed away on the day before the inspection and the manager said that the resident had been discharged from the hospital to enable the resident to die in the home, surrounded by their family. The home supported the family through this process and enabled the religious observances to be carried out. Appropriate pain relief has been sought for terminally ill residents. There are policies and procedures in place in respect of death and dying and the Jewish faith is respected in these. Staff have received training in respecting religious and cultural beliefs during the process of dying and death. Spanish & Portuguese Jews Home For The Aged DS0000017448.V319470.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 Quality in this outcome area is good. A comprehensive programme of activities, both inside and outside the home provide residents with opportunities for stimulation 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 praised the atmosphere in Edinburgh House 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. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Spanish & Portuguese Jews Home For The Aged DS0000017448.V319470.R01.S.doc Version 5.2 Page 16 The home has an activities co-ordinator and a dedicated area that is partitioned off in the large lounge, where activities can be held. The area is left set out for activities (cards, board games etc) when not being used for a session so that residents can come and use this area throughout the day. A resident said that she liked to sit there in the evenings. Organised activities include bingo, card games, flower arranging, discussion groups, videos, games etc. It was observed that other members of staff do sewing, knitting or crafts with the residents. There are also keep fit sessions each week. When the weather is fine the home makes use of its transport to arrange outings and residents said that they had visited Henley, Buckingham Palace and Hampton Court. Residents said that some of the outings arranged were suitable for certain lounges, according to the dependency levels of the residents. In the summer the home also arranged a holiday to Bournemouth. On the first week some of the less able residents took part. On the second week some of the more able residents took part. A resident who went on the holiday said that it was very enjoyable. Another resident said that living in the home was like “one long holiday” and that they liked having things to do each day. During the inspection it was noted that residents were able to receive visitors, who were made welcome on their arrival at the home. Residents confirmed that they were able to entertain their visitors either in their room or in the communal areas. A resident said that even their grandchildren were made welcome when they visited the home and that visitors were like part of a community in the home. While visitors are welcome they are asked to respect the privacy of residents at mealtimes and not enter the dining room. Certain religious festivals are times for quiet reflection and visitors are asked to respect this. Information about visiting is contained in the brochure. Residents said that they were able to do as they wanted and one resident said that he was able to go out and do his own shopping. They treated Edinburgh House as their own home and said that they were able to choose whether to take part in activities or whether to spend time quietly on their own. Residents confirmed that they were able to spend time in their rooms during the day, if they wished. It was observed that certain residents locked their bedroom door when leaving their room. Some residents have brought personal possessions with them to make their room “homely” and one resident has installed a desk and bookshelves unit since admission. Residents said that the food was very good although one resident said that it was a little bland for their taste. They agreed that the Jewish dietary laws were respected. They had praise for the cook and for the varied menus. The home offered a vegetarian alternative to the main meal and catered for diabetic residents. The residents in Sunflower lounge and the high dependency lounge have their own dining area on the individual units while all other residents use the main dining room. Spanish & Portuguese Jews Home For The Aged DS0000017448.V319470.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is adequate. A complaints procedure was in place and residents said that they were able to bring any concerns to the attention of the senior staff. However some of the information in the procedure needs updating. Protection of vulnerable adults training for staff and familiarity with the home’s procedure and the interagency guidelines contribute towards the safety of residents. However, recruitment practices need to protect the safety and welfare of residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A complaints procedure is in place in the home. A copy of the procedure is included in the brochure. The procedure includes information about the stages and timescales for the process. Information regarding the regulatory authority for the home was out of date. The complaints book was inspected and 7 complaints have been recorded since the last inspection. It was noted that not every record included the date on which the outcome of the investigation had been communicated to the complainant. Residents said that if they had a complaint they would speak to someone in the office and that it would be listened to and acted upon. Spanish & Portuguese Jews Home For The Aged DS0000017448.V319470.R01.S.doc Version 5.2 Page 18 There is an adult protection procedure in place and the manager said that 1 allegation of abuse has been investigated since the last inspection. A referral was made to the pova list. Staff receive training in the protection of vulnerable adults procedures and were aware of their responsibility under the whistle blowing procedure. Recruitment practices did not promote and protect the welfare of service users (see Standard 29). Spanish & Portuguese Jews Home For The Aged DS0000017448.V319470.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 26 Quality in this outcome area is good. Residents live in a home, which is decorated and maintained to a good standard. 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. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The location of the home is on a main road in Wembley and is close to a synagogue. It is conveniently sited for bus routes, underground stations and shops. The building is well maintained. It is comfortably furnished and Spanish & Portuguese Jews Home For The Aged DS0000017448.V319470.R01.S.doc Version 5.2 Page 20 decorated. A programme of redecoration/refurbishment/replacement is in place, as necessary. Residents benefit from access to 2 garden areas, which are well designed and maintained to a high standard. Residents said that they were pleased with the building and how it is set out and maintained. Residents were satisfied with their private accommodation. Since the last inspection a review of the communal areas available in the home has taken place. This was carried out taking into account the dependency levels of current residents. The open plan lounge and dining room, which is used by dementia care residents (Sunflower Lounge), remains how it was. The facilities for the high dependency, physically frail residents (Second Floor Lounge) have been increased. A room on the second floor has been converted into a dining room and on the first inspection day the room was being made ready for use that evening. A room on the ground floor, which had been used for training, has been converted into a lounge for more able residents (the New Lounge). The large lounge on the ground floor has a reduced number of residents using this and the additional space created has been partitioned off and is used by the activities co-ordinator. This area is set out for activities and can be used at any time of the day. There is a large conservatory and reception area, which has 2 main seating areas that are also used by residents. All areas are comfortably furnished and decorated. Residents confirmed that they were able to move around the communal areas and those using the New Lounge confirmed that they enjoyed this facility. In the summer there are garden areas in which residents can relax and enjoy outdoor living. A discussion took place with the manager regarding religious activities and festivals. Services and celebrations can be held in the dining room. Residents and their relatives can continue the services and observances in the units. A tour of the premises took place and it was noted that all areas were clean and tidy and free from offensive odours. Residents said that the home is cleaned every morning and is kept spotless. The manager confirmed that staff have received infection control training. The laundry is situated near the entrance hall and is away from where food is stored, prepared or consumed. The room contains 3 commercial washing machines that have a sluicing cycle and 3 commercial tumble driers. Although clothing is named there was a complaint from a relative that the resident was missing some of their clothing and had some clothing belonging to other residents in their room. Another resident praised the “excellent laundry service”. Spanish & Portuguese Jews Home For The Aged DS0000017448.V319470.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Overall quality in this outcome area is adequate. Staffing levels were sufficient to meet the needs of residents. The home continues to support staff undertaking NVQ training, as residents benefit from staff that have developed their understanding and awareness of the needs of the client groups. However progress towards meeting a target of 50 of carers trained to NVQ standards remains slow. Recruitment practices fail to protect the safety and welfare of residents. A comprehensive programme of training for staff encourages good working practices. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Rotas now reflect the 5 units in the home and each has a dedicated group of staff. Residents were pleased that this offered continuity. There are between 2 and 3 carers on duty in each unit on the morning/early afternoon shift and between 2 and 3 carers on duty in each unit on the late afternoon/early evening shift. At night there are 3 carers and a senior on duty. Residents said that it would be helpful if all staff wore name badges so that they could speak to them and use their name. One resident said that after being greeted by Spanish & Portuguese Jews Home For The Aged DS0000017448.V319470.R01.S.doc Version 5.2 Page 22 name she felt uncomfortable that she could not do the same to all members of staff. In addition to care staff there are domestic staff and catering staff working in the home. A statutory requirement was identified during 2 previous inspections that 50 of care staff achieve an NVQ level 2 qualification within a specified timescale. The manager said that progress in terms of staff completing their NVQ level 2 or 3 training is “going slowly”. So far 3 staff have completed NVQ level 2 training. Five staff are currently undertaking level 3 training and 7 staff are currently undertaking level 2 training. Even when these staff complete their training the home will not achieve the target of 50 of carers being trained to NVQ level 2 or 3 standard. Therefore this requirement remains outstanding. A statutory requirement was identified in previous inspections that each staff file contains an enhanced CRB disclosure. The disclosure must name Edinburgh House as the employer. Five staff files were selected for inspection. The manager was unable to locate the files of 2 members of staff that had been recruited from abroad by an employment agency. Of the 3 files inspected, 1 member of staff was working without 2 references having been obtained. Another member of staff had an enhanced CRB disclosure, which had been obtained by their previous employer, no references and no proof of identity. An immediate requirements form was issued during the inspection for the manager to obtain the necessary references and checks and to put systems in place to ensure the safety of residents until these had been received. Within the staff team there are a number of staff for which English is not their first language. Fourteen staff are currently undertaking a 6-week training course in “English as a Second Language”. Staff confirmed that they had undertaken training in safe working practices and had undertaken courses tailored to meet the needs of residents. Staff working on the dementia care unit confirmed that they had received dementia care training. Spanish & Portuguese Jews Home For The Aged DS0000017448.V319470.R01.S.doc Version 5.2 Page 23 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 38 Overall quality in this outcome area is good. By continuing her personal development, through further training, the manager is promoting the efficient and effective running of the home. Staff, residents and relatives have worked together in building a team spirit and creating an inclusive atmosphere in the home. Feedback from residents and relatives needs to be supplemented by an annual quality assurance survey so that the future development of the service is based on the views of the consumers (or persons acting on their behalf). Support is given to residents who need assistance in managing their finances so that residents’ financial interests are protected. Training for staff in safe working practice topics promotes the health and safety of residents, staff and visitors to the home. However not all equipment in the home has been tested to demonstrate that it continues to be safe to use. This judgement has been made using available evidence including a visit to this service. Spanish & Portuguese Jews Home For The Aged DS0000017448.V319470.R01.S.doc Version 5.2 Page 24 EVIDENCE: The manager has completed the RMA. She was appointed to the post of manager of the home prior to the Commission for Social Care Inspection and prior to its predecessor, the National Care Standards Commission. Since the last inspection she has undertaken team management training and completed a refresher course in protection of vulnerable adults procedures. Certificates on display in the manager’s office include dementia care training, risk assessment training, managing and working safely and an NVQ internal verifiers award. The manager has continued to encourage a sense of loyalty and responsibility within the staff team. Activities benefiting residents are used as an opportunity for staff working on each unit (with the involvement of the relatives of residents) to take part in a competition where prizes are awarded. Currently ponchos are being knitted or crocheted for residents to wear. These will be modelled at a forthcoming “fashion show” to be held in the home. After the recent review of communal lounges the concept of dedicated staff for each unit has been extended from the Sunflower lounge and the high dependency lounge to all units in the home. The book containing the minutes of residents’ meetings was available. The last minutes related to a meeting held in April although the manager said that a meeting had taken place after this to discuss the new units with the residents. The manager said that the residents are being asked for suggestions for a name for the “new lounge.” Residents said that they could put forward ideas and suggestions, if they wished, although not all were acted upon. Quality assurance surveys have been undertaken and response rates have been good. However a survey has not been completed in 2006. Relatives do have the opportunity to raise questions or to make comments at the annual court (an annual general meeting). Residents meetings are held but not on a monthly basis. The minutes of the latest meeting were not on file. There are systems within the home for obtaining feedback from residents, including speaking directly to the manager or senior staff or by raising points during the discussion group, which are then relayed to the manager. It was observed during the inspection that the manager and senior staff have an “open door” policy, which applies to residents and their relatives. Committee members visit the home, including on an unannounced basis, and feedback their comments to the home during committee meetings attended by the manager of the home. Spanish & Portuguese Jews Home For The Aged DS0000017448.V319470.R01.S.doc Version 5.2 Page 25 The home assists 5 residents with their financial affairs. No one in the company acts as an appointee. All other residents receive assistance from a relative or friend. Records of money received, purchases made, balances etc were available for inspection. These were up to date and complete. Where residents receive their personal allowance on a weekly basis it was noted that the resident signed to acknowledge receipt. Records are kept of small amounts of money deposited by a relative for the use of the resident. These were up to date and complete. Staff confirmed that they had received training in safe working practice topics e.g. first aid, manual handling, health and safety, infection control and fire safety. Certificates were available to demonstrate the regular checking and servicing of the hoists, treating the water tanks, the Landlord’s Gas Safety Record, the fire alarm system, the lifts, the electrical installation, the fire extinguishers, the call alarm system and the assisted baths. The testing of the portable electrical appliances was overdue. The testing of the fire alarms and the carrying out of fire drills was recorded and was up to date. Spanish & Portuguese Jews Home For The Aged DS0000017448.V319470.R01.S.doc Version 5.2 Page 26 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 3 3 3 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 2 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 2 3 3 X X X X X 3 STAFFING Standard No Score 27 3 28 1 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 2 X 3 X X 2 Spanish & Portuguese Jews Home For The Aged DS0000017448.V319470.R01.S.doc Version 5.2 Page 27 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 OP7 Regulation 15.2 Requirement That a comprehensive review of the care plan and placement takes place every 6 months and is convened either by the home or by the placing authority. That the resident, and their representative, is invited to attend. That the monthly progress reviews of the care plans are carried out and recorded on a consistent basis. That when a local authority is funding the placement of a resident they are involved in the decision regarding the use of cot sides, where a risk assessment has identified a need. That all records of the administration of medication are up to date and complete. That information in the complaints procedure about the regulatory authority for the home is up to date. That complaints records include the date on which the outcome of the investigation is made known to the complainant. DS0000017448.V319470.R01.S.doc Timescale for action 01/04/07 2 OP7 15.2 01/02/07 3 OP8 12.1 01/02/07 4 5 OP9 OP16 13.2 22.7 01/01/07 01/02/07 6 OP16 22.4 01/02/07 Spanish & Portuguese Jews Home For The Aged Version 5.2 Page 28 7 OP28 18.1 That 50 of care staff achieve an NVQ level 2 qualification. (Previous timescale of 31st December 2005 and 1st November 2006 not met). That there is a staff file for each member of staff, including those recruited abroad by an employment agency. That each staff file contains an enhanced CRB disclosure naming Edinburgh House as the employer. (Previous timescale of 1st July 2006 not met). That each staff file contains 2 satisfactory references, proof of identity and evidence of right to work, if required. That an annual quality assurance survey is undertaken, which includes comments from residents, their relatives, professional visitors to the home and members of the placing authorities. That residents’ meetings, involving all residents wishing to take part, are held on a monthly basis. That the testing of the portable electrical appliances takes place. 31/12/07 8 OP29 19.1 01/02/07 9 OP29 19.1 01/02/07 10 OP29 19.1 01/02/07 11 OP33 24.1 and 24.3 01/04/07 12 OP33 24.1 and 24.3 13.4 01/02/07 13 OP38 01/02/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP1 Good Practice Recommendations That a copy of the brochure is placed in the bedroom when a resident is admitted to the home. DS0000017448.V319470.R01.S.doc Version 5.2 Page 29 Spanish & Portuguese Jews Home For The Aged 2 OP8 3 OP9 4 OP26 5 OP27 That if there are concerns that a resident is reluctant to eat and is losing weight their weight is monitored on a weekly rather than on a monthly basis. That all blister packs begin on the same day of the week i.e. Sunday and end on the same day of the week i.e. Saturday. That when items of laundry are placed in a resident’s room the name is checked to ensure that the resident receives the correct items. That all members of staff wear a name badge. Spanish & Portuguese Jews Home For The Aged DS0000017448.V319470.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection Harrow Area office Fourth Floor Aspect Gate 166 College Road Harrow HA1 1BH National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Spanish & Portuguese Jews Home For The Aged DS0000017448.V319470.R01.S.doc Version 5.2 Page 31 - 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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