Inspection on 09/06/08 for The Jacob Centre

This inspection was carried out on 9th June 2008.

CSCI found this care home to be providing an Good service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

The Jacob Centre 21/06/06

The Jacob Centre 09/11/05

The Jacob Centre 16/05/05

The Jacob Centre 26/01/05

The Jacob Centre 08/09/04

Similar services:

Claremont House

Sun Court Nursing Home

Bramley Avenue (73)

15 Bramble Close

Dolphin Court

Fen Road

Wakes Hall

165 Putnoe Lane

Extracts from inspection reports are licensed from CQC, this page was updated on 28/09/2008.

CARE HOME ADULTS 18-65 The Jacob Centre High Wych Road Sawbridgeworth Herts CM21 0HH Lead Inspector Jane Greaves Unannounced Inspection 9th June 2008 09:40 The Jacob Centre DS0000060010.V366022.R01.S.doc Version 5.2 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 The Jacob Centre DS0000060010.V366022.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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Jacob Centre DS0000060010.V366022.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Jacob Centre Address High Wych Road Sawbridgeworth Herts CM21 0HH 01279 600201 01279 603866 rita.mccarthy@ramsayhealth.co.uk 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) Ramsay Health Care UK Operations Limited Rita McCarthy Care Home 60 Category(ies) of Physical disability (60), Physical disability over registration, with number 65 years of age (60), Terminally ill (60), of places Terminally ill over 65 years of age (60) The Jacob Centre DS0000060010.V366022.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st June 2006 Brief Description of the Service: The Jacob Centre is a care home with nursing, providing accommodation and care for sixty adults with a physical disability or terminal illness. Specialist services are provided for people who have survived a traumatic brain injury or spinal injury, including tracheotomy care and respiratory ventilator support, and for people with complex neurological conditions. It is owned by Ramsey Healthcare Ltd. The home was opened in April 2004 and consists of a two-storey purpose built building. It is situated in a complex of services that includes a private hospital, The Rivers, and another home, The Gardens. The service is divided into 2 units each with it’s own manager and staff group. The home is located in a rural setting on the outskirts of Sawbridgeworth, not far from the outskirts of Harlow. There is a shop in the home, and a pub that also serves food across the road from the complex. Other community amenities, including shops, banks, cafes and leisure facilities, can only be accessed by use of the homes transport. All the bedrooms are single with en-suite facilities. There is a passenger lift. The home has a patio garden accessed from the ground floor dining room and decking areas outside the ground floor lounges. The home is fully accessible for people living there. The Statement of Purpose and Service Users Guide provide information about the home for referring professionals and prospective clients. The current charges range from £985 to £4000 per week as at 9th June 2008. The Jacob Centre DS0000060010.V366022.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes This was an unannounced ‘key’ inspection site visit. At this visit we considered how well the service meets the needs of the people living at the Jacobs centre and how the staff team and management work to provide good outcomes for people. The level of compliance with requirements made at the previous inspection visit was assessed. The site visit took place over a period of 6 hours with a further visit of 1½ hours two days later to feedback our findings to the manager. A tour of the premises was undertaken, care records, staff records, medication records and other documentation were selected and various elements of these assessed. Time was spent observing and interacting with people living at the home, and talking to visitors, management and staff. Prior to the site visit the manager had completed and sent in to the commission the Annual Quality Assurance Assessment (AQAA) of the service. This outlined how the service feels they are performing against the National Minimum Standards, and how they can evidence this. Before this site visit a selection of surveys with addressed return envelopes had been sent to the home for distribution to residents, relatives, involved healthcare professionals and staff. The views expressed at the site visit and in survey responses have been incorporated into this report. Although registered with the Commission for Social Care Inspection as a care home there is a lot of medical input due to the specific needs of the people living at the home. The manager, and other members of the staff team assisted us at the site visit. Feedback on findings was provided to the manager at the inspection and subsequent to the visit, opportunity for discussion or clarification was given. We would like to thank the manager, the staff team, residents and their relatives for their help throughout the inspection process. The Jacob Centre DS0000060010.V366022.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: There are discrepancies between the survey responses received by the commission prior to this visit and Jacobs Centre customer satisfaction surveys. This is specifically in areas of satisfaction with the quality of food and how complaints are dealt with by the home. The management ethos is open and transparent but more work needs to be done to ensure that people’s views are heard and understood. The service needs to continue the work in progress to streamline some documentation including care plans and risk assessments so that they are ‘user friendly’ and give the staff the clear detail they need to provide care and support as safely as possible for the people living at the home. The Jacob Centre DS0000060010.V366022.R01.S.doc Version 5.2 Page 7 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. The Jacob Centre DS0000060010.V366022.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Jacob Centre DS0000060010.V366022.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 3 and 4. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People wanting to move into the Jacobs Centre can be assured that their needs would be met, based on a thorough assessment. EVIDENCE: The service has a Statement of Purpose and Service User Guide to help people considering using the service decide if the Jacobs Centre is right for them. These documents are in the process of being reviewed so that they accurately reflect the facilities provided and the change in provider organisation. The service has developed the web site to include some 360-degree photographs of the centre to help those people that are unable to visit to get a clearer idea of what it is like. One person said via a survey ‘I was told that this was the best place and then I came here’. We looked at 3 care plans to determine how the service makes sure that peoples’ needs can be met at the Jacobs Centre. Experienced qualified practitioners such as nurses, physiotherapists and a consultant in Neuro Rehab make these assessments by gathering information from all parties involved, visiting the prospective resident and assessing them in person before they move into the home. This ensures the staff teams are prepared for the persons’ admission and any specific training is provided, for example relative to a new piece of equipment or training and guidance to meet specific complex The Jacob Centre DS0000060010.V366022.R01.S.doc Version 5.2 Page 10 needs. Staffing levels are reviewed before each admission and adjusted as necessary to ensure there are enough staff members on duty at each shift to meet peoples’ needs. The service encourages trial stays and gradual introduction to the service, for example staying for a few days or a week or two before moving in for a longerterm placement. This enables residents and their relatives to adapt gradually to the change. The manager reported in the AQAA that ‘further to conversations with residents and relatives about their experience on their first day in the service, we are now rostering one staff member to be supernumerary for the full shift to enhance the settling in and getting to know you processes’. This shows that the service listens to what people need and makes sure that the people using the service are the focus of what they do. The Jacob Centre DS0000060010.V366022.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at the Jacobs Centre receive appropriate support to make choices and make decisions affecting their lives. EVIDENCE: The service has been working with residents and their families to develop a new information booklet ’ all about me’. This provides a pen picture of the person including historical information about the person and their individual needs, choices and aspirations. A manager reported how they were piloting the person centred care plan and agreed that there is a strong clinical overtone in the existing model, this is due to the very complex physical needs of the people living at the Jacobs Centre. 4 care plans looked at included areas such as personal care, cleaning and dressing, how showering is to be done, shaving, what hair cuts people want, nail care, how the person wants their teeth to be cleaned and if they have the ability to choose their own clothes. The Jacob Centre DS0000060010.V366022.R01.S.doc Version 5.2 Page 12 In the section about eating and drinking there is detail about how much supervision is needed, if the person is able to make choices about food and how those choices can be provided and what snacks individuals prefer. The section about sleeping includes individuals’ usual pattern and how the person likes to be positioned, if the room needs to be darkened and hot/cold. The section about communication includes some information about how individuals’ are supported to communicate however each staff member spoken with had good knowledge about how to communicate with people with very few communication skills, detail of this is not always recorded. There is a section of the care plan titled working and playing: This includes very little detail and there was no link made with activity records, these are maintained separately from the care plans. Evidence in the care plans and discussion with managers confirm that care management reviews are held at 12 weeks after admission involving Occupational Therapists, Physiotherapists, Speech and Language therapists as well as managers and family members. Thereafter management reviews take place annually unless there are any concerns about individuals’ healthcare. Care plans contain risk assessments for varied aspects of life experienced by people living at the Jacobs Centre including such things as having bedroom doors locked and minibus travel. There is little detail about how staff could support people to overcome or reduce the risks. Staff members were able to describe what actions are taken to minimize risks for people however this is not always documented in the care plans. A manager showed us a new format of care planning that is being piloted that has risk assessment at the core of each section of the care plan. This is to ensure that each aspect of peoples’ daily lives is assessed to reduce the level of risk to peoples’ safety and welfare. The Jacob Centre DS0000060010.V366022.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at Jacobs Centre enjoy appropriate and fulfilling lifestyles in and outside the home. EVIDENCE: Evidence from the manager’s AQAA, observation on the day of this visit and discussion with relatives confirmed that people living at the Jacobs Centre have access to varied forms of entertainment, leisure activities, outings and general stimulation. One relative said, “Social events are fairly frequent with most bank holidays Halloween etc and most stimulating”. People are encouraged to join in as many activities as possible. Examples include shopping, theatre visits, cinema, football matches, visiting places of interest, sailing, canal boating, carriage driving, etc - all of these activities are The Jacob Centre DS0000060010.V366022.R01.S.doc Version 5.2 Page 14 equally available for those who are ambulant and those who are wheelchair users. The service involves people living at the home and their relatives in gardening, there are garden tools that enable wheelchair users to plant and maintain the ground level beds as well as the raised beds. The service has two adapted mini-buses and full time activity co-ordinators for both internal and external activities. All people living at Jacobs Centre, including those with profound disabilities, are assisted to spend time in communal areas, gardens and the community wherever possible. Where they are able to do so, people are encouraged to help with day-to-day chores such as cleaning their room and setting tables for meals. One person had a role assisting the business office team, which they thoroughly enjoyed, and said felt occupied and valued. The service actively encourages people wishing to study and also support people to regain the physical and cognitive functioning they need to pursue or resume their occupation. People are supported and encouraged to use computers, access the internet, correspond electronically, and all rooms have broadband available. Some people have their own computers; those that dont are able to use one provided by the centre, which includes adaptations that help overcome the hurdles presented by some disabilities. Residents and their relatives are able to use the sensory room, which can contribute to stimulation and/or relaxation and there is aromatherapy massage available in house. The service meets peoples’ spiritual needs in a range of ways. For example, observance of religious beliefs through menu choices, privacy, timing of care provision, arranging visitors from various religious communities and/or attending services or events in the community. People are supported to visit their families and take part in family events and celebrations such as weddings and birthdays. There are no kitchen facilities in the home and all catering is provided by contract from The Rivers Hospital, which is part of the Ramsey Healthcare complex. The menus are varied with two main choices as ‘Chefs dish of the day’ and if these are not to peoples’ liking there is an additional lunch menu available with a further eleven choices. The manager reported that there is a link person in each staff team responsible for any queries about food because the service recognises the importance of this area. The residents’ satisfaction survey undertaken by the service as part of their annual quality assurance process identified that 11 of the respondents were not totally happy with the catering, these respondents highlighted individual preferences that have now been implemented by the catering team. The Jacob Centre DS0000060010.V366022.R01.S.doc Version 5.2 Page 15 Surveys received by the commission from people living at the service as part of this inspection process indicate a mixed response to the food. Comments included: “The meals are not cooked properly”, “It depends on what I choose, I choose carefully and the current menus aren’t as good as they have been. The catering staff are very good, they always save me something if I am out at an appointment” and “There is no consistency with the food, one day it is perfect and the next it is horrible”. Three visiting families said they felt the food is good with plenty of variety and that their relatives enjoy it and observation at lunchtime showed us that people enjoyed their meal. Staff spent time with people supporting them to eat in individual ways appropriate to the needs of the person. The service has the support of a dietician who visits twice a week to ensure each person is maintaining a diet appropriate to his or her needs. The Jacob Centre DS0000060010.V366022.R01.S.doc Version 5.2 Page 16 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are well cared for in a way that suits their individual needs and preferences. EVIDENCE: The care plans provide good information about how each person prefers to be cared for, for example how they like to be positioned whilst sleeping, resting or receiving personal care and more in depth information about how they like to have their hair cut or helped to have a shower. The manager’s AQAA states that the service provides individualised programmes of care, therapy and support based on peoples needs, wishes, preferences and aspirations. Individual routines are flexed on a day-to-day basis according to the needs and wishes of the person. For example, a resident may normally prefer to receive assistance to get up, washed, dressed, etc at 10am but sometimes want this to be at 9am if they are going out for the day or expecting visitors or have an appointment. The teams adapt their schedules to accommodate both the normal and ad hoc needs and preferences of people. Choices such as what to wear and how to style hair belong to the person and The Jacob Centre DS0000060010.V366022.R01.S.doc Version 5.2 Page 17 staff support them accordingly, regardless of their own preferences or those of family members. The service accesses various external healthcare professionals as well as having a qualified, trained and experienced staff team meet peoples’ healthcare needs. A GP visits the service twice daily, provides on call cover 24/7 and has a surgery registered at the centre specifically for the people living at Jacobs Centre and the sister home on the same site. The manager’s AQAA states ‘Having visits twice each day from the GP (& more if needed) means that residents’ health needs are attended to promptly. This benefits the resident and also the local hospital with an observable reduction in transfers to A&E, which are now minimal’. Some relatives reported being unaware that residents have the choice to access their own GP. A discussion was held with the manager about including this information in the service user guide and informing the people living at the home currently and their representatives. One healthcare professional responded to the question what does the care service do well? with the following comments: “Patient Care. Therapy. Enabling. Quick response to changes health seeking appropriate care. Good customer service”. Each person living at Jacobs centre has an allocated key worker however the residents’ satisfaction survey undertaken by the service as part of their annual quality assurance process identified that 22 of the respondents did not know who their key worker was and 45 had forgotten who their key worker was. The management have taken action to raise the profile of key workers and to increase their interaction with the residents. Staffing levels are calculated according to each person’s assessed need of 1:1, 1:2 or 1:3. The rotas showed that there are sufficient staff to meet peoples’ needs and observation together with discussion with relatives, clinical managers, nursing staff and care staff confirmed this. An external pharmacist is involved with supporting a monthly medication audit and ordering medicines for each unit. The nursing staff cross check the order and ensure that it equates to what residents need. The orders are then passed to the GP to produce prescriptions. When the medications are returned to the home in sealed boxes they are checked against the audit form and prescriptions and the quantity are dated and signed for. The Medication administration Record sheets (MARs) are then cross referenced against the previous MAR to ensure nothing has been missed. Medication trolleys have an individual locked box for each person. A random sample of medication was physically checked and agreed with MAR. The trolley is stored in a temperature-controlled room. There is a controlled drugs The Jacob Centre DS0000060010.V366022.R01.S.doc Version 5.2 Page 18 cupboard secured to wall in the clinical room. A random sample was physically checked and agreed with controlled drugs register. The Jacob Centre DS0000060010.V366022.R01.S.doc Version 5.2 Page 19 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People can expect to be safeguarded from abuse by good procedures being in place and staff having a sound knowledge of these. EVIDENCE: The residents’ satisfaction survey undertaken by the service as part of their annual quality assurance process identified that 83 of the respondents were aware of the process for expressing comments, compliments and concerns. Since the completion of the survey the service has produced new leaflets clarifying the process and have circulated these to all residents. Some family members reported to us they are happy that any concerns would be dealt with promptly and efficiently however others say they are not confident that their concerns will be dealt with. Staff members say that the ethos of the service is to deal with any issues immediately to ensure that everyone is happy with the outcome and to avoid any unnecessary stress or worry for the resident or relatives. Some residents completing surveys for the commission as part of this inspection indicated that they were not always happy with the way their concerns were dealt with. Comments included “Nobody listens” “When I have problems they tend to go round and round, The problem is sorted out at the time but it always recurs” The Jacob Centre DS0000060010.V366022.R01.S.doc Version 5.2 Page 20 The commission has not received any complaints about this service since the previous inspection. All complaints received by the service are recorded and dealt with inside appropriate timescales in accordance with the service’s complaints policy and procedure. The service has policies on adult protection and whistle blowing. Staff members demonstrated a good knowledge and understanding of these policies, and all have had training in the prevention of abuse. The service has made one referral under adult safeguarding since the previous visit. The proper procedures were followed in accordance with policies and guidelines and the outcome was that the allegations were unsubstantiated. Training in safeguarding vulnerable adults is provided for all new staff through induction training and the manager reported that staff members are working through Herts County Council training on-line. There is no planned refresher training at this time however the focus on safeguarding is maintained through staff meetings etc. The Jacob Centre DS0000060010.V366022.R01.S.doc Version 5.2 Page 21 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People live in a comfortable and clean environment. EVIDENCE: The home is new and purpose built. A physical tour of the premises showed us that the home appears clean and tidy with no offensive odours. The atmosphere is warm and friendly however continues to give the impression of a clinic rather than a home. Over the past 12 months there has been work done to improve the homeliness of the centre by putting up pictures etc however there is still work to do in the communal areas. During the visit we were invited into some peoples’ personal rooms to talk with family members, these rooms appeared personal and made individual. During the tour of the premises it was noted that wheelchairs are stored in corridors and there is a lack of dedicated storage space for trolleys, hoists and wheelchairs. Whilst the corridors are wide and airy and the people living at the The Jacob Centre DS0000060010.V366022.R01.S.doc Version 5.2 Page 22 home can still move around freely this does look unsightly and adds to the clinical appearance of the home. The service has a programme of continual redecoration, the registered manager reports “Décor of the home is not standing the test of time”. Some flooring has been replaced with laminates, the manager recognises that this emphasises the clinical appearance of the unit and is investigating more appropriate alternatives. The service has lounges and dining rooms on both floors and areas for the people to sit in the airy and open hallways. There is a garden to the rear of the building, accessed from the ground floor dining room, with a patio, lawns and raised flowerbeds, and flowerbeds at the front of the home. The registered manager reports that a large shade canopy is to be installed to provide a pleasant area for residents and their relatives to enjoy some fresh air. New garden furniture has been purchased. The residents’ satisfaction survey undertaken by the service as part of their annual quality assurance process identified that 82 of the respondents were very satisfied or satisfied with the accommodation, 10 of those responding were dissatisfied. As a result of this process actions were taken such as one person was supported to move to another room that better met his needs, 2 people are receiving more help to maintain the tidiness of their rooms, the redecoration programme for communal areas and bedrooms has been increased and some bedroom floors have been deep cleaned. The home has neither a kitchen nor a laundry; these facilities are provided by The Rivers hospital and shared with a sister home on the same site. There is a mechanism for reporting any identified maintenance issues. The service has access to maintenance engineers from The Rivers Hospital to carry out any serious repairs and the porters deal with day-to-day repairs expediently. The Jacob Centre DS0000060010.V366022.R01.S.doc Version 5.2 Page 23 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are well looked after by safely recruited, experienced and well trained staff. EVIDENCE: All the staff either spoken with or seen around the home during this visit were friendly, professional, approachable and helpful. Comments from visitors include “The staff are second to none, they are so patient, caring and understanding” and “The staff here are brilliant, they are dedicated and always cheerful and smiling” The manager showed us that periodic assessment of each individual unit is made to see what the dependence levels of individuals were. For example how many people need 1:1 support etc in order to work out what staffing levels are needed for each unit. Staffing rotas showed us that there are sufficient staff members on duty at all times of the day and night to care for people properly and safely. The staffing levels and skill mix are regularly reviewed to ensure that they are appropriate for the needs of the current residents and are always reviewed when a new person is admitted to the unit. The Jacob Centre DS0000060010.V366022.R01.S.doc Version 5.2 Page 24 There is a framed poster in the reception hall of the unit displaying the different uniform colours of the staff team to inform residents and visitors to the home who was who. Red shirt = Carer. Burgundy shirt = clinical manager. Pale blue shirt = registered nurses. Lilac shirt = Clinical support assistants trained to NVQ 3. Green shirt = senior care trained to NVQ 2. Not many staff were wearing name badges on this day, it was reported that the current ones are not very good and are continually breaking however new ones are expected to be delivered imminently. There is a thorough recruitment procedure in place to ensure that the right people are recruited to work with the people living at the home. The process includes taking up two references and an enhanced Criminal Record Bureau disclosure before new people start to work at the home. The staff files of four members of staff were looked at. They all contained the required information and a pre employment health screen. The service has a comprehensive training programme including health and safety training, and essential skills such as moving and handling, fire safety and infection control. All staff members also have specific training in neuro skills to ensure they can safely meet the needs of the people living at the home. The training programme covers both the Jacobs centre and the sister home, The Gardens. A member of administration staff is responsible for coordinating the training requirements for both homes. Staff surveys include comments such as “The training programme is extensive and covers all staff regardless of role” and “The training programme within Jacobs centre covers all aspects of care required by individuals. All staff can apply for training/study days via the core training group” The Jacob Centre DS0000060010.V366022.R01.S.doc Version 5.2 Page 25 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People live in a safe and well managed home. EVIDENCE: The manager is a Registered Mental Nurse, and she has a diploma in management and NVQ assessors award. She had several years’ experience of management in care homes for people with mental health problems before being appointed to manage The Jacob centre when it opened. She attends updates via training sessions held at the home and various external events such as a recent seminar covering brain injuries and mental health issues. The manager holds 1:1 supervision sessions with each clinical manager and business function manager 6 weekly. Each of these line managers has responsibility for supervising a team of staff. Some supervisions are practice based and not all are documented. Staff meetings are held regularly and a The Jacob Centre DS0000060010.V366022.R01.S.doc Version 5.2 Page 26 staff forum. A newsletter called Neuro News is produced primarily for residents and relatives but benefits staff also. Customer satisfaction surveys are undertaken as part of the home’s annual quality assurance processes. The manager pulls together the information and develops a report including pie charts to indicate the percentage of people who are satisfied with various aspects of the service provided for the people living at the Jacobs centre. The management demonstrates an active approach to improving the services and facilities for the people living at the home. The feedback from staff about the management of the home is very positive. Comments such as “I feel supported. The manager is very approachable. If any equipment needed it is not questioned. She listens”. Management team periodically do an exercise where they undertake to do different job roles for a day. For example the registered manager has worked as a carer and in the laundry for the day. This helps to gain an appreciation of what is involved in the different roles and understand issues affecting people’s daily working lives. Appropriate records are maintained to provide evidence that the service protects and promotes the health and safety of the people living there and staff working in the home, and staff follow the home’s policies and procedures. Good procedures are in place for fire drills, and the residents’ room list has information on the evacuation method needed to move each person to safety depending on their abilities. The moving and handling training includes mattress evacuation, this is provided by the fire authority. Each staff member attends a fire drill at least annually and fire alarm is tested weekly. The Jacob Centre DS0000060010.V366022.R01.S.doc Version 5.2 Page 27 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 2 3 3 3 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 4 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 2 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 x The Jacob Centre DS0000060010.V366022.R01.S.doc Version 5.2 Page 28 Are there any outstanding requirements from the last inspection? No 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. Standard Regulation Requirement Timescale for action 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 The Jacob Centre DS0000060010.V366022.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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 The Jacob Centre DS0000060010.V366022.R01.S.doc Version 5.2 Page 30 - 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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