Inspection on 25/08/05 for Vi & John Rubens House

This inspection was carried out on 25th August 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 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

Vi & John Rubens House 07/03/07

Vi & John Rubens House 07/02/06

Vi & John Rubens House 22/12/04

Vi & John Rubens House 03/08/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE Vi & John Rubens House 39 Clarence Avenue Gants Hill Ilford Essex IG2 6JH Lead Inspector Gwen Lording Unannounced Inspection 25th August 2005 10.00 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. Vi & John Rubens House G55_S0000025964_Vi John Rubens_V237139_250805_Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Vi & John Rubens House Address 39 Clarence Avenue, Gants Hill, Ilford, Essex IG2 6JH 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) 020 8518 6599 020 8554 6402 Jewish Care Mrs Mary ORourke CRH Care Home 121 Category(ies) of DE(E) Dementia - over 65 (16) registration, with number OP Old Age (105) of places Vi & John Rubens House G55_S0000025964_Vi John Rubens_V237139_250805_Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 22 December 2004 Brief Description of the Service: Vi and John Rubens House is owned and operated by Jewish Care Ltd. it is a care home registered to provide accommodation with personal care and nursing for up to 121 residents, of whom 16 have dementia type illnesses. All residents are over 65 years and of the Jewish faith. The home is purpose built and situated in a residential area of Gants Hill in the London Borough of Redbridge. The home is well served by public transport and close to shops and other amenities. The majority of the bedrooms are single and have en-suite facilities, some with showers. The home has a passenger lift to all floors. Vi & John Rubens House G55_S0000025964_Vi John Rubens_V237139_250805_Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over one day, commenced at 10.00am and lasted six and a half hours. The inspection was undertaken by two inspectors. The inspectors spoke to fifteen residents individually and had a group discussion with a small number of residents whilst they were in an arts/ crafts session. In addition the relatives of twelve residents were interviewed to get their views and comments about the care in the home. There was also an opportunity to speak to a visiting community chiropodist. Discussion took place with the assistant head of home; administrative; domestic and activities staff; several members of nursing and care staff; and a number of volunteers working in the home. A tour of the home was made and a number of staff and care records were looked at. The Inspectors would like to thank the residents, their relatives/ visitors and staff for their input during the visit. What the service does well: Those residents spoken to, who were able to express a view, were very happy with the quality of care, they were receiving in the home. Relatives/ visitors were also very positive about the care and commented that staff are very welcoming when they visit. Typical comments were: “ My mum is always well dressed and her hair is done regularly”; “ Well looked after, staff do all they can”; “Staff go the extra mile, nothing is too much trouble”. There is a very homely and relaxed atmosphere throughout the home, despite the home being very large. Residents appear unhurried and are given sufficient time and support in their everyday activities. Both residents and relatives spoken to said that they felt able to talk to the manager or a member of staff if they had concerns or worries and that all staff are very approachable. The manager and staff teams are committed to improving the standard of care people in the home receive and to make sure that the residents are well cared for and happy. Vi & John Rubens House G55_S0000025964_Vi John Rubens_V237139_250805_Stage 4.doc Version 1.40 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Vi & John Rubens House G55_S0000025964_Vi John Rubens_V237139_250805_Stage 4.doc Version 1.40 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 Vi & John Rubens House G55_S0000025964_Vi John Rubens_V237139_250805_Stage 4.doc Version 1.40 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 Appropriate pre-admission assessments are carried out for all residents prior to them moving into the home. Care plans are drawn up from the information in this assessment, ensuring that the needs of the residents are identified, understood and met. EVIDENCE: Individual records are kept for each resident and a number of files were examined across all areas of the home. All records inspected had assessment information recorded and the information had been used to continue assessment following admission to the home and develop written care plans. The records showed that residents, where capable and their relatives/ representatives are involved in the assessment process. Where appropriate, information provided by the placing authority was also on file. The home does not offer intermediate care. Vi & John Rubens House G55_S0000025964_Vi John Rubens_V237139_250805_Stage 4.doc Version 1.40 Page 9 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 and 10 Residents’ health, personal care and social care needs are set out in individual care plans but not all care plans accurately reflected the current needs and did not provide staff with sufficient information to ensure that care needs were being met on a daily basis. There are clear medication policies and procedures for staff to follow. However, there are some inconsistencies in the recording and storing of medication resulting in unsafe practices. Residents are treated with respect and the arrangements for their personal care ensure that their right to privacy is upheld. EVIDENCE: Individual care plans were available for each resident and a number of records were examined across all areas of the home. The records for these residents were found to be generally detailed and comprehensive. However, there was inconsistent practice in some areas of the home and the following omissions were noted and discussed with the person in charge: • Whilst examining a care plan on the nursing wing it was noted that that the resident is recorded as having an infected wound site. However, G55_S0000025964_Vi John Rubens_V237139_250805_Stage 4.doc Version 1.40 Page 10 Vi & John Rubens House there was no specific care plan detailing the procedures to be followed by staff in accordance with Universal Precaution Standards in respect of control of infection, including the handling of soiled linen. This was discussed with the nurse in charge of the unit and the assistant head of home at the end of the visit. • The information contained in the care plan of a service user on the dementia unit had not been updated, following the death of her husband. New care planning documentation has recently been introduced and was in various stages of implementation throughout the home. The inspector will review its implementation and progress at the next inspection. An audit was undertaken on the management of medications within the home. The following issues of concern were noted and discussed with the person in charge: • Insulin preparations in current use are to be stored at room temperature and not in the medicine fridge, in accordance with the directions on the container and the product licence. • Handwritten entries on Medication Administration Record (MAR) charts must be signed and dated by the person making the entry i.e. nurse, senior carer. The entry must also include the source of the information i.e. GP, CPN. • The registered manager must seek advise from a pharmacist in respect of the recent changes to the arrangements that affect the disposal of medicines in nursing homes. The inspector was able to meet with the community chiropodist who was visiting the home. He commented that all staff are very professional and make sure that suitable and appropriate arrangements are made for him to consult and treat residents. He is always confident that they will competently carry out any instructions/ follow up treatments directed by him. Vi & John Rubens House G55_S0000025964_Vi John Rubens_V237139_250805_Stage 4.doc Version 1.40 Page 11 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, and 15 Social activities are well managed and provide daily variation and interest for people living in the home. The home is able to meet the cultural and religious needs of people from the Jewish faith. Visiting times are flexible and people are made to feel welcome in the home so that residents are able to maintain contact with their family and friends as they wish. EVIDENCE: The home exclusively admits people from the Jewish faith. However, the home and Jewish Care as an organisation has a workforce from diverse cultures and backgrounds. As part of the induction programme, all staff learn about the Jewish culture and way of life. A large number of volunteers from the Jewish community are employed in the home and provide a valuable contribution to life in the home and the experiences of the people living there. The home has a programme of activities and outings. On the day of the visit the home was making preparations for a lunchtime barbeque with Vi & John Rubens House G55_S0000025964_Vi John Rubens_V237139_250805_Stage 4.doc Version 1.40 Page 12 entertainment. The previous day residents had been on a day trip to Westcliff and despite the poor weather reported that they had a very enjoyable time. The choice of those residents not to be involved in some or any activities is respected. There was an alternative lunchtime menu and suitable arrangements for those residents not wishing to participate in the barbeque. A kosher kitchen is maintained and Jewish Care employ a peripatetic Jewish chef who visits the care homes on a rotational basis to advise on all food issues. Those residents/ relatives spoken to said that there is always a choice of menu and the food is generally “very good”. Others said that they would be offered an alternative if they did not want what was on the menu. Visiting times are very flexible and visitors commented that staff always make them feel welcome. Residents are able to receive visitors in one of the lounges or in their own rooms, as they wish. The inspector spoke to the relative of one resident that is currently in hospital. She was making arrangements with the home for her mother to leave hospital for one day to be able to celebrate her 90th birthday in Vi and John Rubens House with her family and friends. The home was very happy to accommodate these arrangements. Vi & John Rubens House G55_S0000025964_Vi John Rubens_V237139_250805_Stage 4.doc Version 1.40 Page 13 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 The information in the complaints policy/ procedure must be amended to provide residents and their relatives with the appropriate information to ensure that their complaints are dealt with promptly, effectively and to their satisfaction. EVIDENCE: The home has a complaints policy/ procedure and the records indicate the number of complaints received and includes details of investigation, any action taken and the outcome for the complainant. However, some of the residents would not have the capacity to use a written, formal process. Those residents spoken to, who were able to express a view said that they felt able to make complaints and raise issues if they needed to. Relatives said that staff were responsive to any concerns raised and “knew who to speak to, if there was a problem that needed sorting out”. There is a complaints procedure and an accompanying leaflet available for residents produced by Jewish Care, ‘Your View Counts’. However, the information contained in the complaints policy displayed throughout the home, must be amended/ updated to include information for referring a complaint to the Commission for Social Care Inspection (CSCI), at any stage should the complainant wish to do so. Vi & John Rubens House G55_S0000025964_Vi John Rubens_V237139_250805_Stage 4.doc Version 1.40 Page 14 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) 19 & 26 The overall atmosphere in the home is very welcoming, with a good standard of cleanliness and hygiene, providing a safe and comfortable environment for people to live in. EVIDENCE: The building was toured, unaccompanied, by both inspectors. Some bedrooms were seen either by invitation of the residents, whilst others were seen because the doors were open or rooms being cleaned. All areas of the home were clean, tidy and free from odour throughout the visit. There is a very homely atmosphere throughout the home, despite its size. There are a number of rooms throughout the home in which a variety of activities can take place. All the lounges have a different atmosphere, to suit individual preferences, needs and interests. For example small, quiet rooms and larger lounges where residents and their families may meet together. Vi & John Rubens House G55_S0000025964_Vi John Rubens_V237139_250805_Stage 4.doc Version 1.40 Page 15 There is an ongoing programme of renewal for the fabric and decoration of the premises and the standard of the environment within the home provides residents with an attractive and comfortable place in which to live Vi & John Rubens House G55_S0000025964_Vi John Rubens_V237139_250805_Stage 4.doc Version 1.40 Page 16 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, 29 and 30 Staffing levels are satisfactory and there is sufficient staff on duty to meet the personal and nursing care needs of the residents. The procedures for the recruitment of staff are robust and provide safeguards for people living in the home. Residents benefit from a committed team of staff at the home who have the skills and training to meet their needs. EVIDENCE: The home has a relatively stable workforce and in discussion with staff it was evident that they fully support the main aims and values of the home. In addition to qualified nurses and care staff, Vi and John Rubens House employs activity co-ordinators, catering, laundry, housekeeping, maintenance, administrative staff and volunteers. The information on the duty rota was consistent with the names and delegations of staff on duty. The staff files of four staff members employed since the last inspection showed that the home is undertaking all the necessary recruitment checks to ensure the protection of residents. Staff training records showed that staff had done mandatory training in areas such as food hygiene, health and safety and manual handling. Other staff had received training diabetes management and supervisory skills and there is an Vi & John Rubens House G55_S0000025964_Vi John Rubens_V237139_250805_Stage 4.doc Version 1.40 Page 17 ongoing programme of comprehensive and certificated training in dementia care for all care staff. Vi & John Rubens House G55_S0000025964_Vi John Rubens_V237139_250805_Stage 4.doc Version 1.40 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) 31, 32, 33 and 36 The manager is a very experienced and well-qualified person and residents benefit as the home is run in their best interests. EVIDENCE: The registered manager has been in post for more than ten years and is well qualified and experienced to manage the home. She is supported in clinical issues by the deputy manager, who is an experienced and suitably qualified nurse who manages/ advises on the nursing elements of the service. The management structure also consists of a senior sister/ charge nurse and two assistant heads of home that report to the manager on issues relating to the nursing unit, dementia unit and residential unit of the home. There is clear leadership and lines of accountability and the manager and her team work closely together and demonstrate a clear commitment to achieve high standards for residents in the home. Vi & John Rubens House G55_S0000025964_Vi John Rubens_V237139_250805_Stage 4.doc Version 1.40 Page 19 The registered providers check the quality of care in the home through monthly monitoring visits. A comprehensive report is produced and a copy is sent to the Commission. A new system for monitoring the quality of care in the home has been introduced. This is based on seeking the views of residents, relatives, carers and others, to make sure the home is running in the best interest of the residents. The home has a ‘Quality Assurance’ team, which is made up of a group of staff from within the home. At the last inspection a requirement was made for all staff to receive regular formal supervision and through discussion with staff it was evident that this is now happening at all levels across the home. Vi & John Rubens House G55_S0000025964_Vi John Rubens_V237139_250805_Stage 4.doc Version 1.40 Page 20 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x x 3 3 3 x x 3 x x Vi & John Rubens House G55_S0000025964_Vi John Rubens_V237139_250805_Stage 4.doc Version 1.40 Page 21 NO 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 7&8 Regulation 13 & 15 Requirement Timescale for action 30/09/05 2. 9 13 3. 9 13 4. 16 22 All care plans must accurately reflect the current needs of residents and provide staff with sufficient information to ensure that care needs are being met on a daily basis. The registered manager must 30/09/05 seek information and advise from a pharmacist around the storage of insulin and the disposal of medicines in nursing homes. All handwriiten entries on 30/09/05 Medication Administration Records (MAR) charts must be signed and dated by the person making the entry and include the source of the information. The information in the 31/10/05 complaints policy displayed in the home must be amended/ updated to include information for referring a complaint to the Commission for Social Care Inspection, at any stage should the complainant wish to do so. Vi & John Rubens House G55_S0000025964_Vi John Rubens_V237139_250805_Stage 4.doc Version 1.40 Page 22 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 Good Practice Recommendations Vi & John Rubens House G55_S0000025964_Vi John Rubens_V237139_250805_Stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection Ferguson House 113 Cranbrook Road Ilford Essex IG1 4PU 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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