Care Home: Jah-Jireh Nursing Home

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What the care home does well From speaking with residents it was clear they are happy with the care provided and liked the staff. Visitors can visit at any time and are made welcome by the staff. Residents were satisfied with food served stating they got enough to eat and that they were given choices at each meal. The premises are clean and safe and the standard of the accomodation is good. What has improved since the last inspection? There is an on going programme of refurbishment and decoration. One of the lounges on the ground floor had recently been decorated and a fire place fitted. The lounge was tastefully decorated, comfortable and well equipped. What the care home could do better: Information on returned staff comment cards and from discussions with staff and on checking the staff rosters it was evident that on several occassions that shifts were not adequately covered. Gaps in the staff duty rosters were noted. An immediate requirement was made to ensure that the home is suitably staffed to meet the needs of the residents at all times. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Jah-Jireh Nursing Home 141 Springfield Road Beech Hill Wigan Lancashire WN6 7RH     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Judith Stanley     Date: 0 7 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 24 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 24 Information about the care home Name of care home: Address: Jah-Jireh Nursing Home 141 Springfield Road Beech Hill Wigan Lancashire WN6 7RH 01942243533 01942243747 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Kathleen Soar Type of registration: Number of places registered: Trustees of Jah-Jireh (Charity) Homes care home 45 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability terminally ill Additional conditions: A revised Statement of Purpose and Service User Guide, in a format suitable for intended service users, must be provided to the CSCI by 30/11/05. The Registered Person must ensure that all staff working in the home have dementia awareness and dementia care training, which equips them to meet the needs of the service users accommodated, as defined in the individual plan of care. The home is registered for a maximum 45 service users to include:- up to 45 service users in the category of OP (Older People) up to 5 service users in the category of PD (Physical Disabilities under 65 years of age) up to 4 service users in the category of TI(E) (Terminal Illness over 65 years of age) up to 5 service users in the category of DE(E) (Dementia over 65 years of age) Care Homes for Older People Page 4 of 24 0 0 5 0 Over 65 5 45 0 4 The service should at all times employ suitably qualified and experienced members of staff, in sufficient numbers, to meet the assessed needs of the service users with dementia. The service should employ a suitably qualified and experienced Manager who is registered by the CSCI. Date of last inspection Brief description of the care home Jah Jireh Care Home is a faith home for brothers and sisters who are baptised members of the Jehovahs Witness faith. The home offers accommodation, nursing and personal care and support for up to 45 individuals with varying needs. Jah Jireh is situated in the Springfield area of Wigan and is close to local amenities and is approximately 10 minutes drive from Wigan and Standish town centres. The home is a purpose built two storey building with private accommodation on both floors. The home offers 39 single rooms and 3 shared rooms, all rooms have en suite facilities. The home offers comfortable lounges and a large separated dining room. The enclosed gardens are well presented and were accessible to all residents. Limited car parking is available at the front of the home. The home has some staff accommodation and a hospitality suite for visiting relatives. The current scale of fees ranges from 380.00 to 490.00 pounds per week. Additional charges are made for chiropody, hairdressing, massage and aromatherapy, telephone calls, magazines and holidays. Care Homes for Older People Page 5 of 24 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This unannounced visit at Jah Jireh took place over a 6 hour period. We looked at some records the home holds on residents (care plans) and other records the home needs to keep to ensure the home is being run properly, for example staff rosters, staff files, accident reports, menus and activities. We also looked around the home. To find out more about the home we spoke with residents and staff and made observations as staff went about thier work. Comment cards, asking resdents, relatives and staff what they thought about the home were sent out. Relatives were complementary about the home, the staff and the care their relatives receive. Care Homes for Older People Page 6 of 24 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 7 of 24 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 8 of 24 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides residents and their supporters with up to date information about the home and the services and facilities offered. Evidence: The home has a statement of purpose and a service users guide. This is available to prospective residents and to residents all ready living at the home. The information is clear and concise and informs people about the services and facilities available. As this is a faith home enquires are made for different parts of the country, therefore the information is posted out to prospective residents. Four residents files (care plans) were chosen for inspection. All had a contract/statement of terms in place regardless of how their care was purchased. On examination all files contained a pre admission assessment. Where possible the Care Homes for Older People Page 9 of 24 Evidence: manager will carry out this assessment. Due to the location of some prospective residents the assessment could be carried out by a member of the senior management team or by a senior member of staff from another Jah Jireh home . The assessment is detailed and covers the residents well being, areas of risk, mobility, past medical history, continence, mental alertness, personal care required, communication, nutritional status, likes and dislikes etc. The home is registerd to offer care for up to five people with a dementia related illness. From observations and discussions with residents it was apparent that other residents had memory and communication problems. To ensure staff know how best to meet the needs of residents all staff at the home had undertaken training in dementia care. Care Homes for Older People Page 10 of 24 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Information details the support and care needs of the residents and how this will be provided. Evidence: We continued working with the same four care plans selected. Care plans are drawn up from the initial assessment and include personal details, mental health, personal care, social care, nutrition, mobility and communication. Risk assessments covered aspects of moving and handling, bathing, pressure care and use of bed rails and hoists were in place. Supplementary information includes personal care record of weight, bathing, blood pressure, blood sugar etc. Daily progress notes are also maintained. Feedback from residents (able to comment) and those who returned comment cards was mixed, some were complementary about staff and the care provided. One resident said, I am very happy here, the staff cant do enough for you. Another said, We need more staff as sometimes they are not available when you need them. I would like feedback after I make a complaint as to what had been done about it. Occasionally one Care Homes for Older People Page 11 of 24 Evidence: or two staff are over familiar verbally with a little harsh or cutting remarks. They need to know boundries. The services of opticians, chiropodist and doctors were accessed either at the home or in the community as and when required. Information of professional visits and hospital appointments were recorded in the care plans. We checked the medication for the four residents whose files we were working with. Medication was stored in a locked drugs trolley in the treatment room. Nurses administer all medication. On checking the administration and recording of the four residents no errors were noted. Those residents able to comment indicated the staff respected their privacy and dignity. During the inspection, staff were observed to treat residents with respect and consideration. Residents were observed to be dressed in clean well maintained clothing. Attention was given to personal grooming. Staff were seen to knock on doors and wait for a response before entering rooms and toilets. Care Homes for Older People Page 12 of 24 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Daily routines promote residents independence and choice. Residents are provided with a well balanced and nutritous diet and are offered variety and choice. Evidence: The home plans and delivers a range of activities. Each month there is a different trip out planned, some residents were looking forward to the next trip to Albert Dock. Activities offered include arts and crafts, flower arranging, concerts, one to one chats etc . A major part of the residents daily life is the religious study groups. Residents have access to the reading materials they need and look forward to the service that is relayed in to the home from the Kingdom Hall. Those residents who wish to attend the Kingdom Hall are supported in doing so. Visitors are welcome to visit the home at any time, there are no restrictions imposed. As the residents at the home come from different parts of the country it may be difficult for some people to visit. It was noted that several residents had telephones in their rooms to make and receive calls. The home does have the facilities of a hospitality suite if relatives need to stay overnight. Care Homes for Older People Page 13 of 24 Evidence: Residents spoken with confirmed that they are supported and encouraged to make their own choices and decisions. For some this is more difficult and assistance is needed. One residents spoken with said, I get up when I want and go to bed when I am ready. If I want something different to eat I ask for it. It was noted that a flexible breakfast is served, residents were seen at 09:45 still coming down for breakfast. This gives people the opportunity to have a lie in if they wish. A good choice of hot and cold dishes are available including fruit juice,porridge, cereals, toast and preserves, tea and coffee. A lighter lunch is served and residents were offered home made soup, sandwiches, or potato waffles, eggs and beans, followed by fruit, cake or cheese and biscuits. Evening dinner is the main meal of the day and residents were to be offered fish and chipped or creamed potatoes, brocolli and carrots and turnips, or an alternative of tuna pasta bake followed by peaches and ice cream or Manchester tart. The dining room is comfortable and the tables were nicely set with matching crockery and cutlery, tableclothes, napkins and condiments. It was noted that staff were on hand to assit anyone that needed help with their meals and this was done discreetly and in a sensitive manner. Residents spoken with after lunch were complementary about the quality and quantity of the food served. Hot and cold drinks and snacks are served during the day and supper is offered before residents retire. Care Homes for Older People Page 14 of 24 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home holds clear procedures regarding complaints and adult protection, ensuring that residents were listened to and protected. Relevant training is provided to members of staff. Evidence: A complaints procedure exists and records of complaints are kept and recorded along with the outcome. The manager confirmed that two complaints had been made to the home and outcomes were still ongoing. No complaints has been made to the CSCI since the last inspection. It was discussed with the manager about a comment made on a returned comment card that one resident would like feedback after making a complaint and what had been done about it. The manager is reminded that any concerns or complaints made either verbally or in writing must be documented along with the outcomes. There have been no adult safeguarding issues reported by the home within the last year at least. All staff have had training in the protection of vulnerable adults. Care Homes for Older People Page 15 of 24 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is maintained to a good standard making it a homely, comfortable, clean and pleasant home for residents to live in. Evidence: From a tour of the premises, it was evident that the home is maintained to a high standard both internally and externally. Since the last inspection one of the lounges had been decorated and and a new fireplace had been fitted. All communal areas on both floors were comfortable and well equipped. It was noted that the carpet leading in to the quiet lounge near the door had started to fray, this requires attention as it could become a tripping hazard. It was also discussed with the manager that in one bedroom a new carpet was required. Several bedrooms were looked at, some residents had picked their own colour scheme. Bedrooms were seen to be warm, clean and tidy and had been personlised with residents own possessions brought with them from home. Bathrooms are decorated in a domestic style so to offer a relaxed atmosphere for residents when bathing. Care Homes for Older People Page 16 of 24 Evidence: The outside of the home is well maintained and the grounds were seen to be neat and tidy. Systems were in place to control the risk of cross infection. Staff were seen wearing different protective clothing when carrying out different tasks. Some of the staff spoken with were not happy about wearing their own clothes and would rather wear a uniform, it was felt that there may be a risk of cross infection as their clothes cannot be washed at a high temperature. The laundry is sited away from food preperation and food storage areas and does not intrude on the residents. Care Homes for Older People Page 17 of 24 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is inconsistency in staffing levels, therefore residents well-being and individual needs are at risk of being compromised. Evidence: The staff rosters for the week were available for inspection and on examination showed that on more than one occasion that staffing levels were not being met. There were gaps where shifts had not been covered, either due to sick leave or annual leave. We appreciate that sick leave cannot be predicted, however annual leave is booked in advance and cover should be arranged. It was evident that if a nurse is required that agency staff are used, but not for care staff. There is a diary kept which shows the numbers of staff that worked each day. For all of September 2008 there was evidence to show that on numerous occassions shifts were working one or two carers down. Staff spoken with were concerned about staffing levels, and most of the returned staff surveys made reference to lack of staff, one said, The home is very busy and demanding. We always have less staff on shift and we are not allowed agency, its to much to cope with sometimes. A immediate requirement was made regarding staffing levels. The home meets the standard of having at least 50 of staff qualified to NVQ in care. Care Homes for Older People Page 18 of 24 Evidence: The files of three staff employed were looked at and showed all the necessary recruitment checks had been undertaken. Files contained: a written application form, two written references, Criminal Records Bureau check ( CRB) and other forms of identification. Staff training is on going and staff had completed mandatory training as required. Care Homes for Older People Page 19 of 24 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is a clear line of accoutabilty in the home which residents and staff are aware of. Quality assurance systems are in place but improvements are needed to ensure the performance of the home is regularly monitored. Evidence: The manager has a number of years experience in working with the elderly and is a nurse and has achieved the Registered Managers Award. There is a clear line of accountability in the home which residents and staff are aware of. During the inspection, it was observed that residents and staff had no hesitation in approaching the manager if they had anything they wished to discuss. Qualtiy assurance sytems are in place. The home holds resident and staff meetings. A represtative of the company visits the home to audit records and deal with personal allowances etc. However it was noted that the monthly regulation 26 reports were not Care Homes for Older People Page 20 of 24 Evidence: available for each month. Senior management oversees residents finances if they have been handed over to the home for safekeeping. These are dealt with and checked every Monday. We did not inspect the monies or balanced sheets on this occasion. Equipment and systems used in the home are serviced and maintained, and records are well kept and accessible. Repairs are carried out by the maintenance man and other service contracts are in place. On the information provided prior to the inspection, the manager completed a list of maintenance and associated records. A sample including the water, electrics, hoists, gas, nurse call and the lift were checked during the inspection. All were up to date. Health and safety policies and procedures were in place. Accidents had been recorded and filed, however the home had failed to inform the CSCI of some accidents that had occured. Any accidents, injuries and incidents must be reported on a regulation 37 form and forwarded to the CSCI as soon as possible after the event. Care Homes for Older People Page 21 of 24 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 22 of 24 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 33 26 A member of the company 28/11/2008 must visit the home monthly and complete a written report. To obtain residents views on the home and for the representative to get an overview of what is happening and any improvements needed. 2 38 37 To inform the CSCI of any accident, injury or incident on a Regulation 37 form To keep the CSCI informed at all times. 28/11/2008 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 19 The carpet leading in to the quiet lounge requires attention as it is starting to fray and could become a tripping hazard. Care Homes for Older People Page 23 of 24 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 24 of 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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