Care Home: Jane`s House

What the care home does well The home is well run, and the registered manager provides clear leadership. Case files are held at the home in respect of each resident, which reflect their changing needs. Residents are encouraged, have opportunities and are supported to enable them to maintain appropriate lifestyles both within and outside the home. Contact with friends and family is supported and encouraged. Personal support is provided that is appropriate to their needs and wishes. Their health care needs are comprehensively addressed. Residents areinvolved in choosing and preparing individual meals, which is good practice. They have been consulted about their final wishes, which promotes respect. Home provides a homely environment with adequate communal and individual space. It is furnished in a domestic style and the residents have spacious bedrooms, which they can personalise, and access to a range of communal areas. The home was clean to a high standard and well maintained. Systems are in place to address Health & Safety issues. What has improved since the last inspection? The statement of purpose and the service users guide has been reviewed to include all the information required in Schedule 1 of The Care Homes Regulations 2001. The kitchen and dining area has been refurbished and redecorated, which has made it clean and more homely. Documentation of records is being developed and is more through and has more information and detail. What the care home could do better: Staff induction training needs to be more formalised in line with Skills for Care induction training. Although the home is developing a quality control system, there still needs to be a formal approach to quality control and getting the views of the residents, family and other professionals. The home needs to be clear they are offering and giving the type and level of care the resident and care provider want and they are all working towards the same goals. The registered provider needs to look at how the organisation can develop and motivate the staff team. CARE HOME ADULTS 18-65 Jane`s House 89 Barrow Road Streatham London SW16 5BP Lead Inspector Lynne Field Key Unannounced Inspection 30th April & 1st May 2008 09:30 Jane`s House DS0000022736.V363828.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 Jane`s House DS0000022736.V363828.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. Jane`s House DS0000022736.V363828.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Jane`s House Address 89 Barrow Road Streatham London SW16 5BP 0208-677-6196 0208 677 4273 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) Jane’s House Limited Ms Chan Bisessar Care Home 5 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (5) of places Jane`s House DS0000022736.V363828.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care Home Only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: 2. Mental Disorder, excluding learning disability or dementia - Code MD The maximum number of service users who can be accommodated is: 5 31st May 2007 Date of last inspection Brief Description of the Service: Jane’s House provides long term care for people who have enduring mental health problems. There are currently three male residents, although the home has accommodated a mixed gender group since opening in 1990. The home is situated in a residential street off the main road leading to Streatham High Street, and is close to public transport routes, shopping and leisure facilities. It is a semi-detached house on four floors, and blends in well with other houses on the same street. The registered manager owns the property and also owns two other small homes nearby. The philosophy of care states: The home is flexible with care and support provided as required by anyone who has suffered with mental ill health. The registered provider said the current fees payable is in the range of £420.00p to £850.00 per week. There are additional charges made for toiletries, hairdressing newspapers and holidays. Jane`s House DS0000022736.V363828.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 stars. This means the people who use this service experience good quality outcomes. This unannounced inspection took place over parts of two days in April and May 2008. We were joined on the second day by the Contracts Monitoring Officer, who came to monitor the service the home is providing to a resident they fund to live there. There was a full discussion about the expectations of the contracts monitoring officer and resident and what the home was actually providing. This needs to be explored more fully at the residents review so all have a clear understanding and an agreement of the outcomes for the resident. The registered provider returned a standard form, the Annual Quality Assurance Assessment (AQAA), to CSCI and this was used as part of the inspection. We checked records of the care plans, staff records and building maintenance records. The registered provider and three members of staff were present over the two days of the site visit to the home. The registered provider has another small home with mental health needs in the same road and staff work in both homes as required. The records, policies and procedures follow the same format in both homes but are individualised for each home. A range of documents was examined and a tour of the building took place. There were four residents living at the home on the day of the inspection and the home has one vacancy. We spoke to three residents, who said and indicated they liked living at the home and were happy there. One resident showed us their bedroom and said they were happy with it. Staff were observed to be competent and caring. Staff interaction with residents was observed to be knowledgeable and was conducted in a respectful manner. What the service does well: The home is well run, and the registered manager provides clear leadership. Case files are held at the home in respect of each resident, which reflect their changing needs. Residents are encouraged, have opportunities and are supported to enable them to maintain appropriate lifestyles both within and outside the home. Contact with friends and family is supported and encouraged. Personal support is provided that is appropriate to their needs and wishes. Their health care needs are comprehensively addressed. Residents are Jane`s House DS0000022736.V363828.R01.S.doc Version 5.2 Page 6 involved in choosing and preparing individual meals, which is good practice. They have been consulted about their final wishes, which promotes respect. Home provides a homely environment with adequate communal and individual space. It is furnished in a domestic style and the residents have spacious bedrooms, which they can personalise, and access to a range of communal areas. The home was clean to a high standard and well maintained. Systems are in place to address Health & Safety issues. 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. The summary of this inspection report can be made available in other formats on request. Jane`s House DS0000022736.V363828.R01.S.doc Version 5.2 Page 7 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 Jane`s House DS0000022736.V363828.R01.S.doc Version 5.2 Page 8 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): 1,2,3,4 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The information in the Statement of Purpose and Resident Guide has been revised to include all details required under Schedule 1. Resident’s needs are assessed by the registered provider before they move to the home and know that staff have decided that the home can meet their needs before they move there. Prospective residents and their relatives can come and look around the home and meet staff and have over night stays before they decide to move there. EVIDENCE: We looked at the statement of purpose and residents’ guide and discussed this with the registered provider who came to the home on both days of the inspection. The home has up dated its statement of purpose and the service user guide since the last inspection in May 2007. The home has had one new admission since the last inspection and the home followed the policy and procedures of making a full assessment of a resident’s needs prior to admission. They received assessments from the multiJane`s House DS0000022736.V363828.R01.S.doc Version 5.2 Page 9 disciplinary team involved with the new resident and the home completed a form of their own assessment that we saw in the residents’ file. All the residents at the home had a contract of terms and conditions in their file. We discussed the admission policy with the provider who said this includes obtaining a full assessment from prospective resident’s social workers as well as completing their own assessment. Prospective residents are able to visit the home prior to any admission and the registered provider to ensure the home could meet their needs would assess them. The registered provider said prospective residents are encouraged to visit the home prior to admission to see if it was suitable for them and bring relatives and friends. It they thought they would like to live in the home they would come for a tea visit, then for a meal, building up to an over night or weekend stay. They would be given the statement of purpose and the service user guide to help them decide if the home would meet their needs. The home would use the visits to assess the prospective residents to ensure they could meet the resident’s needs. We were told the six week review was booked for June 2008 to look at how the placement was progressing. This resident has no family but his advocate / friend will attend. We met the new resident on the first day of the inspection but he was reluctant to speak to us as he said he was not well that day. Jane`s House DS0000022736.V363828.R01.S.doc Version 5.2 Page 10 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): 6,7,8,9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents have individual care plans and are involved in making decisions about their lives. The residents, relevant care professionals and their family (where appropriate) are involved in the planning and the reviewing of the care. Risk assessments are in place, and records are kept securely in the home. EVIDENCE: We looked at two residents personal files, including the one of the new resident. Case files seen contained daily records, monthly evaluations, care plans and minutes of review meetings. These provided evidence that residents’ needs are assessed and kept under review. Each resident’s file had sections for any identified needs, the objectives and actions required to meet any identified needs. They are evaluated after six months. The new resident has a review planned for six weeks from the date they moved to the home and we were told all professionals and their advocate would attend the review. Jane`s House DS0000022736.V363828.R01.S.doc Version 5.2 Page 11 The care plan format has been reviewed to include more information about resident’s needs and how they wanted their needs to be met. The registered provider said the key worker goes through the daily records and other information and this will be used to draw up a new care plan. The cares plans viewed by us had the signatures of the resident and the registered provider. There were risk assessments in place and there was information around issues to do with behavioural issues. There was information about triggers and warning signs around deterioration in residents’ mental health along with information on actions to be taken. The registered provider said that they review these once a year or more often if the need arises. The home has discussions with the residents’ care manager and psychiatrist about the category of risk and each resident has a relapses and risk management plan. The risk could be self-harm, such as a history of taking over doses of medication. There are action plans for each risk identified and steps to be taken to minimise the risk. The registered provider is aware of residents’ needs regarding confidentially and is able to reassure residents that they will be informed of any actions taken with regard to the contact of other agencies and that their permission will be sought with regard to passing on information where this is appropriate. We met and spoke to all residents during the inspection. One resident came to see us and said they would like to speak to us. They told us about their life in the home. They said they could come and go as they pleased and attended a number of activities they enjoyed doing. They said they travel by bus to the day centre and then go on to see their mother. They talked about going out for the day and where they would like to go on holiday. The registered provider and the residents all confirmed that they could come and go freely as they wanted to and they had front door keys. They said they would tell the staff when they were going out and where to and what time they hoped to be back by. One resident said they are able to choose when to get up/go to bed, and reported that they are regularly consulted and involved in decision-making. We were shown the minutes of the residents meetings that are held every two to three months. At the last meeting they looked at samples of wallpaper and paint because the kitchen / dinning area was going to be decorated. Residents meetings are when holidays and outings are discussed and agreed. Jane`s House DS0000022736.V363828.R01.S.doc Version 5.2 Page 12 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): 11,12,13,14,15,16,17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents engage in appropriate, enjoyable and fulfilling activities and mix with the general community. Residents are actively encouraged to keep in touch with friends and family and develop appropriate friendships. Residents’ rights and responsibilities are respected but the home needs to consider how it can encourage the residents to develop more independent living skills. The registered provider needs to make sure the home is working in line with current thinking of the placing authority to ensure the residents and home are all working towards the same outcomes. EVIDENCE: Jane`s House DS0000022736.V363828.R01.S.doc Version 5.2 Page 13 During the inspection we met all the residents living in the home. One resident who is Indian said he likes listening to his Indian music and he goes to the Temple. The registered provider said they all enjoy each others culture and she had arranged an outing for two of the residents to a local venue that was putting on some Indian music. Like the providers other home, this home does not have a weekly activities programme because all activities are very much centred on individual resident’s wishes and choices. We were told there was a routine around some aspects of the home, i.e. residents had particular days when they do their washing with the support of staff if needed but they are sometimes very reluctant to do these chores. A member of the local authority contact monitoring team who was monitoring residents in both homes contacted us during the inspection. We met them for part of the visit. They shared their concerns with us and the registered provider about the residents lacking motivation to develop independent living skills. There was a discussion with the registered provider about the expectations of what the service was providing and what it was perhaps now being expected to provide. It has been some years since both residents moved to the home and care in the community for people with mental health issues has changed. We discussed how now the expectation now of purchasers of a service is that for most residents this would be a transient period of time spent in a residential home. The emphasis has moved to rehabilitation through developing and maximising the residents functioning potential to help them live more independent lives in the community. In our discussions it was acknowledged this would not be suitable for all residents but the home could do more to encourage them to develop daily living skills that could help them move on to independent living scheme if it was felt this is right for the residents. The three residents are very comfortably settled, having lived at the home for many years and it provides all they need. The registered provider needs to look at how staff can encourage residents to be motivated to develop more independent living skills. The issues and expectations of the placing authority, residents and home need to be fully discussed with each residents at a review of the service, so all are clear what outcomes they are working towards. One resident told us they visit their mother several times a week and sometimes stayed with her over the weekend. They keep in touch with their family who visit them and attend any social that the home arranges on special occasions. The resident who recently moved in does not have any family but has an advocate who keeps in touch and manages his financial affairs. The registered provider said staff try to encourage residents to keep in touch with family and friends and they are always invited to the social occasions, such as the BBQ they have in the summer and other events at Christmas and other cultural festivals the residents celebrate. Jane`s House DS0000022736.V363828.R01.S.doc Version 5.2 Page 14 The home does not have a menu and residents decide on the day what they want to eat and are encouraged to eat a healthy diet. The staff encourages residents to choose what they want to eat and help cook the meals. Staff said they had attended a course on Nutrition and Health at Croydon College, which they said has raised their awareness of healthy eating. On the first day of the inspection we arrived at lunchtime and met the residents going out to the other home owned by the registered provider to have their lunch. This was because the kitchen in their home was being refurbished. We went with them and found the registered provider had cooked a chicken curry with rice. One resident said the registered provider is a good cook and they always enjoyed her meals. The registered provider said “she wanted people to live like herself” and encouraged them to learn daily living skills but the residents were reluctant to cook for themselves. The four residents are from different cultures and enjoy trying the different foods from those cultures. We were told the new resident is reluctant to eat and the member of staff described how she tried to tempt him to eat by offering him food she knows he likes. When we asked the resident about his food he said he was not hungry. One resident told us he enjoyed the food at the home but did not want to cook for his own meals. One resident enjoys going for a walk but gets lost if he goes out on his own. To help promote his independence, he walks down the road to one of the other homes the registered provider owns. Staff phone the home to say he is on his way and watch him for a short distance and when he arrives the staff phone to say he has arrived. Jane`s House DS0000022736.V363828.R01.S.doc Version 5.2 Page 15 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): 18,19,20,21 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are supported in ways they prefer and their health and emotional needs are met. Residents are protected by the homes policies and procedures for dealing with medicines. Residents are consulted about their final wishes and the home is sensitive about how it does this. EVIDENCE: The residents’ files and care plans give information about residents’ health needs. Staff continue to support the residents to maintain their physical and emotional health. One resident has moved in recently and needs a lot of support and encouragement in his personal care. Two residents of the other three residents in the home are fairly independent with regard to personal care. Staff said they support residents with personal hygiene by Jane`s House DS0000022736.V363828.R01.S.doc Version 5.2 Page 16 encouragement rather than providing direct physical care and this is documented in their care plans. We looked at two files and saw residents are in contact with various health professionals including care coordinators, psychologists and social workers. The registered provider and staff said the residents were well supported by other professionals and could discuss problems or issues with them if they needed. This was confirmed by the records kept by the staff and registered provider as well as by the letters seen in the resident’s files. The home has gathered information around residents’ wishes and views regarding aging and death and this was seen on file. The home keep a running total for the amount of medication they have left for each resident to ensure that they have the correct amount and this corresponds to the medication signed for from the pharmacy. All medication coming into the home and medication that is not required is recorded in the medication book. Medication not needed is returned to the pharmacy for disposal and this is recorded in the book. One resident had recently seen their GP and one medication had been stopped and another had been increased. This had been recorded in the daily diary, in their file and on the medication chart. We checked the residents’ medication with the registered provider and it was found to be correct. The registered provider said she does a spot check of the medication once a week. It would be good practice if the spot checks on the medication could be recorded on the medication charts. Jane`s House DS0000022736.V363828.R01.S.doc Version 5.2 Page 17 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): 22,23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents said they were listened to, and had no complaints. The home has an appropriate complaints procedure and the home has a copy of the local authority adult protection guidelines. EVIDENCE: The home has a complaints procedure. There have been no recent complaints. The complaints book is on display in the hall for residents or visitors to look at or write in. The home has information on the protection of vulnerable adults. We saw a copy of the multi-agency procedure that the home obtained from the local authority. We spoke to the staff on duty and they said they would contact the registered provider if they were suspicious or were told of any abuse taking place. Staff said they had training in adult protection May 2006. The registered provider said the residents were encouraged to speak about any complaints they might have at residents meetings. Both residents told us they did not have any complaints but would speak to the registered provider or their key worker if they did. Two residents we spoke to told us if they were not happy with anything they would tell the registered provider or the staff. Jane`s House DS0000022736.V363828.R01.S.doc Version 5.2 Page 18 The home has a policy regarding the protection of the resident’s finances. As part of the inspection we checked the residents’ money files and they were in order. The registered provider told us that residents meetings are held every two to three months. They have three small homes, two in the same street so they have one residents meeting for the residents from all the homes. We saw copies of minutes of the meetings and noted that residents are encouraged to speak out about any concerns they may have. These covered a range of issues including meals, answering the phone and taking messages, planning activities, trips out, and the garden. One resident said he went to the meetings and felt able to say what he wanted. The member of staff we spoke to confirmed the resident’s have meetings that are held in the home. Jane`s House DS0000022736.V363828.R01.S.doc Version 5.2 Page 19 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): 24,25,28,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is bright and comfortable and the shared accommodation is furnished appropriately and well maintained. One resident’s bedroom was in a poor stated of decoration and repair. It was in need of urgent maintenance and redecoration. EVIDENCE: The home is situated in a Victorian house in a residential street. We were given a tour of the home. The communal sitting room with French doors leads to a conservatory that is used as a smoking room. The sitting room was redecorated before the last inspection in May 2007 and still looks fresh and homely. The kitchen leads into a spacious dining room that were in the process of being refurbished and the kitchen units replaced. The dining room, which is to the rear of the ground floor, leads into a pleasant and well-maintained garden. The home has had a new garden wall built at the back of the garden. Jane`s House DS0000022736.V363828.R01.S.doc Version 5.2 Page 20 One residents’ bedroom is on the ground floor and there is a separate toilet. Two residents have bedrooms on the first floor. On the half landing there a bathroom and WC and a separate WC. One resident said they had tidied their bedroom that day. They showed us their bedroom and said they were very happy with it. The bedroom was shabby and in need of redecoration. The carpet was very dirty and should be replaced. Rainwater was coming in around the top of window and the plaster on the ceiling was discoloured, blown and cracked. This could be making the room damp that could be a health hazard. On the first day of the inspection we met the new resident in their bedroom and their room looked very bare and sparse but they said they were happy with it. The residents’ key worker said they had only been at the home for a short time and they would help and encourage them to make the room more homely and personal. Another resident’s bedroom on the ground floor was clean and tidy and well decorated. The house has a cellar where there are laundry facilities. Tinned and dry food is stored in this area but away from the laundry area and this was generally well set out with items stored on shelving. Jane`s House DS0000022736.V363828.R01.S.doc Version 5.2 Page 21 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): 31,32,34,35,36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Appropriately trained staff meets the residents’ individual needs but need to be more motivated in helping residents develop their full potential. The recruitment procedures followed are safe, thorough and comply with legal requirements. It was not possible to inspect the homes induction procedures because there had been no new staff employed since the previous inspection. This will be checked at the next inspection. EVIDENCE: We looked at the staff rota and confirmed the number of staff on duty was correct. The home has one member of staff on duty during the day and one sleeping member of staff at night. Extra staff are asked to work to act as an escort or the registered provider will cover the home if a resident needs to be escorted to an activity or attend an appointment for some reason. The Jane`s House DS0000022736.V363828.R01.S.doc Version 5.2 Page 22 registered manager was included on the rotas inspected and he lives at the home. Two staff files were examined. These included copies of the application forms, two written references, a signed copy of their contract stating terms and conditions and identification. All files checked had CRB checks. The registered provider said they would not start a member of staff to work in the home unless they had been CRB checked. At the previous inspection we noticed several staff that have been employed by the home for a long period of time, had CRBS that were three or more years old. To keep them up to date the home has renewed these. All staff working at the home has qualified to level 2 NVQ or above. There were copies on the staff files of the certificates issued for the courses staff had attended. At the last inspection although there were copies of the induction training that was given, this was only about the home and health and safety issues and did not fully comply with “Skills for Care” level of induction. This was said to be needed to be addressed but because there have been no new staff since the last inspection so the home’s induction procedures could not be fully checked at this inspection and will be checked at the next inspection and this has been left as a requirement. The registered provider is very enthusiastic about encouraging staff to develop new ways of thinking and passes on any information and training she attends to staff. She had recently attended a seminar run by Well London about Mental Health and wellbeing and had spoken about this in staff meetings and at residents meetings. Six training course/lectures, such as Handling Aggression, Depression and Schizophrenia have been carried out to update knowledge and improve the skills of the staff. There is a long-standing staff group who know the residents well and they work across all the registered providers homes. This gives the residents consistent care. One care professional who responded to the survey we sent out before the inspection felt staff they had met sometimes lacked motivation and in turn this reflected in their motivation of the residents to achieve the skills they need in life. There could be a number of reasons for this and the registered provider needs to look at how the organisation can help staff become more motivated which in turn will benefit the residents by helping them to achieve their potential. There were copies of staff supervision records in the staff files we checked. The registered provider and the member of staff had signed these. We distributed copies of the staff survey to the staff at the inspection but none have been returned at the time of writing the report. Jane`s House DS0000022736.V363828.R01.S.doc Version 5.2 Page 23 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): 37,38,39,42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s benefit from a well run home and management is experienced in supporting people with mental health needs. Systems are in place to address Health & Safety issues. EVIDENCE: The registered manager demonstrated a clear understanding of the needs of the residents and her responsibilities in ensuring that the home met registration standards. Staff told us the registered provider was very supportive and was sympathetic if they had any personal problems and would help if she could. Residents said they felt they could talk to her and she would try to help. Feedback from professionals who responded to the survey said Jane`s House DS0000022736.V363828.R01.S.doc Version 5.2 Page 24 they found the “registered provider very knowledgeable and works hard to maintain the home” and “she actively seeks out activities / social forums which would benefit the residents”. The inspector observed throughout the inspection the interaction between staff and residents was warm and appropriate. The home has just developed quality assurance monitoring forms they are giving to Health Professionals and Care Managers. The home does not carry out surveys of relatives that visit the home but they have completed a number of self-monitoring reports and sent a copy to the CSCI office. The inspector saw copies of residents meetings and these were very informal but noted residents were able to speak about and make their views known about the menus, holidays and outings. The home had a policy on health and safety and the inspector viewed health & safety records held in the home. The registered provider confirmed that there were regular checks at the required intervals, by external contractors, for servicing the fire safety system, the boiler, central heating system and the emergency call system. Certification was in place regarding the Landlord’s Record of Gas Safety, Portable Electrical Appliance testing, and Certificate of Electrical Installation. Records showed that regular checks of the fire alarm call points were made and that fire drills were conducted. A fire risk assessment and floor plan was completed and is in place. Jane`s House DS0000022736.V363828.R01.S.doc Version 5.2 Page 25 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 3 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 3 23 3 ENVIRONMENT Standard No Score 24 3 25 2 26 X 27 X 28 3 29 X 30 3 STAFFING Standard No Score 31 3 32 3 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 x LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 3 3 3 X X 3 x Jane`s House DS0000022736.V363828.R01.S.doc Version 5.2 Page 26 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA35 Regulation 18 (1) (c) (i) Requirement The registered manager must ensure that all staff receives a full induction and foundation programme during the first six weeks and then six months of their employment. No new staff have been recruited so we were unable to check this requirement had been complied with and have carried it for to the next inspection. Timescale for action 31/10/08 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 YA11 Good Practice Recommendations The issues and expectations of the placing authority, residents and home need to be fully discussed with each residents at a review of the service, so all are clear what outcomes they are working towards. It would be good practice if the registered provider recorded on the medication chart when she does her spot checks. The registered provider should explore ways to help staff DS0000022736.V363828.R01.S.doc Version 5.2 Page 27 2 3 YA20 YA31 Jane`s House to be more proactive in motivating the residents. Jane`s House DS0000022736.V363828.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG 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 Jane`s House DS0000022736.V363828.R01.S.doc Version 5.2 Page 29 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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