Care Home: Jasmin Court Nursing Home

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What the care home does well People who may wish to use the service are able to access the information needed to make an informed decision about the home. The health and personal care that people receive is based on their individual needs. The staff respect the dignity and privacy of the people who live at the home. The people who live at Jasmin Court are able to make choices about their lifestyle, and receive support from the staff to maintain and improve their life skills. People who use the service are able to express their concerns and they have access to a complaints procedure. The people using the service and the staff working at the home are protected from abuse and their rights are protected by the management style and the systems in place. The physical design and layout of the home enables people who use the service to live in a safe, clean and comfortable environment, which encourages independence. The garden to the rear is private with comfortable seating and flower beds which helps the people to relax and enjoy the surrounding. The staff working at the home are trained, skilled and are employed in sufficient numbers so that they are able to support the people who live at Jasmin Court and contribute to the smooth running of the service. The management and administration of the home is based on openness and respect to those who use the service and those who work at the home. The management have developed an effective quality assurance system and the staff are encouraged to use the tools and monitor the service. What has improved since the last inspection? The frequency of staff supervision has improved. The garden area to the rear has been developed to encourage people to relax in and enjoy the surroundings. The daily care progress records have improved and they reflect the actual care given to the people. This information helps staff monitor progress made by the service users in their care. What the care home could do better: The staff and the management of the home need to continue their commitment to deliver good quality care to the people who live at Jasmin Court. Arrangements for social, cultural and recreational activities need to reflect the expectations of the people living at the home to alleviate boredom. The nurses need to take every effort to help service users manage their medication as part of their rehabilitation program . Key inspection report Care homes for older people Name: Address: Jasmin Court Nursing Home 40 Roe Lane Pitsmoor Sheffield S3 9AG     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Marina Warwicker     Date: 1 7 0 6 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. that people have said are important to them: They reflect the things 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. Care Homes for Older People Page 2 of 27 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Jasmin Court Nursing Home 40 Roe Lane Pitsmoor Sheffield S3 9AG 01142781595 01142787257 jasmincourt@fsmail.net Notavailable Sage Care Homes (Management) Ltd Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mr Christopher John Engel Type of registration: Number of places registered: care home 50 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: 3 of the 50 beds are registered for old age (OP) OR physical disability (PD) for people aged 50 years or over. Date of last inspection Brief description of the care home Jasmin Court is a purpose built nursing home situated within the community of Pitsmoor, Sheffield. It offers such amenities as local shops, public houses, schools and a church. The people from Pitsmoor have easy access to the city centre by public transport. The staff at the home together with the Sheffield teaching hospital physiotherapy and occupational therapy provide rehabilitation - step down service - to service users who are transferred from hospital prior to being discharged into the community. Care Homes for Older People Page 4 of 27 0 Over 65 50 Brief description of the care home The staff philosophy is to enable the service users to realise their own aims and help them achieve goals in all aspects of daily living. The current scale of charges is from 327 GBP to 480 GBP per week. Additional charges are made for hairdressing, chiropody, dry cleaning, toiletries and newspaper. Care Homes for Older People Page 5 of 27 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: three star excellent 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: We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. The last key unannounced inspection was on 25th June 2007. The quality rating for this service is 3 star. This means that the people who use this service experience excellent quality outcomes. An inspection of this care home was carried out on Tuesday 19th June 2009 between 9am and 4pm. The staff, the management, the people using the service or the visitors were not informed of our visit and therefore it was unexpected. Care Homes for Older People Page 6 of 27 Ten people who use the service and four visitors were consulted on the day. We also spoke with eight staff that were on duty. A further 15 people using the service, 10 staff and four professionals who came into contact with the people were contacted by post and telephone to obtain their views on the service. Comments received from the surveys have been included in the body of the report. Time was also spent observing and chatting with staff and the people using the service. The registered manager was on duty at the time of our visit. We informed him of our findings throughout the day, which helped both parties to verify and start taking action if and when it was required. The premise was inspected, which included bedrooms of people using the service and communal areas. Private areas i.e. bedrooms, were accessed with the permission of the people and/or the staff at the home so that we respected the peoples wishes. Samples of records such as the care plans, staff recruitment and training files were checked. We would like to thank the people who live at Jasmin Court, their relatives, the staff who took part and the management for their contribution toward this process. Care Homes for Older People Page 7 of 27 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 on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 8 of 27 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 9 of 27 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who may wish to use the service are able to access the information they need to make an informed decision about the home. Evidence: We spoke to three visitors and two staff to find out the process for admitting people into the home. We also checked two recently admitted peoples needs assessments, which had been completed by the placing authorities. The following were our findings. The new admissions were referred to the home with a multidisciplinary team assessment from the hospital. The staff said that the manager or one of the senior nurses visited the people at the hospital if they were able to. Usually the admissions were hospital referrals and the staff got to know the service user only at the point of admission. Two relatives said that people had come to live at Jasmin Court through recommendations from relatives. We ascertained that the majority of people using the Care Homes for Older People Page 10 of 27 Evidence: service on a permanent basis had come to the home for rehabilitation and returned for long term care since they liked the care. The care staff said that individuals took a different length of time to settle in and some were happy to return to the home since they had good experience when they received rehabilitation. We observed the residents to be contented and comfortable. Care Homes for Older People Page 11 of 27 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and personal care that people receive is based on their individual needs. The principles of respect, dignity and privacy are put into practice by the staff and monitored by the management of the home. Evidence: We observed the residents during our visit, checked four care plans, consulted with one visiting professional and interviewed five staff on duty. The care plans had been prepared from the individual assessments. There were several examples where the care plans had been changed to reflect the changing needs of the people. During interviews the staff said that they tried to develop a good rapport and gain the trust of the residents so that they were able to settle into the home. They also said that they kept close and regular contact with the relatives which helped people get familiar with the staff. These were some of the comments from the staff, We are mindful of the anxiety relatives must go through when they leave their loved ones with us. We keep them informed of any changes and maintain a friendly relationship. It takes time to get to know the people and their families it must be similar for the residents. We work toward developing a mutual trust. One professional said, I observe what goes on Care Homes for Older People Page 12 of 27 Evidence: here when I visit. The staff are very kind and hard working. I see them spending time with the residents. During the tour of the premise we noticed a few residents remaining in their bedrooms. We were informed by the manager, either the service users were too ill or people chose to stay in their rooms. We spoke to three people who were in their bedrooms and they confirmed that it was their choice. The staff told us that none of the residents had pressure sores. We witnessed residents who were prone to developing pressure sores being turned regularly and records maintained by the care staff. Those residents we chatted with were clean and smartly dressed. Some of the residents were seen sitting in the lounge, listening to music, watching TV or chatting to staff/visitors. We noted a sense of calmness within the home. The residents were offered drinks and snacks during the day by care staff. Some residents were encouraged by the care staff to drink plenty. We observed a nurse administering medication to residents in one of the units. We noted before moving on to the next resident s/he made sure the person had taken the medicine. The supplying pharmacist had carried out medication audits and had made some positive comments. The manager said that if recommendation were made they were actioned by the nurses without delay. The nurses said that the disposal of medication was contracted out and it was collected regularly from the home. We received comments with regards to people at the home not being encouraged to self medicate by the nurses. We spoke to three service users who were receiving rehabilitation whether they would like to manage their medicines. They were reluctant and preferred not to. We discussed the comments with the manager. The general practitioner visited the home twice a week and saw people who needed medical attention. During these visits reviews of medication also took place. We sought comments from the general practitioner. She was happy with the care the people received and the commitment shown by staff. She said that the visits helped her maintain contact with the residents and review their medical management. Four residents and two relatives said that the staff were prompt in attending when Care Homes for Older People Page 13 of 27 Evidence: they rang for help. One person said, If the staff are late it is because they cant always leave what they are doing. I know that. We observed staff discreetly toileting service users before meals. The care staff said that they had support and training on end of life care of residents and also how to take care of the relatives. The care staff said, I make sure they are treated just like all the other residents. We keep them clean and comfortable and the family are kept informed. We stay with them if the family are not around. Sometimes it could be difficult when we are busy. We are a good team and we always help each other if that happened. Two relatives made the following comments. I cant tell you how much the staff here, have helped my X. They need a medal for the way they have supported my X. They are all angels. I have visited different homes; but at Jasmin Court everyone including the manager support residents and are friendly when we visit the home. All the staff know us and they are so professional nothing is too much for them. They are always happy to go that extra mile. I will give them nine and a half out of ten for the service they provide. Care Homes for Older People Page 14 of 27 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. People who live in Jasmin Court are able to make choices about their lifestyle, and are supported to maintain and improve their life skills. Arrangements for social, cultural and recreational activities need to reflect the expectations of the people living at the home to alleviate boredom. Evidence: On the day of our visit the residents said that the activities person Y worked part time and that they enjoyed having time with her. This was some of the feedback we received. I like going out. I am not keen on the games and activities they do. Can you do any thing about it? I like it when Y is around. She is very good and spends time with me. She does craft work with me. I know carers are too busy they dont have time to chat wish they could. Care Homes for Older People Page 15 of 27 Evidence: We used to be able to use our mini bus to go out. But it has disappeared. This home is tucked away and its difficult to get out about. I need help with walking, thats a nuisance. I like going out and my family take me out when they can. It is difficult for staff to take me out. We saw relatives visiting during the day. They were made welcome by the staff at the home. The visitors told us that they could speak to the residents in private in their individual bedrooms. The relatives were very positive about the staff and the manager and praised them for their support and care. We saw lunch being served to residents and we had lunch at the home. Meals were brought to the dining area by the kitchen staff. They served the meals but the care staff took the meals up to the residents and gave them assistance. One of the care staff took the meals to those who were in their bedrooms in a trolley. The staff working on each floor made sure that people received help during their mealtimes. The food was hot and well presented. A hot sweet was an option. Yogurts and fruits were made available to all. The residents said that they enjoyed their meals and that the food was nice. Three visitors confirmed that the meals served at the home were varied and the puddings were lovely. Food supplements were given to those who were unable to have a wholesome diet. Care Homes for Older People Page 16 of 27 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. People who use the service are able to express their concerns and have access to a complaints procedure. The people using the service and the staff working at the home are protected from abuse and their rights are protected by the management style and the systems in place. Evidence: We checked the complaints records; we spoke with the visitors and the staff to find out how the management handled formal complaints. The complaints had been investigated and reports had been prepared with action points to make improvements when the issues raised had been upheld. We were informed by the staff when concerns were raised by the relatives, they try to correct the issues immediately if possible and let the nurse or the manager know of the complaint. Three relatives were asked for their comments. They said that the manager was around most of the time and the open door policy to the office helped them discuss any problems before they got out of context. Four staff training records were checked and there was evidence that the staff had received training on Protection Of Vulnerable Adults. The staff were able to tell us what actions they would take if they were to witness any type of abuse at the home. These were some comments from the people using the service. We are well looked after and the staff are respectful and caring. Care Homes for Older People Page 17 of 27 Evidence: My family takes care of my finances. They give the administrator some spending money which I can get anytime I want. I understand what abuse is. Here the nurses and the care staff look after us so well. I dont think I in am any danger. I will inform the manager or the nurse if I feel that people are mistreating me in any way. Care Homes for Older People Page 18 of 27 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 physical design and layout of the home enables people who use the service to live in a safe, clean and comfortable environment, which encourages independence. Evidence: We measured this outcome area by speaking to the residents, the visitors and the staff. We also took onboard what the people said and also using our observations on the day. The outdoor area was tidy and kept safe allowing access for the people using the service. A programme of routine maintenance and renewal was in place. We made the following observations. When we entered the home at around 09.30 am the care staff were busy delivering personal care and the domestic workers were busy cleaning the communal areas. During the tour of the premise later that day we found the home clean and tidy. Bedrooms were kept personalised and tidy. The rooms were centrally heated and had natural lighting. The staff said that they had sufficient aids, hoists and equipment to use when they moved and handled the people. Laundry facilities were sited away from the food preparation area. The laundry assistant was on duty during our visit. S/he explained to us the system in place for Care Homes for Older People Page 19 of 27 Evidence: laundering residents clothes and relacing them in their bedrooms. Care Homes for Older People Page 20 of 27 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The staff working at the home are trained, skilled and employed in sufficient numbers so that they are able to support the people who live at Jasmin Court and contribute to the smooth running of the service. Evidence: The staff rotas were completed in advance and the manager said that they took every effort to cover sickness with their regular staff so that continuity could be maintained. Domiciliary staff were employed in sufficient numbers to deal with cleaning cooking and house keeping. Generally staff were happy with the support they received from the management. The care staff were given the opportunity to take part in (NVQ Level2) National Vocational Qualifications in care and this had been taken up by most care workers. We checked four staff training records and spoke to two staff about the training they receive at the home. The records we checked were up to date. These were some of the comments from the staff. I have attended mandatory training here. The nurses let us know when we need to go on study days. They are good at putting us down for training. I have been on several sessions. The manager is good at helping us develop. He is fair and gives everybody Care Homes for Older People Page 21 of 27 Evidence: opportunities. Care Homes for Older People Page 22 of 27 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. The management and administration of the home is based on openness and respect to those who use the service and those who work at the home. The management have developed effective quality assurance systems and the staff are encouraged to use the tools and monitor the service. Evidence: The manager is an experienced first level nurse. He is registered with the Care Quality Commission CQC. The senior staff were familiar with the disease and conditions associated with old age. We noticed that there was a clear line of accountability within the home. The staff were able to access expert advice with regard to rehabilitation from the therapist( i.e. physiotherapy, occupational therapy) who visit the home regularly. Two care staff and a nurse told us that they received regular supervisions and support from their line managers and that they found this very useful. During the record checks there was evidence of staff supervision. Care Homes for Older People Page 23 of 27 Evidence: The manager had records of all accidents, injuries and incidents and these events have been notified to the Care Quality Commission. The staff training records showed that there was a rolling programme of training on health & safety, moving & handling, fire safety, food hygiene and Infection control. The manager confirmed that all service certificates (such as lift checks, electrical circuit, portable appliance checks etc.) were up to date and that regular maintenance checks had been carried through. Two recently employed staff confirmed that they had induction training and worked alongside experienced staff before they were allowed to work on their own. Care Homes for Older People Page 24 of 27 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 25 of 27 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 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 9 The nurses should make every effort to encourage people living at the home take responsibility for their medication and introduce systems to test out the individuals capability. All service users should be given opportunities for stimulation. The peoples expectation and preferences should be taken into account when organising activities. 2 12 Care Homes for Older People Page 26 of 27 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.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 © (2009) Care Quality Commission (CQC). 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. 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