Care Home: Jasper Lodge

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What the care home does well The service completes comprehensive assessments and transition plans for any person moving into the accommodation. The home provides staff with good induction training, which includes all basic statutory training and also training appropriate the role of the support worker and the needs of the service users. The service monitors and plans for health needs with good recording and the provision of Health Action Plans. There are good systems in place for the monitoring the service and for planning for improvements with regular regulation 26 inspections being completed and other systems of quality assurance being put into place. What has improved since the last inspection? As this is the first inspection of this service this is not applicable. What the care home could do better: The service needs to develop and establish the reviewing processes for care plans and risk assessments. The service needs to find effective methods for holding staff meetings. The storage of some cleaning materials needs to be risk assessed. CARE HOME ADULTS 18-65 Jasper Lodge Matson House Matson Lane Gloucester GL4 6ED Lead Inspector Mr Simon Massey Key Unannounced Inspection 24 & 25 September 2008 09:30 th th Jasper Lodge DS0000071548.V372069.R02.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 Jasper Lodge DS0000071548.V372069.R02.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. Jasper Lodge DS0000071548.V372069.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Jasper Lodge Address Matson House Matson Lane Gloucester GL4 6ED 01452 307069 01452 311742 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) Selwyn Care Limited Mr Richard Mark Fletcher Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Jasper Lodge DS0000071548.V372069.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service: Care home with personal care only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: 2. Learning disability (Code LD) The maximum number of service users who can be accommodated is 8. Date of last inspection Brief Description of the Service: 3.1 Jasper Lodge is five individual one bedroom two-storey apartments and one individual two-storey apartment for two people. There is a central office and staff room located within the same building but all the flats are self contained and are equipped to meet the needs of people living on their own with staff support. The home is located in spacious grounds, which also contain other services run by the Provider. The home is located in the Matson area and is approximately two miles form the centre of Gloucester. The current fee range is from £1500 to £2300 per week. 3.2 3.3 Jasper Lodge DS0000071548.V372069.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This Inspection took place over two days and the Inspector met with the Registered Manager, the Responsible Individual and also the newly appointed Manager who will be applying to be registered when the current manager returns to another position within the organisation. The Inspector also met a number of care staff and several of the service users. Records relating to care planning, health and safety, staff training and recruitment, medication and health care were examined. An inspection of the environment was also carried out. Some of the service users accommodation was not visited as they were occupied at the time of the visit and would have been disruptive to the people concerned. The provision of individual flats which are fully self contained is a particular feature of this service, as it provides care and support for some service users who have previously experienced difficulties in living in any sort of communal setting. What the service does well: What has improved since the last inspection? What they could do better: The service needs to develop and establish the reviewing processes for care plans and risk assessments. The service needs to find effective methods for holding staff meetings. The storage of some cleaning materials needs to be risk assessed. Jasper Lodge DS0000071548.V372069.R02.S.doc Version 5.2 Page 6 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. Jasper Lodge DS0000071548.V372069.R02.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 Jasper Lodge DS0000071548.V372069.R02.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): Standard 2 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. A thorough approach to admissions means that people moving into the home can be confident that their needs will be appropriately assessed and met. The Statement of Purpose provides accurate and accessible information to service users and prospective admissions to the home. EVIDENCE: The service is currently fully occupied and number of assessments were examined that had been completed prior to admission. These were comprehensive and showed that efforts had been made to identify particular needs and how these could be met. Where appropriate people had been offered overnight stays and visits. Feedback from relatives was very positive about the admission process. Service users have also had transition plans completed prior to admission, which provided guidance and information for staff and managers. The service has visited previous placements, including schools, to gain information to better inform their practice. Some service users had moved from accommodation run by the same Provider and staff explained how they had supported the transition to the new setting and how this had so far been a positive experience for the service users who had moved. Several staff had also moved to work in the new setting and this has been beneficial in terms of continuity and consistency. Jasper Lodge DS0000071548.V372069.R02.S.doc Version 5.2 Page 9 This is a new service that has been registered for six months and has an up to date Statement of Purpose and Service User Guide that provides all the required information. Jasper Lodge DS0000071548.V372069.R02.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): Standards 6,7& 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Detailed care plans ensure that the service user’s needs are documented and guidance is available to staff. The home takes action to encourage service users to make choices and supports them to take appropriate risks. EVIDENCE: All service users have detailed care plans in place, some of which came with them, and some that have been developed by the staff team. As the service has only been in operation for six months the methods and processes for reviewing and updating are still being developed but staff were able to demonstrate a good understanding of these plans and also the person centred approach which underpins them. There was evidence of good regular recording being completed and good details being recorded of antecedent behaviours and outcomes. Care plans provide clear guidance to staff on how to manage certain issues and behaviours and also on how personal care and support should be delivered. Some documents were unsigned and not dated and as the service develops this needs to be addressed. Currently all risk assessments are up to date. Jasper Lodge DS0000071548.V372069.R02.S.doc Version 5.2 Page 11 Plans contain pen pictures, communication details, detail of any challenging behaviours and also some have a “tactile protocol”. This provides guidance to staff on how individual people respond to touch. The service makes good use of symbols and pictures to improve communication and encourage service users to make choices about their lives. Any limitations or restrictions in place are correctly recorded and documented. Staff and managers explained that now the staff team was reasonably settled and the transition completed for the service users, one area that they would be concentrating on was the process and procedure for updating and reviewing the individual care plans. Individual risk assessments contain information about accessing the community, awareness of dangers, clothing issues and also staffing levels required to provide support whilst in the community. Jasper Lodge DS0000071548.V372069.R02.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): Standards 12,13,15,16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are supported to pursue their interests and hobbies, and are able to access the local community with support. Service users benefit from the positive relations that have been developed between relatives and the home. Service users are encouraged to eat healthily but their right to choose their diet is respected by the staff team. EVIDENCE: All service users have individual routines they follow on a daily and weekly basis. Some plans show more variety than others but interviews with staff demonstrated how this is an ongoing task for support staff. Service users were observed leaving to undertake activities in the community and also in the day centre that is run by the Provider. People were also being supported to undertake some domestic chores and tasks. As the reviewing and monitoring of the care plans develops it is intended that new opportunities will be identified for people. However a feature of the service is the self contained accommodation which particularly meets the needs of people who can have Jasper Lodge DS0000071548.V372069.R02.S.doc Version 5.2 Page 13 difficulties living communally, and this will obviously also impact upon the range of activities that can be supported in group or busy settings. Staff spoken with appeared to be pro-active and imaginative in accessing community based outings and activities that would benefit service users and also realistic about the limitations that some behaviours can place on individuals. The individual flats are equipped to meet personal interests and hobbies if required and service users are supported to follow these, with staff support if necessary. Staff who have moved to the new home after working previously with the service users commented upon the improvements the new setting has made for some service users in terms of their challenging behaviours, and also being generally more settled and relaxed whilst in their own self-contained flats. All the flats have their own kitchens and all were well stocked with fresh and packaged food. All service users have their own menus that, if they are able, they have helped to draw up. Records show that healthy diets are encouraged but that choice is respected. Service users help with food planning and cooking depending on their interest and their individual abilities. Any restrictions on access to any of the kitchens are clearly recorded and the reasons stated. Service users can have visitors or relatives to stay overnight if they choose, with accommodation being provided in their living rooms. Jasper Lodge DS0000071548.V372069.R02.S.doc Version 5.2 Page 14 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): Standards 18,19 & 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People’s personal and healthcare needs are met, promoting their dignity and wellbeing. Satisfactory arrangements are in place for the handling of medication, promoting service users’ wellbeing and, where appropriate, their independence. EVIDENCE: All the care plans contain information about the personal care that is required and how this should be delivered. This information is based upon the needs of the individual concerned and the knowledge the team have of their particular issues or behaviours. Detailed records are being kept of all health appointments and any actions that are required as a result of these visits. All service users have Health Action Plans in place, which provide guidance and information, and is evidence of good person centred planning. All service users also have a booklet completed which is titled their “Life Plan”, which contains person centred information and guidance for staff. Service users are supported to access the specialist services of the local Community Learning Disabilities Team if required. Jasper Lodge DS0000071548.V372069.R02.S.doc Version 5.2 Page 15 An examination of the medication administration and storage was undertaken and found to be in order. All staff must complete training before they are assessed as being competent to perform this task. Two service users are supported to self medicate and one service spoken to was very positive about this arrangement. Jasper Lodge DS0000071548.V372069.R02.S.doc Version 5.2 Page 16 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): Standards 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has satisfactory arrangements and procedures in place for the protection of service users. Arrangements and help are in place to enable as far as possible people using the service to raise concerns and complaints. EVIDENCE: There is complaints policy in place and action has been taken by the home to ensure that all relatives and people involved with the service are aware of this and how to access it. Training around communication and the use of various visual aids help the staff to seek the views of the service users, and also encourage people to make decisions about their daily lives. It would be difficult for most of the service users to make a complaint without support or intervention from the staff, but people are further protected by the close involvement of many of the families in the lives of the service users. Service user’s care plans contain guidance for staff on how to manage challenging behaviours and all staff must complete training in this area during their induction. Updates must also be completed. The service has a Training Manager, who has responsibility for monitoring training and organising refreshers and updates. Systems are in place for the recording of any incidents that may occur and also the recording of any injuries can be documented on charts in the personal files. Jasper Lodge DS0000071548.V372069.R02.S.doc Version 5.2 Page 17 Staff have received training in Adult Protection issues and in interview staff were able to demonstrate an understanding of the various issues. Jasper Lodge DS0000071548.V372069.R02.S.doc Version 5.2 Page 18 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): Standards 24 & 30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home provides an environment that is appropriate to the needs of the service users and is decorated and maintained to a high standard. Service users are supported and encouraged to personalise their living space according to personal taste and needs. EVIDENCE: The home has been completely renovated and decorated prior to opening and all the accommodation has been finished to a high standard. The individual flats are well equipped, spacious and homely and service users appeared very positive about their accommodation. The flats are furnished according to particular needs and any reasons for particular arrangements are recorded in the personal files. All the accommodation seen was clean and hygienic at the time of the visit. Jasper Lodge DS0000071548.V372069.R02.S.doc Version 5.2 Page 19 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): Standards 32, 34 & 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from motivated staff that have a positive approach to their care and support. Staff receive training appropriate to the needs that are to be met, which encourages and supports them to develop the required skills. EVIDENCE: Staff complete handover sheets at completion of shifts and these support the promotion of good communication and teamwork. Staff spoken with said they thought they worked well as a team but there were some difficulties in organising staff meetings due to the high level of one to one care that was always in place. There have been two meetings since the home opened. Staff appeared motivated to promote choice and the development of the individual care and support that is being provided. Staff were positive about the training and induction, which they said had been very thorough and professionally delivered. Staff said they felt well prepared before working on their own and that there were good levels of support available, both from within the team and also from the Group Manager. New staff were positive about the induction process and support they received during their initial stage of employment. Jasper Lodge DS0000071548.V372069.R02.S.doc Version 5.2 Page 20 The records relating to staff recruitment were examined and found to be in order. Information relating to the most recently recruited staff was seen and contained all the required information and showed that all necessary checks had been completed. The service has a full time Training Manager and all staff were up to date with the required training and it is clear that this is closely monitored. Additional training is provided, such as autism awareness and communication training. After their six-month probation period all staff are expected to undertake NVQ training. The Provider has stopped using the accredited training it was accessing in respect of managing challenging behaviours and has now started delivering its own, as yet unaccredited training, titled “Understanding the Severn Senses.” This training does not incorporate any physical intervention techniques, though it was explained that there are staff in the service that can deliver this, if required. The training does teach breakaway and make safe techniques and there have been occasions when this has been required. Appropriate staffing levels are maintained and the rotas supported showed that all the required one to one working arrangements were in place at the time of this inspection. Staff confirmed that shortages were rare and that agency staff are only used when alternatives are not available. Jasper Lodge DS0000071548.V372069.R02.S.doc Version 5.2 Page 21 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): Standards37, 39 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from a home that is well managed and organised and committed to providing quality care and support. Systems are in place that help to monitor and improve the quality of the service. EVIDENCE: The home has a Registered Manager who was seconded from another service run by the same Provider and they will shortly be returning to this post. A new manager has been appointed and had in fact started their employment just prior to this inspection visit. The service has been thoroughly and professionally set up with input from the Group Manager, and other staff working for the Provider. This has been beneficial to the service users who have moved into the accommodation from the other services run by the Provider. Jasper Lodge DS0000071548.V372069.R02.S.doc Version 5.2 Page 22 Staff were positive about the leadership and direction they are provided with and were clear about the objectives of the service and the individual care packages that are being provided. The home is well run and organised with managers and staff aware of the areas they wish to develop and improve. There is a structure in place for senior staff to support new and inexperienced staff and promote team working. This is an area that is still being developed as the majority of the work is done in a lone working situation, as service users receive their individual care and support in their own accommodation. The Deputy Manager has been supervising staff formally and the Manager has had responsibility for completing annual appraisals on staff. The Personnel Manager also undertakes some supervision responsibilities for staff during their probation period of employment. Regulation 26 visits have been undertaken by managers from within the service, and this has produced action points, which have been followed up. The Manager was clear about objectives and tasks that have been identified from these visits. The Manager is supervised by the Group Manager and has an improvement and development plan that is monitored during their supervisions. The Manager said he felt well supported in his role. It was observed during the Inspection that the communal area outside the office was used by staff to write notes and reports and confidential material was left on the table. This paperwork should be stored securely and once written work is completed it should be returned to its correct location. Records are kept of health and safety checks and all fire testing and safety checks were completed and up to date. In some of the individual kitchens there were some products being stored under the sink cupboards that may be potentially harmful. These need to be risk assessed and located in a more secure area if required. Jasper Lodge DS0000071548.V372069.R02.S.doc Version 5.2 Page 23 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 x 2 4 3 X 4 X 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 4 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 x 32 3 33 X 34 3 35 4 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 x LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 X 3 X X 3 x Jasper Lodge DS0000071548.V372069.R02.S.doc Version 5.2 Page 24 no Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 2 Standard YA41 YA42 Regulation 17(1)(b) 13(4)(a) Requirement The home must ensure that all confidential records are correctly and securely stored. The home must risk assess the storage of cleaning materials in the kitchen cupboards Timescale for action 30/11/08 30/11/08 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 YA33 Good Practice Recommendations The home should ensure that regular staff meetings are organised and supported Jasper Lodge DS0000071548.V372069.R02.S.doc Version 5.2 Page 25 Commission for Social Care Inspection South West Colston 33 33 Colston Avenue Bristol BS1 4UA 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 Jasper Lodge DS0000071548.V372069.R02.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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