Care Home: Jerome House

What the care home does well Information is given to each resident in the form of a pack that includes their daily plan of care, the statement of purpose, a care plan summary, an activities profile, information about their medication and general information about the local community. The current residents are African, South American and African Caribbean men and the staff team reflects the gender and culture of the residents. The food prepared in the home meets the dietary, religious and cultural needs of residents. Residents have access to activities and classes arranged by the African Caribbean Resource Centre. A care manager that completed a survey form confirmed that the home met the cultural needs of their client. A care manager said during a review meeting that the client had benefited so much from being in Jerome House. What has improved since the last inspection? The statutory requirements identified during the previous inspection in September 2007 have been met. The rotas are now more informative and show what hours the manger is working on site so that members of staff are quickly able to seek advice and support when needed. The recruitment process has been strengthened and the manager now ensures that members of staff do not start working in the home unless a pova first check has been carried out, pending the return of a satisfactory enhanced CRB disclosure. References now include a reference from an applicant`s most recent employer. These measures help to prevent unsuitable people working in the home. Members of staff now have access to accredited medication training to ensure that they have the depth of knowledge necessary to support residents. During this inspection the manager gave examples of how feedback arising from the quality assurance systems in place, including comments from residents, has been used to make improvements in the service. Some refurbishment has taken place in the home to maintain a comfortable environment for residents. What the care home could do better: Some refurbishment is needed in the home to maintain a pleasant environment for residents. A review of the content of the induction programme is needed to ensure that it equips carers with all the knowledge needed to begin working in the home. At the end of the induction training package the carer needs an opportunity to confirm whether there are still any gaps in their knowledge and understanding. CARE HOME ADULTS 18-65 Jerome House 71 Randall Avenue Neasden London NW2 7SS Lead Inspector Julie Schofield Key Unannounced Inspection 19th August 2008 11:55 Jerome House DS0000017485.V367065.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 Jerome House DS0000017485.V367065.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. Jerome House DS0000017485.V367065.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Jerome House Address 71 Randall Avenue Neasden London NW2 7SS 020 8450 8544 020 8452 8544 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) Mrs Lucille Rabor Mrs Lucille Rabor Care Home 4 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (4) of places Jerome House DS0000017485.V367065.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 - MD The maximum number of service users who can be accommodated is: 4 3rd September 2007 Date of last inspection Brief Description of the Service: Jerome House is situated within walking distance of the shops at Neasden. Randall Avenue is close to a bus route and there is access at one end of Randall Avenue to the North Circular Road. The nearest underground station is Neasden. It is a large semi-detached house with a small area at the front of the house and a garden at the rear of the property. The house has a driveway providing on site parking. There is also parking space available on the street outside the house. The home is registered for 4 adults with mental health problems and there are bedrooms on both the ground, first and second floor with bathing and toilet facilities on all floors. Communal space is situated on the ground floor and consists of an open plan lounge and dining area, which leads to a small, indoor smoking area. There is an office on the first floor. At the time of the inspection there were no vacancies. The registered manager of Jerome House is also the registered manager of Randall House, which is another care home owned by the company. Both of the care homes are situated in Randall Avenue and they are very close to each other. Details of the fees charged may be obtained, on request, from the manager of the home. Fees are calculated according to the individual needs of the resident. Jerome House DS0000017485.V367065.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 a 2 star. This means the people who use this service experience good quality outcomes. The inspection took place on a Tuesday in August. The visit started at 11.55 am and finished at 5.40 pm. During the inspection we spoke with the registered manager, the general manager and with members of staff. We also met and spoke with each of the residents. We would like to thank everyone for their assistance and for their comments during the inspection. We saw the evening meal being prepared. Records were examined and the care of residents was case tracked, a tour of the building took place and compliance with the statutory requirements identified during the previous key inspection in September 2007 was checked. We sent survey forms to residents, members of staff, health care professionals and stakeholders and at the time of writing the report we had received replies from 4 residents, 1 care manager and 3 members of staff. Prior to the inspection we received the Annual Quality Assurance Assessment (AQAA) that had been completed by the home and the information contained in the AQAA was used to inform the inspection. What the service does well: Information is given to each resident in the form of a pack that includes their daily plan of care, the statement of purpose, a care plan summary, an activities profile, information about their medication and general information about the local community. The current residents are African, South American and African Caribbean men and the staff team reflects the gender and culture of the residents. The food prepared in the home meets the dietary, religious and cultural needs of residents. Residents have access to activities and classes arranged by the African Caribbean Resource Centre. A care manager that completed a survey form confirmed that the home met the cultural needs of their client. A care manager said during a review meeting that the client had benefited so much from being in Jerome House. Jerome House DS0000017485.V367065.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Some refurbishment is needed in the home to maintain a pleasant environment for residents. A review of the content of the induction programme is needed to ensure that it equips carers with all the knowledge needed to begin working in the home. At the end of the induction training package the carer needs an opportunity to confirm whether there are still any gaps in their knowledge and understanding. Jerome House DS0000017485.V367065.R01.S.doc Version 5.2 Page 7 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. Jerome House DS0000017485.V367065.R01.S.doc Version 5.2 Page 8 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 Jerome House DS0000017485.V367065.R01.S.doc Version 5.2 Page 9 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): 2, 4 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. A comprehensive assessment of the needs of the resident, prior to admission to the home, enables the home to determine whether a service tailored to the individual needs of the resident can be provided. A programme of preadmission visits to the home enables the prospective resident to sample life in the home and to decide whether the service provided is acceptable. EVIDENCE: We looked at the case file of a resident that had been admitted to the home since the last key inspection in September 2007. There was a wealth of information that had been provided to the care home, prior to the admission of the resident. This information had been requested as part of the admission procedure. The information included an Activities of Daily Living Assessment report, a patient history, a CPA nursing report, a risk management report and a psychological report. Any restrictions on choice, freedom, services or facilities were clearly identified and recorded. Jerome House DS0000017485.V367065.R01.S.doc Version 5.2 Page 10 An assessment of the needs of the prospective resident had also been undertaken by the manager and was contained in the Prospective Resident’s Assessment Portfolio. There was evidence that the care plan developed by the home, with the involvement of the resident, is based on the assessment of need. An integral part of the pre-admission process is a programme of visits to the home, by the prospective resident. There was a record of these visits on the case file and included information about the content of the visits. Observations made by members of staff were recorded, any comments made by current residents were noted and comments made by the prospective resident were also included in the records. The record of each visit concluded with an assessment of the outcome of the visit. We saw that on the first visit the key worker from the hospital, the care co-ordinator and a relative accompanied the prospective resident. It was recorded that the prospective resident had viewed 2 care homes but preferred the room in Jerome House. The new resident was also already known to some of the residents and it was recorded that the existing residents were positive about the new admission. At the end of the process the manager completed a Potential Client Pre-Admission Assessment and she had recorded that a number of satisfactory visits had taken place and that she would confirm, with the funding authority, that the home could meet the needs of the prospective resident. The new resident said that he had settled in well and that they (the other residents) were a nice crowd. Jerome House DS0000017485.V367065.R01.S.doc Version 5.2 Page 11 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, 9 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Comprehensive care plans have been drawn up for each resident so that the service provided can meet the individual needs of the resident. The home is able to demonstrate that changes in the needs of residents are identified and addressed through a system of regular review meetings. The resident’s right to make decisions about their life in the home is respected. Responsible risk taking contributes towards the resident leading an independent lifestyle. EVIDENCE: Three case files were examined. It was noted that each contained a care plan that focuses on the mental health needs of the resident. There were also care plans covering personal care needs and general health needs. Monthly evaluations are carried out and it was noted that these were up to date. There Jerome House DS0000017485.V367065.R01.S.doc Version 5.2 Page 12 were also daily plans for support workers in respect of the care and support needed by the resident. There was evidence that regular CPA meetings took place. There were also regular review meetings convened by the home and placement reviews by the funding authority. Two members of staff ticked that they were “always” given up to date information about the needs of the people they supported, when they completed the survey form, and 1 member of staff ticked “sometimes”. One member of staff referred to care plans being updated after verbal communications about changes in need. None of the residents receive support from advocacy services although they may receive assistance and support from a member of their family. No one from the company is an appointee for any resident as each resident has control over their finances. However, the home will help a resident if the resident is having problems with their benefits etc and they will help them with budgeting. Records are kept of these transactions and were available for inspection. When completing the survey form 1 of the 4 residents ticked that they “always” made decisions about what they did each day, 1 resident ticked “usually” and 2 residents ticked “sometimes”. However, they all agreed that they could do what they wanted during the day, the evening and at weekends. Each file contained risk assessments, tailored to the individual needs of the residents. The hazard was stated, identified risks listed, a risk rating was awarded and the action to be taken was specified. Risk assessments covered areas including provision of keys to the bedroom door and front door, vulnerability in the community, personal hygiene, restlessness and lack of assertive skills. Risk assessments were subject to regular evaluations, which were up to date. Jerome House DS0000017485.V367065.R01.S.doc Version 5.2 Page 13 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): 12, 13, 14, 15, 16, 17 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Using community resources gives residents the opportunity to enjoy an interesting and purposeful lifestyle, which meets their cultural needs. With staff support, residents are encouraged to maintain contact with their families and to enjoy fulfilling relationships. Residents are encouraged to make decisions and their wishes are respected. Residents are offered a varied and wholesome diet, which meets their religious, dietary and cultural needs. EVIDENCE: We spoke with the manager about the daily routines of residents. Residents are encouraged to keep regular hours and to get some exercise by going out to do their personal shopping etc. Three of the residents attend the African Caribbean Resource Centre and have joined the English and the Maths sessions Jerome House DS0000017485.V367065.R01.S.doc Version 5.2 Page 14 and 2 residents also attend the computer class and the drop in facility. One of the residents recently attended an art therapy class. The fourth resident chooses not to attend any centres at the moment. An OT runs group and 1:1 sessions in the home and in the community for residents on 2 days per week. Sessions include working with computers, arts and crafts, cookery, shopping and outings. Recently 2 of the residents attended a 3 week summer school and studied history and tourist attractions . Residents recently received Certificates of Achievement during an Open Day held in one of the other Randall Care Homes. The certificate contained a section where the resident had summarised their achievements since living in Jerome House and another section where the managers had summarised the resident’s achievements. Residents showed me the certificates and 1 resident said that he had enjoyed the BBQ during the Open Day and mentioned the good food, drink and music. Residents are encouraged to use community resources and facilities so that they don’t become insular. All of the residents travel independently in the community and use public transport, taxis or they walk to where they are going. They use shops, post offices, college, cinemas, leisure centres, the library, restaurants, parks and pubs. The names of residents are entered on the electoral roll and they vote if they wish, either in person or by using a postal ballot. Residents have the opportunity to take part in activities outside the home and outings. A cinema trip is arranged every 2 weeks for residents living in all of the Randall Care Homes and the manager said 2 residents from Jerome House have taken part. Trips have also been made to the bowling alley. There is a walking group that takes place on 3 days of the week and residents are encouraged to take part. After asking residents where they would like to go an outing to Brighton was recently arranged and 2 residents took part. One of them said that he had enjoyed walking on the sea front and eating fish and chips. A week’s holiday has been organised for September for those residents that are interested. Within the home residents are able to choose whether they want to socialise with other residents or whether they want to take part in any activities. Residents do sit together and talk with each other. They also watch television in the lounge or they can watch television or listen to music in their rooms. There are board games and cards if they wish to use these. Since the last inspection a pool table has been installed in the open plan lounge/dining area and residents said that they liked to use this. Residents are encouraged to maintain contact with their family and residents that we spoke with said that members of their families visited them on a regular basis and sometimes also kept in touch by telephone. Residents can entertain residents in their rooms or in the lounge areas. One resident goes to Jerome House DS0000017485.V367065.R01.S.doc Version 5.2 Page 15 stay with his family for the weekend, on a monthly basis. Relatives are invited to social events and to parties. A recent example of this was the Open Day that the company held in the garden of one of their other care homes. Residents are encouraged to take part in the domestic routines in the home and each resident is expected to keep their own room clean and tidy and to do their laundry. Some of the residents will help with the preparation of a meal, after encouragement and motivation by the members of staff on duty. We saw that residents were able to decide whether to socialise with other residents, whether to spend time in their room, what to wear, what to eat, when to go to bed and when to get up in the morning etc. We saw that the home has a 5-week rolling programme of menus. These were varied and included African and African Caribbean foods. The home encourages a programme of healthy eating and is introducing more fresh vegetables. The meals for each of the Randall Care Homes is cooked in one of the care homes and each of the homes take a turn. Where the meal is cooked is recorded on the staffing rota. Records are kept of the food eaten by each resident. Residents are offered a cooked meal in the evening and a lighter meal at lunchtime and a choice is available. Halal meat is used in the menus, as one of the residents is Muslim. Mealtimes are flexible. During the inspection the evening meal was being prepared. It consisted of chicken, rice and mixed vegetables. It looked and smelt appetising. One of the residents said that there was a varied menu and that it included African Caribbean food. He said that he liked the meals served in the home. Another resident agreed and said that the menu was very good and that the members of staff were good cooks. A third resident said that he would like more African dishes. Jerome House DS0000017485.V367065.R01.S.doc Version 5.2 Page 16 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 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Members of staff give discreet and caring support to residents so that the privacy and dignity of the resident is respected. The health and well being of residents is promoted through regular health care checks and appointments. Residents’ general health and well being is promoted by members of staff that assist residents to take prescribed medication. Accredited training for members of staff assures residents of the competence of staff in dealing with medication. EVIDENCE: Residents are self -caring and no direct assistance is required with personal care tasks. Sometimes staff may need to prompt a resident so that they maintain a clean and tidy appearance and this is carried out discreetly and with regard to the feelings of the resident. The staff team consists of male and female members of staff and includes African and African-Caribbean staff. The Jerome House DS0000017485.V367065.R01.S.doc Version 5.2 Page 17 current residents are African, South American and African-Caribbean men. The home provides each resident with the support of an occupational therapist that visits the home twice a week. The home has a system of key working. A care manager commented on the survey form that all staff members treated their client with privacy and dignity. There was evidence in the case files that residents received support with their health care needs. Where appropriate, a member of staff is available to accompany a resident that has an outpatient appointment at the hospital. There were records of regular appointments with the psychiatrist, GP, CPN, optician podiatrist and dentist. There was evidence of access to routine screening e.g. blood tests. Residents have their medication reviewed on a regular basis. A care manager commented on the survey form that the health care needs of their client were “always” properly monitored and attended to by the home. We saw that in a prospective resident’s assessment portfolio the need for glasses and dentures had been identified. These have been provided to the resident after health care appointments. A resident said that he is feeling better since coming to live in the home. Medication records were inspected and it was noted that these were up to date and complete. It is the policy of the home that the GP and the psychiatrist are made aware of any resident’s refusal to take medication. Medication is administered from dosette boxes and the compartments that were empty were in accordance with the time of day and the day of the week when the inspection took place. The storage of medication was safe. All members of staff administering medication have received accredited training to give them a basic knowledge of how medicines are used and how to recognise and deal with problems in use. At the moment a resident is medication free, with the approval of the doctor, and this is being closely monitored. Jerome House DS0000017485.V367065.R01.S.doc Version 5.2 Page 18 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 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents are aware of their right to complain if the care that they receive is not satisfactory. An adult protection policy and protection of vulnerable adults training for staff contribute towards the safety of residents. EVIDENCE: A complaints procedure is in place in the home. A copy is placed in the service user guide and this document is given to each resident, as part of the admission procedure. There is also a copy on the back of the residents’ bedroom doors and on display in the communal areas. The procedure includes contact details for the Commission for Social Care Inspection. The complaints record book was examined and it was noted that 5 complaints have been recorded since the last inspection. No complaints have been made directly to the CSCI. We could see that the manager has investigated the complaints and that feedback was given to the complainant. It was noted during the inspection that residents were accustomed to an “open door” policy with the managers and that they were also able to discuss their concerns, at any time, with members of staff on duty. Residents have confirmed that they know who to speak to if they are not happy and that they know how to make a complaint. Residents were comfortable in speaking with the registered manager or with other managers within the company or with members of staff. The home Jerome House DS0000017485.V367065.R01.S.doc Version 5.2 Page 19 prefers to deal with matters before complaints develop and has a system of meetings, which are recorded, taking place between the resident and manager and/or key worker. There are also residents meetings where concerns can be raised and the minutes of these were available for inspection. Members of staff confirmed that they knew what to do if someone had concerns about the home. A protection of vulnerable adults procedure is in place. This includes a link to the whistle blowing procedure. The manager said that no allegations or incidents have been recorded since the last inspection. There was evidence on the staff files that protection of vulnerable adults training had taken place. A refresher course for members of staff took place in 2008 and certificates of attendance were on the staff files examined. During a discussion with a member of staff he confirmed that he had undertaken training in adult protection procedures and was aware of his duty to report any disclosures of abuse to the manager. The home had a copy of the local authority’s interagency guidelines in the event of abuse. The company has also purchased a training video. Jerome House DS0000017485.V367065.R01.S.doc Version 5.2 Page 20 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, 30 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents live in a home, which is generally comfortably furnished and provides a pleasing environment for residents to relax in and enjoy. Some minor refurbishment is needed to keep the maintenance of the home at a good standard. Standards of cleanliness provide residents with hygienic surroundings. EVIDENCE: A site inspection took place and all residents gave permission for their rooms to be seen. It was noted that the home was decorated and furnished in a “homely” manner and that the general upkeep of the property is good. Some items had been replaced since the last key inspection including the removal of the old cooker and the installation of a new hob in the kitchen. The manager Jerome House DS0000017485.V367065.R01.S.doc Version 5.2 Page 21 said that other appliances would be repositioned so that the best use was made of space. However, the doors on the kitchen units are looking worn and are in need of replacement. There are tiles in the ground floor shower room that need replacing. The floor covering in the toilet on the first floor is lifting at the edges and allowing dirt to be trapped there. A small table in a bedroom is unsteady and needs replacing. Overall residents were satisfied with their rooms and thought that they were of a good size. Residents considered the location of the home to be suitable as it is close to bus routes, tube station and local shops. Although there are steps from the paved area at the front of the house to the front door there is level access to the home, via the driveway to the side of the house, and through the smoking lobby at the back of the house. None of the current residents have problems with accessing the front of the house. A resident that has a phobia about stairs is accommodated on the ground floor and confirmed that he is able to use the ground floor shower room and toilet. We noted during the site inspection that the areas inspected were clean and tidy and free from any offensive odours. Laundry facilities are located on the ground floor and access is either from the dining area or from the smoking lobby, which has a door leading to the garden. It is unlikely in cold or unpleasant weather that residents carry their laundry around the side of the house to avoid walking through the dining area. Whichever route is taken it does not involve carrying laundry through an area where food is stored or prepared. The manager confirmed that residents do not have problems with continence. There was evidence in the staff files examined that members of staff have recently received training about infection control procedures. We saw that in the first floor bathroom an open basket was provided for the disposal of paper towels. Jerome House DS0000017485.V367065.R01.S.doc Version 5.2 Page 22 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): 32, 33, 34, 35 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents benefit from a service provided by carers that have demonstrated their skills and understanding through the achievement of relevant qualifications. The rota demonstrates that there are sufficient members of staff on duty to support the residents and to meet their needs. Recruitment practices promote and protect the safety and well-being of residents. The training programme enables members of staff to broaden and to develop their knowledge and skills and encourages good working practices. EVIDENCE: We discussed NVQ training. A member of staff that we spoke with said that she had completed her NVQ level 2 training and had started to work on her level 3 training. Another member of staff said that she had completed her level 3 training. When we looked at 3 staff files we saw that 2 members of staff had completed their NVQ level 2 training and that I member of staff was studying for their master’s degree in psychology. The general manager that Jerome House DS0000017485.V367065.R01.S.doc Version 5.2 Page 23 supports the home is and RN. There is an RMN that also supports the home. Both of these members of staff have shifts recorded on the rota. The home has met the target of 50 of carers in the home achieving an NVQ level 2 or 3 qualification. We saw a copy of the current rota for week commencing the 26th August. The hours worked by the manager, on site, were recorded. The staffing levels identified on the rota i.e. 1 or 2 members of staff on duty on the early shift and 1 member of staff on duty on the later shift were sufficient to meet the existing needs of the current residents. The 3 members of staff that completed a survey form ticked that there were “usually” enough staff on duty to meet the individual needs of all the people using the service. At night there is 1 member of staff on waking night duties. There is also information on the rota about the 24-hour call system for contacting a manager when advice or support is needed. At the bottom of the rota there was a note of the hours worked in other Randall Care Homes, by members of staff working in Jerome House. This allows managers to monitor the total weekly hours worked by individual members of staff. The staff team reflects the cultural and gender composition of residents. There was evidence that regular staff meetings take place and the minutes of the meeting were available. There was also evidence that the manager followed up non-attendance with the individual members of staff. The home has a recruitment and selection policy and it is linked to their equal opportunities policy. We looked at the staff files of 3 members of staff. We saw that each file contained a checklist at the front of the file so that required checks and references could be logged. Inside each file there was an application form and 2 of the 3 files had a photograph of the member of staff attached. There was an enhanced CRB disclosure, 2 references and proof of identity (passport details). Where necessary the right to work and to reside in the UK had been checked and copies of documents were on file. Files also contained a job description and a contract. We looked at 3 staffing records and noted that files included a training profile, which was updated each year. Certificates of achievement or of attendance for training courses were on file. These demonstrated that members of staff received mandatory training that is refreshed on an annual basis e.g. manual handling, food hygiene, infection control, first aid and fire safety training. Members of staff had also recently received training specific to their role e.g. health and safety, protection of vulnerable adults and medication training. Two of the 3 files had certificates for attending mental health training and the third file belonged to a member of staff that was studying for a master’s degree in psychology. When completing a survey form the members of staff agreed that they had received training that is relevant to their role, helps them to understand and meet the individual needs of residents and keeps them up to date with new ways of working. Each of the staff files examined included Jerome House DS0000017485.V367065.R01.S.doc Version 5.2 Page 24 evidence of completion of an Induction Programme Record. This met the Sector Skills Council’s Common Induction Standards. When asked on the survey form whether the induction covered everything that the member of staff needed to know to do the job when they started 1 member of staff ticked “very well”, 1 member of staff ticked “mostly” and 1 member of staff ticked “partly”. This person added, “I had to learn by my mistakes and also go to meetings so I could learn and listen to other staff and ask questions.” To address the comment made by the member of staff the content of the induction training programme needs to be reviewed and amended as necessary. An evaluation of the induction training programme is needed on its completion by a new member of staff. A copy of the Training and Development Plan for Jerome House, from April 2008 to March 2009 was available. It included listing a course of training, deciding who needs this training and within what timescale, who can provide the course, the cost, how the effectiveness of the training is to be evaluated and the progress made. Jerome House DS0000017485.V367065.R01.S.doc Version 5.2 Page 25 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, 39, 42 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. The registered manager continues to develop her knowledge through further training and this contributes towards understanding the needs of residents and staff. Incorporating information obtained through quality assurance systems into the planning and development of the service ensures that the service continues to meet the needs of the residents. Regular servicing and checking of equipment used in the home ensures that all items are in working order and safe to use. Training in safe working practice topics enables members of staff to safeguard the health, safety and welfare of the residents. EVIDENCE: Jerome House DS0000017485.V367065.R01.S.doc Version 5.2 Page 26 The registered manager has completed her Registered Manager’s Award and has shown evidence of this on a previous inspection. As she is also the registered manager of another care home in Randall Ave there is an assistant manager post in each of the 2 care homes to help her with the management role. In addition there is also a post of general manager for the company to support all of the 4 care homes that it operates. Since the last key inspection the manager has undertaken short training courses or training sessions to update her skills and knowledge. These have included training in safeguarding adults, Mental Capacity Act, manual handling, medication and food hygiene. Members of staff completing the survey form agreed that the manager meets with them to give them support and to discuss how they are working on a regular basis. We discussed quality assurance systems in place in each of the care homes within the company. We were told that residents’ meetings are held on a regular basis, in each of the care homes, and a record is kept of these. In addition to this the other methods of obtaining feedback from the residents about the quality of the service include meetings between the resident and their key worker or the manager (on a 1-1 basis), during review meetings, on an informal basis with an “open door” policy to the office and by the use of survey forms. When asked for examples of how any feedback has been used to develop the service provided we were told that residents are now given a copy of their care plan, changes have been made to the menus and the venue for activities outside the home and for outings are chosen by residents. We then looked at opportunities for members of staff to give feedback and we were told that comments could be given at staff meetings, during supervision, on an informal basis and by the use of survey forms. We were given examples of changes that had been made as a result of feedback including adapting the supervision recording form to include a section for comments from the member of staff and for amending the appraisal form so that it included a selfassessment by the member of staff. The home encourages relatives to make comments during their visits to the home and we saw that positive feedback had been recorded. We looked at the maintenance and servicing records for the equipment and systems in use in the home. There were valid certificates for the checking/servicing of the fire alarm system, fire extinguishers, portable electrical appliances, the electrical installation and the Landlord’s Gas Safety Record. There were records for the testing of the fire alarms on a weekly basis and for carrying out a fire drill (including an evacuation of the home) on a weekly basis. These were up to date. The Fire Risk Assessment was dated June 2008. There was evidence in the training records that members of staff have received training in safe working practice topics i.e. food hygiene, first aid, fire safety, manual handling and infection control procedures and that these are refreshed according to the recommended frequencies. Jerome House DS0000017485.V367065.R01.S.doc Version 5.2 Page 27 Jerome House DS0000017485.V367065.R01.S.doc Version 5.2 Page 28 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 3 3 X 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 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 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 3 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 Jerome House DS0000017485.V367065.R01.S.doc Version 5.2 Page 29 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA24 Regulation 23(2) Requirement Timescale for action 01/12/08 2 YA35 18(1) 3 YA35 18(1) To assure residents of an environment that is pleasant and comfortable some refurbishment in the kitchen, shower room and 1st floor toilet must take place. To gauge whether induction 01/11/08 training gives a new member of staff all the information needed when they begin working in the home a review of the content of the training programme must be carried out. To assure managers that a new 01/11/08 member of staff has benefited from the induction training given there must be an opportunity for the member of staff to identify any gaps in their knowledge and understanding so that these can be addressed. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. Jerome House DS0000017485.V367065.R01.S.doc Version 5.2 Page 30 No. 1 2 3 Refer to Standard YA17 YA30 YA30 Good Practice Recommendations That more African dishes are available as a choice on the menu. That residents are encouraged to avoid carrying their dirty laundry through the dining area. That a pedal bin is provided in the first floor bathroom for the disposal of paper hand towels. Jerome House DS0000017485.V367065.R01.S.doc Version 5.2 Page 31 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 Jerome House DS0000017485.V367065.R01.S.doc Version 5.2 Page 32 - 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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