Care Home: Jessie Place

What the care home does well All residents have a full assessment of care needs and are only admitted if the home feels they are able to meet the resident`s needs. Residents continue to be encouraged to become more independent, both in the home and the community with staff support. There is a stable staff team who are supportive and helpful. Residents say they are happy living in Jessie Place and that they liked their bedrooms, the lounge, garden and the food. The service is user lead. The resident`s families are welcomed and encouraged to visit the home at any time. Residents are involved in choosing and preparing individual meals, which is good practice. They have been consulted about their final wishes, which promotes respect. Interactions between the staff and the residents continue to be relaxed and good-humoured and residents approach staff with apparent ease and familiarity. The registered provider is very proactive about staff training and attended a number of training courses and this is relayed to staff in training sessions and workshops run by the organisation. The home has continued with its redecoration and refurbishment program. What has improved since the last inspection? The home has sent out audit forms to professionals, residents and family members and the result was positive. Risk assessments are more robust and have been reviewed with more detail included in them. The home has installed new windows through out the house and is continuing with the redecoration program. The home has complied with all the requirements left at the last inspection. The administration of medication has improved and staff are more aware of medication procedures. What the care home could do better: Staff induction training needs to be more formalised in line with Skills for Care induction training. Although the home is developing a quality control system, there still needs to be a formal approach to quality control and getting the views of the residents, family and other professionals. The home needs to be clear they are offering and giving the type and level of care the resident and care provider want and they are all working towards the same goals. CARE HOME ADULTS 18-65 Jessie Place 39 Stanthorpe Road Streatham London SW16 2DZ Lead Inspector Lynne Field Unannounced Inspection 9th July 2008 10:00 Jessie Place DS0000022737.V367122.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 Jessie Place DS0000022737.V367122.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. Jessie Place DS0000022737.V367122.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Jessie Place Address 39 Stanthorpe Road Streatham London SW16 2DZ 0208-769-3591 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Jane`s House Limited Mr Raja Manikam Paramal Care Home 6 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (6) of places Jessie Place DS0000022737.V367122.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care Home Only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: 2. Mental Disorder, excluding learning disability or dementia - Code MD The maximum number of service users who can be accommodated is: 6 26th November 2007 Date of last inspection Brief Description of the Service: Jessie Place is a large semi-detached house in a residential area. It is within a few minutes walking distance from a main shopping area, which has full community facilities and public transport links. It is a privately owned home, registered since November 1999, which provides long-term residential care for people with mental health problems. The home is registered for 6 residents, who are accommodated in six single bedrooms, one with an en-suite bathroom. There are three communal areas, one of which is a large conservatory with steps leading down to a large landscaped back garden and there is a front garden area that has been converted for parking use. The staff team is small, but fairly stable and experienced with this resident group. The home is not designed to cater for people with physical disabilities, although wheelchair users would have access to the ground floor, which has one bedroom, a toilet and all the communal areas. The home aims to encourage residents to take part in daily activities and to reach their optimum level of functioning, with current residents attending a variety of regular daily activities outside the home. The registered provider said the current fees payable is in the range of £420.00p to £850.00 per week. There are additional charges made for toiletries, hairdressing newspapers and holidays. Jessie Place DS0000022737.V367122.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. This unannounced inspection took place on 9th July 2008. We met the Contracts Monitoring Officer of a local authority who is providing the funding of a number of residents who live in the provider’s other homes. There was a full discussion about the different expectations of the contracts monitoring officer and residents and what the home was actually providing. This needs to be explored more fully at the residents review so all have a clear understanding and an agreement of the outcomes for the resident. The registered provider returned a standard form, the Annual Quality Assurance Assessment (AQAA), to CSCI and this was used as part of the inspection. We checked records of the care plans, staff records and building maintenance records. The registered manager and one member of staff were present on the day of the site visit to the home. The registered provider has two other small homes for residents with mental health needs in the same area and staff work in all homes as required. The records, policies and procedures follow the same format in all homes but are individualised for each home. A range of documents was examined and a tour of the building took place. There were six residents living at the home on the day of the inspection and there are no vacancies. We spoke to four residents, who said and indicated they liked living at the home and were happy there. We had a tour of the home and two residents showed us their bedrooms and said they were happy with them. What the service does well: All residents have a full assessment of care needs and are only admitted if the home feels they are able to meet the resident’s needs. Residents continue to be encouraged to become more independent, both in the home and the community with staff support. There is a stable staff team who are supportive and helpful. Residents say they are happy living in Jessie Place and that they liked their bedrooms, the lounge, garden and the food. The service is user lead. The resident’s families are welcomed and encouraged to visit the home at any time. Residents are involved in choosing and preparing individual meals, which is good practice. They have been consulted about their final wishes, which promotes respect. Interactions between the staff and the residents continue to be relaxed and good-humoured and residents approach staff with apparent ease and familiarity. Jessie Place DS0000022737.V367122.R01.S.doc Version 5.2 Page 6 The registered provider is very proactive about staff training and attended a number of training courses and this is relayed to staff in training sessions and workshops run by the organisation. The home has continued with its redecoration and refurbishment program. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Jessie Place DS0000022737.V367122.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Jessie Place DS0000022737.V367122.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Statement of Purpose and Residents Guide contains the required information residents need to help them make a decision about coming to live at the home. Prospective residents’ needs and aspirations are assessed, so that a service tailored to their needs could be provided. EVIDENCE: We looked at the statement of purpose and the resident’s guide, which includes the complaints procedure in the resident’s guide. The registered manager said these are regularly checked and updated to reflect the changes in the home and the organisation that runs the service. We spoke to the registered provider who said the organisation had p dated its statement of purpose and the service user guide in May 2007. All the residents have lived at the home for several years; the most recent admission was in 2003. We were told by the registered manager should a vacancy occur the home would follow the homes admissions procedure. We discussed the admission policy with the provider who said this includes Jessie Place DS0000022737.V367122.R01.S.doc Version 5.2 Page 9 obtaining a full assessment from prospective resident’s social workers as well as completing their own assessment. Prospective residents are able to visit the home prior to any admission and the registered provider to ensure the home could meet their needs would assess them. Both the registered provider and the registered manager said prospective residents are encouraged to visit the home prior to admission to see if it was suitable for them and bring relatives and friends. It they thought they would like to live in the home they would come for a tea visit, then for a meal, building up to an over night or weekend stay. They would be given the statement of purpose and the service user guide to help them decide if the home would meet their needs. The home would use the visits to assess the prospective residents to ensure they could meet the resident’s needs. The prospective resident would be invited to visit the home with family members or friends to help them decide if the home could meet their needs and a trial over night stay before moving in. There are contracts in the resident’s files that we checked and these were signed by the registered manager, resident and the care manager where appropriate. Jessie Place DS0000022737.V367122.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents have individual care plans, and are involved in making decisions about their lives. Residents, relevant care professionals and their family are consulted in planning and reviewing care. Risk assessments are in place, are reviewed when appropriate. EVIDENCE: We looked at three care plans and noted they had all been reviewed and were up to date and this included the sections for identifying needs, objectives and actions to be taken. The registered manager said care plans are reviewed and evaluated on a regular basis, depending on the needs and any changes in the residents life and health needs. The files viewed had risk assessments and there were risk management plans in place. These were comprehensive and Jessie Place DS0000022737.V367122.R01.S.doc Version 5.2 Page 11 there was evidence of risk assessments being reviewed annually or earlier if it was necessary. All files had up to date daily records and these outlined activities and changes of mood or signs of deterioration in resident’s mental health. They showed evidence of contact with the community mental health team and visits by other health and social work professionals. One resident sees the nurse every two weeks and one resident’s social worker comes to visit them every week and another social worker visits two residents each month. On the day of the inspection the registered manager said he had called community mental health team because one residents mental health and behaviour had deteriorated over the last few days and was causing concern. This had been recorded in their care notes. The nurse came to see the resident during the inspection but we were only able to speak to them briefly. They said someone from the team came regularly to support residents who live in the home. They spoke to the resident and were making arrangements to help the resident and the home deal with the change of behaviour and find out what was the cause of the change. We spoke to four residents who said they liked living at the home. One resident said they were helped about their lives and the residents spoken to say that they were able to decide how they would spend their day and what they wishes to do. The home is client led with regard to care planning. We checked resident reviews and noted they have been taking place annually. The registered manager said they try to ask all the relevant people who are involved with the resident and they are invited to attend and the written actions agreed are on file. One resident told us about their life in the home. They said they were helped by the staff to come and go as they pleased and attended a number of activities they enjoyed doing. They talked about going out for the day and where they would like to go on holiday. They said the registered manager helped them a lot and gave them confidence in themselves. One resident said they would tell the staff when they were going out and where to and what time they hoped to be back by. Residents said they are able to choose when to get up/go to bed. They told us they are regularly consulted and involved in decision-making. They said they had regular meetings with residents from the other homes the registered provider owns. We were shown the minutes of the residents meetings that are held every two to three months. Residents meetings are when holidays and outings are discussed and agreed. Jessie Place DS0000022737.V367122.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,13,14,15,16,17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are encouraged to develop independent skills and interests as well as access the community with the support of staff when required. They are given opportunities for personal development and maintain links with family. Residents are able to choose what they would like to eat, but are encouraged to eat a healthy diet. The registered provider needs to make sure the home is working in line with current thinking of the placing authority to ensure the residents and home are all working towards the same outcomes. EVIDENCE: Jessie Place DS0000022737.V367122.R01.S.doc Version 5.2 Page 13 On the day of the inspection we met four residents. Each resident has different daily routine and interests. The staff supports residents to maintain links with their family, either by supporting them to visit their family or by their family visiting them at the home. Residents are free to have visitors and are able to visit their families. One resident talked about their mother who they see regularly and is very involved in their care. They told us about their daily life and that they go out to the day centre two times a week. They said they could spend as much time as they like in their bedroom and likes to listen to music and watch videos there. Residents either do their own shopping or are supported to shop with a carer accompanying them. Staff encourage residents to cook for themselves and if needed will be supported in the kitchen. The home does not have a menu and residents decide on the day what they want to eat and are encouraged to eat a healthy diet. A copy of what has been eaten is kept in the menu book. During the inspection residents made came into the kitchen to make themselves tea and snacks. They seemed very at ease doing this and one resident asked us if we would like a drink. The registered provider said they have tried to educate and raise the awareness of all the residents on nutritional values and have tried to improve the daily menu in each of the homes she owns. The home does not have a weekly programme as such because all activities are very much centred on individual resident’s wishes and choices. We saw that residents continue to attend the local college and three at present attend a mental health day centre. Residents are encouraged to access the local community and are supported as needed to do this. The residents we spoke to indicated they are free to make decisions about the activities they undertake and some residents spend more time in the home than others. Staff support residents to attend local activities such as going to the Library or leisure facilities at the leisure centre. This is done on a flexible basis depending on residents’ wishes. Two residents attend the local church, which they said they enjoyed going to. The home will escort residents who need support to attend activities or events. One resident is supported to collect their money from the local bank. On the day of the inspection plans were being made to attend a local event that was being held on the common. One resident was asked if they would like to go but they said they did not want to go because they were frightened of getting lost or someone taking them away. The registered manager tried to reassure them saying they would be with staff but still the resident said “no”. All the residents have keys to their rooms and to the front door. We were told there was a routine around some aspects of the home, i.e. residents had particular days when they do their washing with the support of staff if needed. Staff said they encourage residents to help in the home because it gave them an opportunity to develop their daily living skills. This included helping to prepare vegetables for the meal and doing their laundry with the support of staff. Jessie Place DS0000022737.V367122.R01.S.doc Version 5.2 Page 14 As part of the ongoing inspection process a member of the local authority contact monitoring team who has been monitoring residents in all the providers homes contacted us before the inspection. We met them at the sister home for part of the visit. They had shared their concerns with us and the registered provider about the residents lacking motivation to develop independent living skills. There was a discussion with the registered provider about the expectations of what the service was providing and what it was perhaps now being expected to provide. It has been some years since the residents moved to the home and care in the community for people with mental health issues has changed. We discussed how now the expectation is that for most residents this would be a transient period of time spent in a residential home. The emphasis has moved to rehabilitation through developing and maximising the residents functioning potential to help them live more independent lives in the community. In our discussions it was acknowledged this would not be suitable for all residents but the home could do more to encourage them to develop daily living skills that could help them move on to independent living scheme if it was felt this is right for the residents. The registered provider needs to look at how staff can encourage residents to be motivated to develop more independent living skills. The issues and expectations of the placing authority, residents and home need to be fully discussed with each residents at a review of the service, so all are clear what outcomes they are working towards. Jessie Place DS0000022737.V367122.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20,21, Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home support residents to maintain their mental and physical health and they work effectively with other health and social care professionals. Medication handling and procures have improved since the previous inspection and staff are following the homes procedure for the administration of medication. The home will support residents to make plans with regard to illness and death. EVIDENCE: We spoke to a member of staff on duty during the inspection who said the home supports residents around personal care as needed and this is mainly done with supervision and encouragement, as all the residents are independent. Jessie Place DS0000022737.V367122.R01.S.doc Version 5.2 Page 16 When we checked the resident’s files we found evidence on the files that the home works closely with other mental health professionals and that they have alerted the mental health team with regard to deterioration in a resident’s mental health. On the day of the inspection the registered manager was at the home waiting for a health care professional to come to the home to assess resident whose mental health had deteriated over the past week. Some residents have had quite serious physical and mental health issues that the home has supported them with. One resident has had problems with eating and had illusions. We checked the files and found evidence of residents attending for physical health tests and mental health professional’s advice being sort as well as the outcomes of these tests being recorded. With regard to the resident with challenging behaviour around eating, there was a record of this being discussed at a CPA meeting and staff are aware that this was an issue. The home has a form to complete with regard to residents wishes around illness and end of life. Some residents had completed this form, but others had not wished to and this had been recorded on the form. All medication is kept in a locked cupboard in the office. We checked two residents medication. The recording of medication had improved since the previous inspection. Risk assessments are on file. The home have introduced a running total for the amount of medication they have left for each resident to ensure that they have the correct amount and this corresponds to the medication signed for from the pharmacy. All medication coming into the home and medication that is not required is recorded in the medication book. Medication not needed is retuned to the pharmacy for disposal and this is recorded in the book. Weekly medication audits are more robust. The contractmonitoring officer who contacted CSCI before the inspection said they had checked the medication as part of their contract monitoring and had found it correct too. The registered manager said he does a spot check of the medication once a week. It would be good practice if the spot checks on the medication could be recorded on the medication charts. Jessie Place DS0000022737.V367122.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is not keeping a record of complaints being made or of actions taken to deal with the complaint. Out comes of complaints are not being recorded. The record keeping relating to residents money needs to be simpler, clear and more robust. EVIDENCE: The home has a complaints policy and a complaints book. There was one complaint the home had received a complaint from a neighbour in May 2008 about the noise coming from the home and a number of other complaints such as the tree in the garden of the home was too big and the antisocial behaviour of two residents that was causing the next door neighbour distress. Both the registered manager and the registered provider said they had spoken to the residents about the complaint and discussed this with the individual residents as to how they could deal with this. The registered provider followed the complaint up with the neighbour and fed back what measures they had put in place. The registered provider said the neighbour was happy with the outcome and there had been no further complaints. The registered manager said they would continue to monitor the noise levels and reinforce this at resident and staff meetings. Residents spoken to say that they would raise any issues they had with staff or the manager and felt that they would be listened to. The registered manager said a resident had a complaint they would speak to their social worker that Jessie Place DS0000022737.V367122.R01.S.doc Version 5.2 Page 18 would help them with the complaint. One resident’s mother would advocate for them if the need arose. The home has a policy regarding the protection of the resident’s finances. As part of the inspection we checked the residents’ money files and they were in order. Residents’ money was checked with the registered manager. The staff of the home will get receipts for any items purchased even if they if they go with the resident. However if a resident purchases small items on their own and they do not get receipts for these. There were receipts for purchases made for the residents; these are kept in the safe with the resident’s money. A member of staff said they had training in the financial procedures of the home and would follow the procedure if they purchased anything for a resident, even if the resident was with them. All the money held in the safe tallied with the amounts recorded in the resident’s cashbooks. Jessie Place DS0000022737.V367122.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,26,27,28,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The standard of décor within the home is good providing the residents with a homely place to live. The home is comfortable with adequate private and shared space, toilets and bathrooms. Residents’ bedrooms promote their independence. EVIDENCE: The home is situated in a three-story house in a residential street off Streatham High Road. It is comfortable and homely and was clean and tidy on the day of the inspection. There is a range of communal spaces, including large lounge and conservatory leading to a pleasant garden at the rear of the house. The home communal areas are homely and pleasantly furnished. The kitchen has been replaced and re decorated and it has a large dining area with table where the residents eat their meals. The windows in the home have recently been replaced. The registered manager said they now kept the door between Jessie Place DS0000022737.V367122.R01.S.doc Version 5.2 Page 20 the kitchen and the living area, which is a fire door, shut rather than having a door guard fitted that was the requirement in the last report. The registered manager said the residents had liked to have the door open for easy access but they have agreed to keep it closed. We were given a tour of the home. All residents have single bedrooms and two residents invited us to look at their bedrooms. Both bedrooms were spacious and in reasonable decorative order. They were furnished adequately and the residents had individualised them with personal items, such as family photos and pictures. They had comfortable chairs they could sit on to watch their televisions, read or listen to music. The home installed a shower cubicles in one of the bedrooms and refurbished the bathroom and separate toilet on the first floor. Three residents on the first floor now share the bathroom and other resident’s have an en-suite or a cubical in their room. This has all been done to a good standard. The resident who had the shower cubical said they “did not use it because they preferred to have a bath”. The home provides care for people who have problems with their mental health but are ambulant so there are no adaptations or disability equipment in the home. The laundry facilities are located out side in a shed set up for this purpose and well away from where food is prepared and eaten. Jessie Place DS0000022737.V367122.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35,36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The staff team is stable and know residents needs. Staff has undertaken training and supervision that meets the needs of residents and staff needs. EVIDENCE: The rota was inspected and was accurate and fully completed. The staff group have been very stable. Staff were observed to be friendly and relaxed when interacting with residents. We spoke to four residents and they said they found staff helpful and supportive. We met one member of staff and were able to speak to them. We checked four staff files as part of the inspection at the other providers home where all staff files are kept. These included copies of the application forms, two written references, a signed copy of their contract stating terms and conditions and identification. All files checked had CRB checks. The registered provider said they would not start a member of staff to work in the home unless they had Jessie Place DS0000022737.V367122.R01.S.doc Version 5.2 Page 22 been CRB checked. At the previous inspection we noticed several staff that have been employed by the home for a long period of time, had CRBS that were three or more years old. To keep them up to date the home has renewed these. All staff working at the home has qualified to level 2 NVQ or above. There were copies on the staff files of the certificates issued for the courses staff had attended. At the last inspection although there were copies of the induction training that was given, this was only about the home and health and safety issues and did not fully comply with “Skills for Care” level of induction. This was said to be needed to be addressed but because there have been no new staff since the last inspection so the home’s induction procedures could not be fully checked at this inspection and will be checked at the next inspection and this has been left as a requirement. The registered provider is very enthusiastic about encouraging staff to develop new ways of thinking and passes on any information and training she attends to staff. She had recently attended a seminar run by Well London about Mental Health and wellbeing and had spoken about this in staff meetings and at residents meetings. Six training course/lectures, such as Handling Aggression, Depression and Schizophrenia have been carried out to update knowledge and improve the skills of the staff. There is a long-standing staff group who know the residents well and they work across all the registered providers homes. This gives the residents consistent care. One care professional who responded to the survey we sent out before the inspection had visited the service prior to CSCI inspection and was positive about the home and the service provided by the home. There were copies of staff supervision records in the staff files we checked. The registered provider and the member of staff had signed these. Jessie Place DS0000022737.V367122.R01.S.doc Version 5.2 Page 23 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s benefit from a home that is well run and managed with a relaxed and non-institutional ethos. The health, safety and welfare of service users is promoted and protected EVIDENCE: The registered manager demonstrated a clear understanding of the needs of the residents and her responsibilities in ensuring that the home met registration standards. Staff told us the registered provider was very supportive and was sympathetic if they had any personal problems and would help if she could. Residents said they felt they could talk to her and she would try to help. Feedback from professionals who responded to the survey said Jessie Place DS0000022737.V367122.R01.S.doc Version 5.2 Page 24 they found the “registered provider very knowledgeable and works hard to maintain the home” and “she actively seeks out activities / social forums which would benefit the residents”. The registered manager is a trained registered mental health nurse and has worked in the service since the home opened thirteen years ago and knows the residents well. Residents are given the opportunity to give their views of the home at residents meetings, which were recorded in the minutes of the meeting that are held every two months. We were shown copies of the minutes of the meetings. The registered manager said the provider had sent out audit forms to the resident’s family and had given them to residents as well. We were shown copies of the completed residents surveys and they were all positive. All families who responded said they were aware of the complaints policy and would use it if they needed to. The home had a policy on health and safety and the inspector viewed health & safety records held in the home. The registered provider confirmed that there were regular checks at the required intervals, by external contractors, for servicing the fire safety system, the boiler, central heating system and the emergency call system. Certification was in place regarding the Landlord’s Record of Gas Safety, Portable Electrical Appliance testing, and Certificate of Electrical Installation. Records showed that regular checks of the fire alarm call points were made and that fire drills were conducted. A fire risk assessment and floor plan was completed and is in place. We were shown copies of the minutes of staff meetings that are held every two months. The registered manager said they were held staff meetings at one of the other homes in the organisation. Jessie Place DS0000022737.V367122.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 3 4 3 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 x LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 3 X 3 X X 3 x Jessie Place DS0000022737.V367122.R01.S.doc Version 5.2 Page 26 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 YA35 Regulation 18 (1) (c) (i) Requirement The registered person must ensure that all staff receives a full induction and foundation programme during the first six weeks and then six months of their employment. No new staff have been recruited so we were unable to check this requirement had been complied with and have carried it for to the next inspection. Timescale for action 31/12/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA11 Good Practice Recommendations The issues and expectations of the placing authority, residents and home need to be fully discussed with each residents at a review of the service, so all are clear what outcomes they are working towards. It would be good practice if the registered provider recorded on the medication chart when she does her spot checks. DS0000022737.V367122.R01.S.doc Version 5.2 Page 27 2 YA20 Jessie Place 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 Jessie Place DS0000022737.V367122.R01.S.doc Version 5.2 Page 28 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!