Care Home: Jubilee Nursing Home

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What the care home does well Good assessments are completed before the service user moves into the home to make sure all of their care needs can be met and people are given lots of information so that they can make a decision if they want to move into the home or not. The medicines held by the home are well looked after by trained staff and all procedures are followed. Service users are helped to attend appointments regarding their health needs when necessary. If anyone living in the home has a concern or complaint the complaint forms are written in an understandable way and people spoken with are confident any concerns or complaints would be dealt with satisfactorily. Good staff training is given to all staff and good policies and procedures ensure the home runs smoothly on a day to day basis. What has improved since the last inspection? The service has made a number of improvements to the home to make the home comfortable and homely. A new conservatory has been errected and new bathing facilities have been installed. A good programme of activities is made available to service users should they wish to take part that includes outings in the summer months. What the care home could do better: The care plans need to be better and need more information in them so that staff know how to look after people and meet their care needs on a day to day basis. All concerns or complaints made about the service must be recorded so that people will be confident that their complaints will be dealt with effectively. A number of maintenance issues must be attended to and a large number of the homes windows must be replaced so that they are safe for people both inside and ouside of the building. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Jubilee Nursing Home Thornhill Crescent Sunderland SR2 7AD     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Eileen Hulse     Date: 2 8 0 5 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Jubilee Nursing Home Thornhill Crescent Sunderland SR2 7AD 01915652727 01915654734 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Jubilee Home (Sunderland) Limited care home 35 Number of places (if applicable): Under 65 Over 65 35 0 old age, not falling within any other category physical disability Additional conditions: 0 5 The maximum number of service users who can be accommodated is: 35 The registered person may provide the following category of service only: Care home with nursing - Code N To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP, maximum number of places: 35 Physical disability - Code PD, maximum number of places: 5 Date of last inspection Brief description of the care home Jubilee Care Home is a purpose built three-storey building, which can provide nursing and personal care for up to 35 older people. It is of traditional brick build design and has an ample size car park to the rear of the building. There are large lounges, a separate smoking lounge and a dining room on the ground floor with bedrooms on the first and second floors. On the ground floor there is a pleasant conservatory at the front of the building, which has level access into the garden area. The Home offers both single and double bedrooms, with the majority having en-suite facilities. The Home is very close to the city centre of Sunderland and benefits from being near the Care Homes for Older People Page 4 of 27 Brief description of the care home shopping centre, library and the transport network. There is a large park close to the Home as well as local tourist attractions. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The last inspection on this service was completed on 19th June 2007 This is an overview of what the inspector found during this inspection The quality rating for this service is 2 STAR. This means that people who use this service experience good quality outcomes. Before the visit we looked at information we have received since the last visit on 19th June 2007 How the service dealt with any complaints and concerns since the last visit. Any changes to how the home is run. The providers view of how well they care for people. The views of people who use the service their relatives and staff. Care Homes for Older People Page 6 of 27 During the visit we observed staff practice and talked with people who use the service and looked at how well their needs are met. We looked at other records which must be kept. Checked that staff had the knowledge skills and training to meet the needs of the people they care for. We looked around the building to make sure it was safe clean and comfortable and checked if any improvements had been made. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 27 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Good assessments are included within the plans of care for all service users that help to form the basis of the individual care plan, this ensures that before admission takes place the home is able to know if the care needs can be met by them. The home does not provide intermediate care. Evidence: All service users currently living in the home have had pre admission needs assessments carried out by a care manager and a registered nurse employed by the service prior to their admission. When a vacancy occurs, a care manager makes a referral to the home and the prospective service user spends some time in the home meeting other service users and having a meal with the people who live there, in some instances an overnight stay is offered. This gives the person the time to decide if they would like to move in and ensures the correct equipment and care plans are made available prior to their admission. The homes admission and assessment procedure Care Homes for Older People Page 10 of 27 Evidence: ensures that people have an informed choice about moving into the home. They are given information at the time of the initial enquiry in the form of a brochure, list of menus, complaints procedure and a statement of purpose before visiting the home that informs them how their care needs are to be met. Following admission, each service user has a care plan developed from information gathered during the assessment so that when followed by staff it helps the care needs to be met on a daily basis. The person lives in the home for six weeks to see if they want to live there permanently and to ensure the home can meet their needs. This period is followed with a review meeting held between the service user and their representatives, the home staff and the care manager. In discussions with relatives they had been given information about the service. Comments they made included, I was given loads of information before my mam came in and someone was always available to answer any questions I had Staff keep me informed at every given opportunity My friend visited before coming in to make sure it was what she wanted to do Care Homes for Older People Page 11 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users living in the home have individual plans of care, however, they do not explain in detail how the care needs are to be met by staff and therefore the home cannot be sure that care needs are being met on a day to day basis. Service users have access to all NHS facilities and services and this ensures healthcare needs are met and good medication administration procedures ensure that medicines are given safely. Evidence: All service users have an individual care plan that is completed by staff and gives the staff guidance on how the care needs of people living in the home will be met and during the visit three care plans were looked at. The care plans were organised and included areas such as pre admission assesments, full admission details, personal information, Healthcare and assessments, lifestyles and interests and other healthcare information that should be kept. However, the day to day care plans did not include detailed enough information to inform staff if the care Care Homes for Older People Page 12 of 27 Evidence: needs are met everyday. One care plan stated that (name) is to establish therapeutic relationships and to use diversional therapies but no detail was given as to what this meant or to tell staff how to carry this out. All service users have a choice of GP and there are regular visits from all local GPs and other healthcare professionals such as the tissure viability nurse, chiropodists, dental service and opticians. Service users needing to attend to hospital out patient appointments are escorted by a member of staff or if the person prefers a family member. The home uses a manrax monitored dosage medication system that is delivered to the home on a monthly basis. Only registered nurses administer medications to service users and annual assessments are carried out on each nurse to ensure their knowledge is updated on a regular basis. Medicine administration records were signed and up to date and a medication audit confirmed medication held by the home was correct. Administration of the lunchtime medications was observed, this was carried out in line with the homes medication procedures. Care Homes for Older People Page 13 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A range of social activities are made available and service users are encouraged and supported to join in activities of their choosing and ability and this helps to contibute to varied and fulfilling days. Service users are offered and receive a varied, wholesome and nutritious diet and this helps to promote the well being of people. Evidence: An activity co-ordinator is employed by the service twenty eight hours per week to provide social activities monday to friday to organise social events for service users. A notice board is up on the wall so that service users and their friends and families are kept informed of events taking place and shows three weeks activities plans that are written in a format that can be understood by everyone, it also shows there is various entertainments organised and many thank you cards from relatives and friends of people living in the home. Activities include one to one days and sometimes group outings. Recently some of the service users attended the theatre to see Swan Lake. Other outings include Sunderland Park and the Winter Gardens which has proved very popular with people in the summer months. Service users talked about going to the local pub for lunch out Care Homes for Older People Page 14 of 27 Evidence: and about how they look forward to the Little Sisters coming into the home every sunday. During the visit a number of service users were taking part and enjoying a pamper day and time was spent chatting with some of the people who live in the home and their comments included the following, The staff sometimes take me out which is nice I have been here over a year and there is always something going on I would rather live at home but thats just me not the home Its lovely living so close to the sea and nice to go there During the visit, a lunchtime meal was taken with service users and it was observed staff were very helpful and attentive to people requiring assistance throughout the meal in a discreet and sensitive manner. Tables were well set with tablecloths, serviettes and condiments and a choice of cold drinks were offered throughout the meal, this was followed with hot drinks being served in the lounge immediately after lunch. The cook asks everyone what they would like to eat, the dinner was hot and well presented and provided service users with a choice at the time of serving the meal. Service users comments during lunch included, There have been many changes in the home but all have been better Its a lovely staff team and they make sure everyone can manage Its nice here and the staff are nice Care Homes for Older People Page 15 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users and their families have the information they need should they have a concern or complaint about the service and good safeguarding policies and procedures are available and this helps to protect service users should an abuse situation arise or be suspected. However all concerns or complaints must be recorded to make sure they are identified and acted on appropriately. Evidence: The home has a complaints procedure that is given to service users and their representatives before moving into the home and tells people how to make a complaint and the length of time it will take before a response is received telling the complainant how the service will deal with the complaint. However although staff were able to state how they act on any concerns or complaints received they are not always recorded and therefore no information is available to know if complainants are happy with the outcomes of their concerns. Staff have received complaints training and protection of adults training both internally by the company and externally from South Tyneside Local Authority and in discussions with staff it was clear they would know what to do should an abusive situation arise or a complaint be received whilst they were on duty. The home has received many compliments about the service they provide from service Care Homes for Older People Page 16 of 27 Evidence: users relatives and friends and these are displayed so everyone has access to them. Safeguarding procedures are made available to staff so that they know what to do should they suspect an abusive situation has arisen. Service users were aware of how to make a complaint if they were not happy and they were all confident that it would be addressed. Care Homes for Older People Page 17 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is clean, generally well maintained and although a number of home improvements have been made since the last inspection, further refurbishments are necessary to make sure service users have a comfortable and safe place to live. All staff have received training in relation to infection control. Evidence: The home is a purpose built property offering accommodation over three storeys and there are a variety of communal sitting areas for service users to choose from. A large number of improvements have been made to the home since tha last inspection, a new conservatory has been errected, in one of the bathrooms a jacuzzi has been installed as well as a new bathing hoist and showers have been replaced. Flat screen televisions have also been purchased for each of the lounges. However, a number of issues still need to be addressed as a matter of urgency, the wood surrounding the windows is rotting away and breaking up and the window in one of the bedrooms cannot be opened at all. The staircase walls are dirty and scuffed and the carpets are stained and worn and in some areas the walls are cracked and in need of replastering. One bedroom carpet is stained and smelling quite badly and needs to be replaced. Vent axias throughout the building were caked in dust and require regular Care Homes for Older People Page 18 of 27 Evidence: cleaning. Cleanliness of the home has improved, generally all areas of the building appeared clean with no unpleasant smells. A handyman is employed by the service to ensure all maintenance issues are addressed quickly and that checks and schedules are completed when they need to be. There are large pleasant andwell maintained gardens with ample seating areas that are used regularly in the summer months by service users and their families. Care Homes for Older People Page 19 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Well trained and competant staff are in post and there good recruitment procedures used and this helps to ensure that service users are kept safe and that they receive a good quality of care. Evidence: The duty rota reflected the numbers of staff on duty on the day of the visit and the staffing levels were adequate to meet the current needs of service users. The staff on duty included two registered general nurses, four care assistants, three domestic staff and two kitchen staff, other staff on duty included an admin person, maintenance handyman and the activities co-ordinator. The home has a policy and procedure on staff recruitment that is used when the home have staff vacancies. The Acting manager was able to explain in detail the process that is used from sending out the initial application form to the letter that is sent offering employment in the home. Staff do not commence Over fifty percent of the care staff currently employed in the home have achieved an NVQ qualification in care and the home uses Thirdforce to ensure all members of staff complete mandatory training. Staff also use the internet to complete various care modules with regular assessments. The training matrix identifies the training needs Care Homes for Older People Page 20 of 27 Evidence: and shows training that has taken place and records evidenced that all the necessary mandatory training had been completed and was up to date. Inspection of the personal staff files for two members of staff one of whom was recently recruited was carried out. Both personal files were organised and kept up to date and the information included all of the necessary documentation that the home is required to keep such as job application, interview, references, personal identity and criminal record bureau checks. In discussions with staff on duty they were positive about the service and made the following comments, Its a great place to work and we get loads of support There have been many changes in the home but they seem to be working well We are like one big family everybody gets on really well All the staff gets loads of training and we are kept well informed of what is going on There have been many changes for the better The home is now run on good lines and getting everything into shape All the staff work as a team with excellant management support Care Homes for Older People Page 21 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is currently well managed by an acting manager registered nurse who is appropriately qualified to manage competantly and shows good leadership skills in managing the staff team and ensures risks to the health and safety of people are minimised. This makes sure the home is run in the interests of people using the service and that they are kept safe. Evidence: The manager of the home is currently on long term sick leave and an acting manager is currently managing the service. She has worked in the home for nine years as deputy manager and head of care and has been in her current role since December 2008. She is a registered general nurse with many years experience and her qualifications include D32,33 AND 34 Assessors award for clinical practice and she has attained her professional trainers certificate in nursing and 703 teaching certificate. The home employs a financial administrator who deals with all financial matters in the Care Homes for Older People Page 22 of 27 Evidence: home. Records evidenced all staff receive one to one supervisions and annual appraisals, separate staff meetings, service user meetings and relatives meetings are held every two months and a health and safety committee has been set up made up of staff. Internal quality assurance systems are well developed and allow the views of service users, relatives and others to be sought and to monitor the quality of the service provided. Observation showed that all staff throughout the day followed safe working practices at all times and records evidenced that staff receive regular training in fire safety, moving and handling and infection control. Care Homes for Older People Page 23 of 27 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 21 23(2)(j) Toilets must be of a design 30/09/2007 that is accessible to disabled and wheelchair users. Showers, bathrooms and toilets must have adequate ventilation. All parts of the home must be kept clean. 31/08/2007 2 25 23 (2) (p) 3 26 13 (3)16(1) (k) 31/08/2007 Care Homes for Older People Page 24 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 7 15 Care plans must explain in detail how the care needs should be met This ensures all the care needs of service users will be met 02/09/2009 2 16 17 All complaints received about the service must be recorded People will know any concerns or complaints will be dealt with effectively 02/09/2009 3 19 13 window frames throughout the building must be replaced This will ensure the safety for everyone insideor outside the building 18/02/2010 4 19 13 Further redecoration and refurbishment needs to be addressed This will ensure service users live in a comfortable environment 18/12/2009 Care Homes for Older People Page 25 of 27 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 26 of 27 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 27 of 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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