Care Home: Miriam Kaplowitch House Care Home

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What the care home does well The home is clean and well maintained providing pleasant individual and communal accommodation. People are treated with respect, have their health needs met and receive their medicines as prescribed. People are able to participate in the Jewish way of life, celebrate important festivals and holidays and receive a kosher diet.Miriam Kaplowitch House Care HomeDS0000002212.V376000.R01.S.docVersion 5.2The staff team are properly and safely recruited and trained to a good standard that exceeds the National Minimum Standard which ensures people are in safe hands. The home is managed properly and there are enough staff to meet people`s needs. What has improved since the last inspection? The manager has addressed all the previous shortfalls that we identified at our last inspection. She has ensured that the registration of the home has been reviewed and that staff are trained in the specific needs of one person who had been admitted out of the homes categories of registration. There is improved management of medicines to make sure that people receive appropriate supervision when self medicating to prevent any risks to them. The bedroom doors have been fitted with screens to the glass panels to promote privacy and dignity. The manager and staff have received training and have access to policies on safeguarding and whistle blowing to make sure they follow appropriate actions to safeguard people from harm. What the care home could do better: The manager must complete a risk assessment to identify potential risks of burning from hot surfaces and to assess the vulnerability of those who may be at risk. Key inspection report CARE HOMES FOR OLDER PEOPLE Miriam Kaplowitch House Care Home 470 Mansfield Road Sherwood Nottingham NG5 2EL Lead Inspector Mary O`Loughlin Key Unannounced Inspection 12th June 2009 09:30 DS0000002212.V376000.R01.S.do c Version 5.2 Page 1 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care homes for older people can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop. The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Miriam Kaplowitch House Care Home DS0000002212.V376000.R01.S.doc Version 5.2 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Miriam Kaplowitch House Care Home DS0000002212.V376000.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Miriam Kaplowitch House Care Home Address 470 Mansfield Road Sherwood Nottingham NG5 2EL 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) 0115 962 2038 0115 969 2326 mkhouse@tiscali.co.uk Nottingham Jewish Housing Association Limited Maria Elizabeth Baddoo Care Home 22 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (1), Old age, not falling within any of places other category (22) Miriam Kaplowitch House Care Home DS0000002212.V376000.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following categories 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: Old age, not falling within any other category - Code OP Mental Disorder, excluding learning disability or dementia - Code MD maximum number of places: 1 The maximum number of service users who can be accommodated is 22 4th April 2008 2. Date of last inspection Brief Description of the Service: Miriam Kaplowitch House an adapted detached house in a residential area in Mapperley Park. It is registered to accept up to 22 older people and it offers care specifically to the Orthodox Jewish Community and prides itself on providing a culturally appropriate service. The accommodation is over two floors and there is a vertical lift for those who have mobility difficulties, there are three lounges available and a separate dining area. There are two kitchens for the separate preparation of dairy and meat products and Kosher products are used for all meals. The home is situated a ten minute walk away from the shopping areas in Mapperley Park and Sherwood, though people with mobility difficulties may struggle with the hills. Public transport can be accessed easily and the home is on a bus route to the Synagogue in Nottingham City Centre. There is a large well-maintained front garden area, which has some seating and there is a large car park for visitors. The current fees range between £331.44 and £600, this does not include private chiropody, hairdressing, newspapers or taxis. All prospective residents receive a copy of the service user guide. The service tells prospective residents and relatives that they can download a copy of the latest inspection report on the internet. There is a copy of the report available Miriam Kaplowitch House Care Home DS0000002212.V376000.R01.S.doc Version 5.2 Page 5 in the office for people living at the service or they can download a copy and print in larger print if needed. Miriam Kaplowitch House Care Home DS0000002212.V376000.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by the Care Quality Commission is about the outcome of the care provided to people using the service. This process considers the providers capacity to meet regulatory requirements and focuses on aspects of service provision that need further development. The main method of inspection used was called case tracking. This involves selecting the care records and looking at the quality of the care people receive by talking to them, examining their care files and discussing how support is offered to them by staff members. People living at the home, members of staff and the manager were spoken with as part of this inspection, documents were read and medication inspected to form an opinion about the quality of the care provided. We looked at what the provider told us they were doing in their Annual Quality Assurance document (AQAA) that they sent to us. We received good responses from our have your say surveys, 8 from people who live there and 4 from staff, the information was used to plan what we looked at. The Quality rating for this service is 2 star. This means that the people who use this service experience good quality outcomes. What the service does well: The home is clean and well maintained providing pleasant individual and communal accommodation. People are treated with respect, have their health needs met and receive their medicines as prescribed. People are able to participate in the Jewish way of life, celebrate important festivals and holidays and receive a kosher diet. Miriam Kaplowitch House Care Home DS0000002212.V376000.R01.S.doc Version 5.2 Page 7 The staff team are properly and safely recruited and trained to a good standard that exceeds the National Minimum Standard which ensures people are in safe hands. The home is managed properly and there are enough staff to meet people’s needs. What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line – 0870 240 7535. Miriam Kaplowitch House Care Home DS0000002212.V376000.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Miriam Kaplowitch House Care Home DS0000002212.V376000.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 3-6 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Before moving to the home people can expect to have an assessment of their needs and the home confirm that they can meet those identified needs. Intermediate care is not provided at the home. EVIDENCE: When we last inspected the home we found that one person had been admitted with mental health needs which the home was not registered to provide care for. Since that time the manager has applied and received a variation of the homes registration certificate to allow one person with mental health needs to be cared for at the home. She has also ensured that the staff team have received training in the specific needs of this person so that they know how to deliver appropriate care and support. Miriam Kaplowitch House Care Home DS0000002212.V376000.R01.S.doc Version 5.2 Page 10 At our last inspection of the home we looked at the initial assessment of the last person to be admitted to the home and found there was a detailed pre admission assessment which the manager completed. No further admissions have taken place since that time. We saw detailed information packs available to anyone that is interested in moving into the home which gives people a good picture of the services the home provides. Miriam Kaplowitch House Care Home DS0000002212.V376000.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 7-8-9-10 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use this service can expect to be treated with respect, have their health needs met and receive their medicines as prescribed. EVIDENCE: We looked at the care plans of 3 people and found that staff regularly review each person’s needs in consultation with them. We saw how any health needs such as nutrition, falls and skin care were regularly risk assessed and from evidence in the plans we saw that people are referred to the doctor promptly and received support from the district nurse as required. The responses we received from residents who returned our surveys shows that all 8 people felt that the staff always make sure they receive the medical care they need. Miriam Kaplowitch House Care Home DS0000002212.V376000.R01.S.doc Version 5.2 Page 12 We asked 4 staff if they felt they had enough support, experience and knowledge to meet the different needs of people in the home and all 4 said they did. When we looked at staff training records we identified how staff access up to date training in the specific needs of people in the home which ensures that people are supported by skilled staff who understand how to plan and support their needs safely. At our last inspection we found some shortfalls in the management of medicines in that some practices needed to improve to make sure that the arrangements for medication were safe and that people received their medicines as prescribed by their Doctor. We looked at what improvements had taken place and found that the medication records are now fully completed, contain required entries, and are signed by appropriate staff. Regular medicine audit checks are recorded to monitor compliance with the homes policies and procedures for those that self medicate and suitable lockable facilities ensure that all medicines including those held by people in their rooms are now safe. From our observations during the inspection and from talking to people receiving care at the home we found that the staff team always demonstrate respectful verbal and non verbal communication, always listen to people and provide information and explanation where needed. People told us that ‘the staff are lovely’ ‘they know how to look after me’. Miriam Kaplowitch House Care Home DS0000002212.V376000.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 12-13-14-15 People using the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use this service can expect to be able to participate in the Jewish way of life, celebrate important festivals and holidays and receive a kosher diet. EVIDENCE: Historically this group of standards have been judged as exceeding the national minimum standards and this inspection found that the quality remains the same. The AQAA tells us that the service provides a full and varied activity programme for everyone. Including using outside agencies for music and movement. There are pub lunches, theatre trips, and full participation in the Leisure and Pleasure Club that is based in the Jewish Community. People confirmed that they are able to celebrate Jewish Festivals with appropriate food and special services and meals as required. People receive Miriam Kaplowitch House Care Home DS0000002212.V376000.R01.S.doc Version 5.2 Page 14 visitors as they wish and make their own decsions about what they participate in each day. People told us they receive visits from the Rabbi and that staff understood their religious and cultural needs. We saw a report from the Environmental Health Officer who inspected the kitchen and food hygeine practices at the home in June 2009 which tells us that there were ‘excellent standards throughout the kitchen’ From the responses we received in our surveys and from people we spoke to at the inspection the food provided is considered to be good and kashrut/kosher is strictly observed. Miriam Kaplowitch House Care Home DS0000002212.V376000.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 16-18 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use this service are listened to and concerns are taken seriously and dealt with appropriately. EVIDENCE: Since out last inspection the manager and staff have received training in how to safeguard people from abuse and they have shown us that they act promptly and in accordance with the local safeguarding adults procedures to ensure that people are protected from harm. The manager has also obtained information on whistle blowing procedures for staff and staff tell us they have been given a leaflet on what to do if they have concerns about anything in the home. There is also a free confidential helpline number that staff can call which is run by the Methodist Housing Association. People living at the home and the staff team have opportunities to meet regularly and minutes of these meetings are provided to everyone. There are also posters displaying how people can complain and they receive information in the service user guide when they first come to stay that explains what to do if they have concerns. Miriam Kaplowitch House Care Home DS0000002212.V376000.R01.S.doc Version 5.2 Page 16 People we surveyed and those that we spoke to directly generally knew what to do and who to speak with if they had any concerns. The manager holds records of all complaints and we saw that 1 complaint has been addressed since our last inspection in a positive way and timely fashion. The commission have not received any complaints about the service in the last year. Miriam Kaplowitch House Care Home DS0000002212.V376000.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 19-26 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service can expect to live in a clean and well maintained environment. EVIDENCE: We did a partial tour of the accommodation and found that the home is homely, comfortable, clean and tidy in all areas. There are some bedroom doors which have glass panels and these have now been covered to ensure the privacy and dignity of the people living at the home. Miriam Kaplowitch House Care Home DS0000002212.V376000.R01.S.doc Version 5.2 Page 18 People told us they were happy with their rooms and that staff help to keep everywhere clean. Information we received from the manager tells us that the home has an appropriate policy for preventing infection and controlling infection. They have obtained up to date guidance from the Department of Health and 23 staff have received training on the prevention and control of infection. Miriam Kaplowitch House Care Home DS0000002212.V376000.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 27-28-29-30 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use this service can expect to be supported by adequate numbers of correctly recruited and well-trained staff. EVIDENCE: The AQAA we received from the manager indicates that the service has over the suggested 50 of care staff trained to National Vocational Qualification Level 2, and the two staff we spoke with had both achieved the qualification. This exceeds the National Minimum Standard. The training records we looked at show that staff have undertaken training on Basic Food Hygiene, Health and Safety, Infection Control, Moving and Handling, safeguarding adults training, Fire training and Dementia care and First Aid. The staff we interviewed confirmed they have done these courses and feel they have the skills they need to provide care and support to people in the home. The staff we spoke with told us they had supplied all of the information and documentation required before they started work and the two staff recruitment records we looked at showed that an appropriate recruitment was followed in practice to make sure people were suitable to work with vulnerable people. Miriam Kaplowitch House Care Home DS0000002212.V376000.R01.S.doc Version 5.2 Page 20 The residents we spoke with and those we sent surveys to all confirm that they receive the care and support they need. Staff responding to our surveys told us that “Training is up to date and everything is covered.” “We have all our training needed and can go on extra courses if we wish to” “We have time to talk to people, we treat them professionally but as part of our family” Staff told us that due to some staff being off on leave they were working very hard to cover shifts. The manager told us both within the AQAA and during the visit that some staff have left recently but they are successfully recruiting new staff to ensure consistent levels of care are maintained. Miriam Kaplowitch House Care Home DS0000002212.V376000.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 31-33-15-38 People using the 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 well managed and the health, safety and welfare of people is monitored and maintained, however, there is a risks of burns to service users due to exposed pipe work and high surface temperatures of radiators EVIDENCE: The manager is registered with the commission and is supervised by a representative from the Methodist Housing Association who have been appointed by the providers of the service, to ensure she receives support and supervision around her professional practice. She has trained in the new Mental Capacity Act and associated safeguards showing she is aware of her responsibilities. Miriam Kaplowitch House Care Home DS0000002212.V376000.R01.S.doc Version 5.2 Page 22 The manager ensures that the staff team are regularly supervised and training plans show that she recognises the importance of a well trained staff team. Staff comments were received within our surveys such as “I feel it’s a well run home and run well by all staff” People using the service told us in our surveys that “Don’t know what the home could do better” “The home gives me everything I ever need” The arrangements for supporting people with their finances was checked at the last inspection and found to be managed safely. This inspection found that the people we case tracked were managing their own money or had small amounts of cash held in safe keeping for them, they were all able to have a copy of any transaction on request. There are regular audits taking place to ensure the manager is aware of any changes or improvements she needs to make and people are regularly consulted on their satisfaction with the care provided at the home. The providers visit the home monthly and prepare a report for the manager on the quality of the care provision which ensures continuous self improvement of the service. The information the manager gave us in the AQAA indicated that all tests and servicing on equipment had been done at the correct intervals. We checked the records of fire tests and equipment along with hoist servicing and found that these are appropriately serviced and tested at regular intervals to ensure people’s safety. We noted that some radiators were not low surface temp or guarded which could present a risk to people from exposed pipe work and high surface temperatures of radiators if they are unable to move away from them quickly or fall on them accidentally. Miriam Kaplowitch House Care Home DS0000002212.V376000.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 2 Miriam Kaplowitch House Care Home DS0000002212.V376000.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No 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 OP38 Regulation 13(4) Requirement A risk assessment must be carried out to identify potential risks of burning from hot surfaces and to assess the vulnerability of those who may be at risk. The maximum surface temperature of hot water pipes, radiators etc should not exceed 43°C. The HSE have written Sector Information Minutes (SIM) on burning risks from hot surfaces in health and social care settings which include information about risk assessment and control measures. Timescale for action 31/08/09 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Miriam Kaplowitch House Care Home DS0000002212.V376000.R01.S.doc Version 5.2 Page 25 Miriam Kaplowitch House Care Home DS0000002212.V376000.R01.S.doc Version 5.2 Page 26 Care Quality Commission East Midlands Region Citygate Gallowgate Newcastle upon Tyne NE1 4PA National Enquiry Line: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. 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. 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