Inspection on 15/02/06 for 17 Jerome Close

This inspection was carried out on 15th February 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 13 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

17 Jerome Close 17/05/07

17 Jerome Close 30/05/06

17 Jerome Close 10/11/05

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 17 Jerome Close 17 Jerome Close Eastbourne East Sussex BN23 7QY Lead Inspector Lindy Latreille Unannounced Inspection 15th February 2006 12:30 17 Jerome Close DS0000021453.V269213.R01.S.doc Version 5.0 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 17 Jerome Close DS0000021453.V269213.R01.S.doc Version 5.0 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. 17 Jerome Close DS0000021453.V269213.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service 17 Jerome Close Address 17 Jerome Close Eastbourne East Sussex BN23 7QY 01323 767399 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) Jemini Response Mr James Edwards Care Home 3 Category(ies) of Learning disability (3) registration, with number of places 17 Jerome Close DS0000021453.V269213.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The maximum number of young adults to be accommodated is three (3). The young adults accommodated will be between sixteen (16) and twenty-five (25) years on admission. Only young adults with a learning disability can be accommodated. Date of last inspection 10th November 2005 Brief Description of the Service: The home is situated in a residential estate on the outskirts of Eastbourne and is close to local shops and facilities. The detached property has three bedrooms. A lounge- dining room, cloakroom, kitchen and third bedroom on the ground floor. On the first floor there is a bathroom with lavatory, two bedrooms and an office. There is a triangular shaped open front garden where additional parking space has been added. The rear garden is enclosed by a perimeter wall and is grassed with a small paved area. The home aims to work with young people with disorders within the autistic spectrum and challenging behaviour. 17 Jerome Close DS0000021453.V269213.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place between12.30 and 19.00. The Registered Manager was on holiday and the Registered Manager of the sister home at 41, Jerome Close, assisted the Inspector until the Team Leader came on duty. Three staff were spoken to, the young people were observed in their daily routine and engaged as they felt able. A visitor from an adult service explained his visit to 17 Jerome Close, which was to support one young person in a new adult educational setting. The working files of the three young people were read along with staff files and handover was observed at 14.30 What the service does well: What has improved since the last inspection? What they could do better: Some staff felt that the Registered Manager is not present in the service enough. Though the Registered Manager had delegated some tasks he retains the responsibility and is not actioning quality assurance monitoring or supervision of staff. Management of the food stores in the home must meet the needs of the residents. The home lacked cleanliness and tidiness. The verbal professionalism of staff whilst working with the young people needs to be clarified by the Registered Manager. All staff at 17 Jerome Close must have satisfactory Criminal Records Bureau checks for POCA and POVA. The service should look to accredited training using the Learning and Disability Awards Frameworks leading to National Vocational Qualification’s. 17 Jerome Close DS0000021453.V269213.R01.S.doc Version 5.0 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. 17 Jerome Close DS0000021453.V269213.R01.S.doc Version 5.0 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 17 Jerome Close DS0000021453.V269213.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2. The company has a policy with regard to the admission of a young person that is followed. EVIDENCE: At the last inspection the service had not followed its own policy on the prospective admission of young people. This was in part due to the Registered Manager having worked with the recently admitted young person in another setting. There have been no further admissions but management are aware that the procedure must be followed. 17 Jerome Close DS0000021453.V269213.R01.S.doc Version 5.0 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7 and 9. The young person is constantly encouraged to make decisions using their preferred method of communication. The management of risk is considered alongside the vulnerability of the young person. EVIDENCE: The young people are encouraged to make decisions throughout the daily routine where it is appropriate. Staff support and communicate with the young people in their preferred method of communication. Where difficulties have arisen the service has engaged with outside agencies to clarify the situation. The young people resident at 17 Jerome Close are very vulnerable and have a limited understanding of danger. As a consequence the staff are aware of the need to assess all activities and routines in or out of the home throughout the weekly routine and they plan for the safety of each resident. 17 Jerome Close DS0000021453.V269213.R01.S.doc Version 5.0 Page 10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,16 and 17. Activities are planned to meet the needs of each young person and are evaluated after each event. The weekly routines include the young people visiting local facilities on a regular basis. All staff demonstrated a respectful attitude for the rights of the young people in their care. Healthy meals are provided and mealtimes are used as social occasions. EVIDENCE: The individual activity programmes are comprehensive and include horse riding, walking, swimming, shopping, meals out and pub visits. Staff are careful to ensure that the three young people do not always follow the same activities and enjoy individual time with staff. Staff confirmed that choice is extended to all of them about any activity. Thorough evaluation follows all activities. 17 Jerome Close DS0000021453.V269213.R01.S.doc Version 5.0 Page 11 The weekly routine includes using community facilities several times in the week. The young people have contact and are known to the local community and this is built in to their activity programme. Daily routines are planned to meet the young people education and leisure activities. Choices are offered where it is appropriate to do so. Staff are aware of the developmental needs of the young people and personal time is discreetly managed. The young people are involved in some of the shopping and encouraged to be involved in the cooking, though no involvement is mandatory. During the evening of the inspection the member of staff cooking supper with one resident, as the others had gone on an activity, had decided with the young person’s agreement on a particular menu for that night. Looking in the cupboards she was unable to cook the agreed meal, as there were no ingredients. She commentated that the cupboard was particularly bare and confirmed that staff from the sister home in the same road do access the home to “borrow” when they are short. A meal was organised but it was a fast food meal as opposed to a home cooked meal. 17 Jerome Close DS0000021453.V269213.R01.S.doc Version 5.0 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 20. The young people health and emotional well-being is monitored and recorded daily. EVIDENCE: Detailed daily reports are written about the holistic well-being of all the young people. These are evaluated weekly and a report is sent to each social worker every month. All health appointments are kept and preliminary preparation work, such as visits, is supported in relation to dentistry. The Family Intensive Support Service (FISS) works with young people in the Eastbourne area of East Sussex and support the staff to maximise their communication with the young people. This interagency working has enabled improved communications to create a better understanding of the holistic needs and behaviour of all the young people. No young person holds their own medication, and there is very little used in the home other than homely remedies. Two staff at the point of administration sign medication. One staff had only signed one entry and it was unclear how the medication was audited for quality assurance by the Registered Manager. 17 Jerome Close DS0000021453.V269213.R01.S.doc Version 5.0 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 23. Staff have an understanding of protecting the young people from self-harm or abuse and have a history of informing the Registered Manager of any concerns. EVIDENCE: Staff have demonstrated their understanding of protecting the young people from self-harm or abuse by reporting their concerns to the Registered Manager. Reports of any young person self-harming are clearly recorded and staff know what it indicates for that young person. Within the home the staff are informal in their manner and dress and verbal banter is common. The Inspector has commented in the past that the style of such verbal banter may be offensive to some staff or possibly disrespectful. The informality of verbal banter can invoke other behaviours, such as play fighting, and has in the past, which is totally unacceptable in a professional setting. While such behaviour still remains the Registered Manager needs to clarify to staff that they are working in a professional environment not a domestic one. 17 Jerome Close DS0000021453.V269213.R01.S.doc Version 5.0 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 30. Aspects of the home do not look well cared for and it was not possible to see the programme that the Registered Manager uses for the quality control. EVIDENCE: The laundry is managed in the kitchen, which is contrary to the requirements of the National Minimum Standards. As there is at present very little soiled laundry it is sufficient that a domestic washing machine is use. There needs to be a policy in place that clearly specifies when and how the laundry is done, the management of soiled items, use of gloves and the maintenance of infection control. Laundry activity must not take place during food preparation. The carpets in the home looked unclean, heavily worn and stained. Curtains in the lounge were broken from the rail and over long causing a possible trip factor and being unhygienic. There were piles of items poorly stacked on the floor that needed to be stored. A metal staff cupboard used for staff files had been moved into the lounge as a young person had tipped it over in another part of the house. This cupboard was not appropriate in the lounge as it was not a piece of furniture and unlocked it contravened confidentiality. 17 Jerome Close DS0000021453.V269213.R01.S.doc Version 5.0 Page 15 17 Jerome Close DS0000021453.V269213.R01.S.doc Version 5.0 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34, 35 and 36. Staff are strongly motivated to meet the young people’s needs and follow training provided. The home did not meet the requirements of the National Minimum Standards in relation to recruitment. The home need to look to the Learning Disability Award Framework (LADF) accredited training to support National Vocational Qualification qualifications. Some staff are not being fully supervised. EVIDENCE: There is provision for in-house training and staff are keen to attend. Staff spoke of the support they received to attend training by the Registered Manager. Many of them had started training while the home was a children’s home and are still following that programme to achieve Care for Children and Young People (CCYP). The requirements are different as the service is now an Adult home. The staff file sampled had an some of the requirements for recruitment but not specific interview questions and the responses, no confirmation of gaps in employment and references did not ask the length of time the reference had known the applicant. One reference was accepted written on 15/04/05 on an applicant who had only been with the referee since 05/03/05. There was no other evidence that another reference had been sought. The Registered 17 Jerome Close DS0000021453.V269213.R01.S.doc Version 5.0 Page 17 Manager does not manage the recruitment process and staff said that he seldom attended the interviews. Now that the home is an adult service with young people 16 –18 years all staff should have a Criminal Records Bureau check that confirms their satisfactory check with both POVA and POCA (Protection of Children and Vulnerable Adults). All staff commented that plenty of training was offered and funded by the service. Most staff are still following their children’s qualifications and will now have to look to the Learning Disability Award Framework accredited training to support the staff qualifications. The Registered Manager should be supervising his senior staff and there is no supportive evidence of supervision at least six time a year or annual appraisals. 17 Jerome Close DS0000021453.V269213.R01.S.doc Version 5.0 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 and 42. The Registered Manager is only in the home for part of the five days that he is on duty. There are some quality monitoring systems, but not effective quality assurance. Health and safety training is provided to support safe working practices. EVIDENCE: The Registered Manager is in the home for part of the five days that he is on duty. Some time is spent in the office of the home at 41, Jerome Close or at home when completing financial matters. Staff in the home spoke of a difficulty in contacting him when he is off-duty and other staff are being contacted in their off-duty to deal with queries that on-duty staff have. The Registered Manager confirmed that he has the telephone with him at all times. The Registered Manager has completed his Registered Managers Award and is awaiting the certificate. 17 Jerome Close DS0000021453.V269213.R01.S.doc Version 5.0 Page 19 There are some quality monitoring systems in place that are carried out by senior staff. Such monitoring should be counter signed by the Registered Manager and he has not done so since 21/11/05. There was no evidence of a programme that monitored all aspects of the home to ensure effective quality assurance from which other agencies and parents contributed. A senior member of staff manages safe working practices and training is provided to ensure the health and safety of the young people. 17 Jerome Close DS0000021453.V269213.R01.S.doc Version 5.0 Page 20 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X 3 X 3 x Standard No 22 23 Score X 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X 3 X 3 x Standard No 24 25 26 27 28 29 30 STAFFING Score X X X X X X 2 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 X 16 3 17 Standard No 31 32 33 34 35 36 Score X 2 X 2 2 2 CONDUCT AND MANAGEMENT OF THE HOME 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 17 Jerome Close Score X 3 3 x Standard No 37 38 39 40 41 42 43 Score 2 X 2 X X 3 x DS0000021453.V269213.R01.S.doc Version 5.0 Page 21 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 YA39 Regulation 17(2) Requirement That the roster shows the hours worked by the Registered Manager as hands-on or management. Previous time scale not met That quality assurance programme is structured. That a policy for the management of laundry is written. That 50 of staff are trained. That adequate food stores are provided to ensure all meals are wholesome. That staff conduct themselves professionally whilst on duty. That the home is maintained in a clean and tidy manner. That 50 of staff are qualified. Timescale for action 15/03/06 2. 3. YA39 YA30 24,35(a) 13(3) 15/06/06 31/03/06 4. 5. 6. 7. 8. 9. 10 11. 12 YA32 YA17 YA23 YA30 YA32 YA34 YA35 YA36 YA37 18(1)(c)(i) 16(2)(i) 12(5)(b) 13(4)(c) 18(1)(a) 15/12/06 15/03/06 15/03/06 15/03/06 15/06/06 15/03/06 15/12/06 15/03/06 15/03/06 Page 22 19(4)(b c) That recruitment requirements are fully met. 18(1)(a) That staff are qualified to meet the needs of young people with learning difficulties. 18(2) That staff are appropriately supervised 9(2)(b i) That the Registered Manager DS0000021453.V269213.R01.S.doc 17 Jerome Close Version 5.0 13 YA39 supports staff through his presence in the home. 24(1)(a b) That the Registered Manager has a programme of quality assurance and improvements for the year. 15/04/06 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 YA1 Good Practice Recommendations That 80 staff working with 16 and 17 year olds are qualified to National Vocational Qualification level 3 in Caring for Children and Young People. 17 Jerome Close DS0000021453.V269213.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT National Enquiry Line: 0845 015 0120 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 17 Jerome Close DS0000021453.V269213.R01.S.doc Version 5.0 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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