Inspection on 25/07/05 for Jericho

This inspection was carried out on 25th July 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Jericho 08/11/06

Jericho 15/02/06

Jericho 11/01/05

Jericho 21/07/04

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Southfields

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Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Jericho 188 Hawthorn Road Bognor Regis West Sussex PO21 2UX Lead Inspector Annie Taggart Announced Monday 25 July 2005, 11:00am th 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 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 Stationary 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. Jericho H60-H11 S14587 Jericho V230657 250705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Jericho Address 188 Hawthorn Road, Bognor Regis, West Sussex, PO21 2UX Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01243 869002 LArche Post Vacant Care Home 6 Category(ies) of PC Care Home only 6 registration, with number of places Jericho H60-H11 S14587 Jericho V230657 250705 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: none Date of last inspection 11/01/05 Brief Description of the Service: Jericho is a care home registered to accomodate six service users with a learning disability. The property is a detached house situated in a residential area in the town of Bognor Regis, West Sussex. The accommodation is arranged on three floors, with service users living on the ground and first floors. Staff members occupy rooms on the first and second floors. The home is owned by LArche which is a voluntary organisation and the responsible individual is Mr. Chris Bemrose. The registered managers post is currently vacant, the home being managed by the acting manager Carmen Benea. Jericho H60-H11 S14587 Jericho V230657 250705 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The announced inspection was carried out at 11am and lasted for four hours. During the course of the inspection the inspector spent time talking to three residents, four staff members and an NVQ assessor who was visiting the home. A tour of the building was undertaken and the inspector observed interactions between residents and staff members. Records were seen including four care plans and daily recording updates, four staff records were sampled and health and safety records which included maintenance checks seen. Prior to the inspection, the last two inspection reports were read along with any documentation and correspondence relating to the service. The service completed a pre-inspection questionnaire, which provided additional information to assist with the inspection. Six service user comment cards were received and all made very positive comments about the standard of care in the home. Five relative/visitor card were also received and some contained comments made regarding the management of the home. Comments were further investigated by the inspector by speaking on the telephone to the people who returned the cards. The responsible individual Chris Bemrose and acting manager Carmen Benea were present during the inspection and assisted by supplying further information. The people living in the home said they preferred to be called residents and this is reflected in the report. What the service does well: The home provides a friendly, supportive and comfortable environment for the people who live there. The staff team are very committed and are well trained and supervised. There is access to a wide variety of community- based activities and residents have opportunities for personal development. The people who live in the home said that they were very happy there and that the people supporting them were kind and caring. Jericho H60-H11 S14587 Jericho V230657 250705 Stage 4.doc Version 1.30 Page 6 There are opportunities available for residents to be involved in the day to day running of their home and to have a say in the management of the wider organisation. What has improved since the last inspection? What they could do better: As good practice care plans showed be agreed and signed by the resident or their representative. The programme of replacing older furniture should be continued. Please contact the provider for advice of actions taken in response to this Jericho H60-H11 S14587 Jericho V230657 250705 Stage 4.doc Version 1.30 Page 7 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Jericho H60-H11 S14587 Jericho V230657 250705 Stage 4.doc Version 1.30 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Jericho H60-H11 S14587 Jericho V230657 250705 Stage 4.doc Version 1.30 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1 2 3 4 5 6 Prospective residents and their families are given sufficient information to enable them to make a choice about whether they wish to live at the home. EVIDENCE: There is a Statement of Purpose and Service User Guide available, which have recently been reviewed and updated. The Service User Guide is also available in an accessible format using words and symbols. A comprehensive pre-admission procedure is carried out which includes an assessment of needs and wishes being undertaken with input from families and other professionals involved in the person’s care. Visits and short stays at the home are carried out to enable the prospective resident and the people already living in the home to make a choice about living together. Residents in the home confirmed that they had made visits to the home before moving in. Residents receive a written contract setting out the terms and conditions of residency and also agree to the mandate and ethos of the organisation. Contracts sampled during the inspection had been signed by the resident or their representative. Jericho H60-H11 S14587 Jericho V230657 250705 Stage 4.doc Version 1.30 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6 7 8 9 10 Individual needs and choices are recorded in a plan of care and residents are encouraged and supported to be as independent as possible. EVIDENCE: Comprehensive individual plan are in place detailing the health and social care needs of each resident in the home. The plans show a “person centred” approach and daily or weekly reports are updated as necessary. There is evidence of residents being encouraged to make choices and identify goals for their future development with input from families and other professionals involved with the person’s care. Risks are identified with plans in place to minimise personal risks to residents and staff members. Daily plans and house meeting records show that residents participate fully in the running of the home and are supported to carry out household tasks. One person said that they were very proud of keeping their room tidy themselves and another said they enjoyed helping with the cleaning and cooking. There is also a house mandate, which is agreed by all of the people living in the home, both staff members and residents. The mandate agrees how the Jericho H60-H11 S14587 Jericho V230657 250705 Stage 4.doc Version 1.30 Page 11 home will be run and includes participation in household tasks. The mandate is produced in an accessible format using pictures and symbols and is posted on the notice board in the house. The home has a confidentiality policy and all records are securely stored in the office. Jericho H60-H11 S14587 Jericho V230657 250705 Stage 4.doc Version 1.30 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11 12 13 14 15 16 17 The people who live in the home are offered opportunities for personal development, there is access the local community and people are encouraged to develop friendships and local networks. EVIDENCE: There is evidence of residents accessing a wide variety of social activities and agreed goals for personal development are detailed in the individual plans. Residents said that they enjoyed going to pubs, clubs, the cinema, parties, BBQ’s, shopping and just out and about in the local community. The ethos of the L’Arche organisation is one of community with inclusion and prayer forming part of the core values and beliefs. Residents are free to choose whether or not they attend the daily prayer meetings and there was evidence in personal files of people attending churches of differing religions. During the visit two residents were working in the garden, one person was baking bread in the day-care facility, one person was working in a charity shop and another was attending a horticultural centre. During the afternoon staff Jericho H60-H11 S14587 Jericho V230657 250705 Stage 4.doc Version 1.30 Page 13 members joined residents in a game of football in the garden. The residents spoken to confirmed they were very happy at the home and said they were treated kindly and with respect. A variety of holidays have been booked, the people living in the home confirmed that they had been offered a choice of destinations and were really looking forward to going away. One person had just come back from a holiday with their family. One person said, “Jericho is my home, the staff and other people I live with are really nice”. Another person said, “It’s peaceful, happy and people are good to me”. All of the six resident comment cards received prior to the inspection recorded positive comments about the home and people said that they were very happy there. Residents said that they are really happy with the food provided in the home and confirmed that they were involved in making up the menus. There is evidence of a variety of fresh food being provided including occasional meals out. Jericho H60-H11 S14587 Jericho V230657 250705 Stage 4.doc Version 1.30 Page 14 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 standard(s) 18 19 20 21 The health and emotional needs of each resident is assessed, recorded and monitored on a regular basis. Policies and procedures regarding medication are robust and designed to protect the people living in the home. EVIDENCE: Individual plans contain details of the personal care needs of each person and identify how the care will be provided. There is evidence of input from a variety of other professionals including doctors, dentists, health clinic checks and advice and support from the community learning disability team and psychiatrists. A family member said that they felt they could have been more involved with the healthcare needs of their child. Mr. Bemrose said that this area is being addressed and parents would be encouraged to offer support providing that agreement is sought from the resident concerned. At the present time there are no residents in the home who manage their own medication. The home has an agreement with the local pharmacy and staff members receive relevant training. Medication is securely stored in the office of the home and all records were found to be in good order. Since the last inspection a “homely remedies” policy has been implemented and has been agreed with the doctors involved with the home. Jericho H60-H11 S14587 Jericho V230657 250705 Stage 4.doc Version 1.30 Page 15 The ageing process is addressed in the individual plan for each person and should a person be reaching the end of their life, a case conference would be undertaken to agree the best course of action for their care. Jericho H60-H11 S14587 Jericho V230657 250705 Stage 4.doc Version 1.30 Page 16 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 standard(s) 22 23 Complaints and concerns are addressed and acted upon and the policies, procedures and staff training in the home are designed to protect the people living there from the risk of abuse or self-harm. EVIDENCE: The organisation has a complaints procedure, which is detailed in the Statement of Purpose and Service User Guide. The procedure is also produced in an accessible format a copy of which is posted in the home. There is evidence of complaints and concerns from residents being recorded and acted upon and residents said they would talk to a member of staff or someone else in the organisation if they were unhappy. There is also evidence of complaints from families having been investigated in a satisfactory manner, but two family members said that they were not aware of the procedure to follow until they actually needed to make a complaint. Mr. Bemrose said that this has been addressed and an updated version of the complaints procedure and Statement of Purpose has now been sent to families and other people involved with the home. Staff members receive training in the protection of vulnerable adults from abuse and those spoken to demonstrated an awareness of the procedures to follow should they suspect an abuse has taken place. Individual plans contain details of resident’s behavioural difficulties and risk assessments are in place to identify and minimise risks to health and safety. Jericho H60-H11 S14587 Jericho V230657 250705 Stage 4.doc Version 1.30 Page 17 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 standard(s) 24 25 26 27 28 29 30 The home offers a comfortable, friendly and well-maintained environment for the people who live there. Gardens are very accessible and bedrooms offer privacy and individualised space. EVIDENCE: The house has a friendly, homely feeling and provides a comfortable and wellmaintained environment for the people who live there. There is a pleasant lounge and kitchen/dining room and the conservatory has a table and chairs in place where hobbies and crafts can be carried out. There is a large pleasant garden, which is accessed easily from the house. Bedrooms in the home have been personalised with TV’s music systems, posters, photos and personal belongings and locks are fitted to doors to ensure privacy. Some of the rooms have recently been redecorated and one person was very happy with the new carpet they had chosen. Some of the furniture in bedrooms is looking a bit “tired” but the acting manager said that plans were in place for renewal and replacement. Residents all said they were very happy with their rooms. The dining room has been redecorated and the flooring replaced. Jericho H60-H11 S14587 Jericho V230657 250705 Stage 4.doc Version 1.30 Page 18 There are sufficient toilet and bathing facilities available and the flooring has been renewed in the upstairs bathroom. Hand- rails and grab handles are in place to assist mobility and the home was clean, fresh and hygienic. Radiators in the home are not covered but risk assessments are now in place to ensure the safety of residents. Jericho H60-H11 S14587 Jericho V230657 250705 Stage 4.doc Version 1.30 Page 19 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31 32 33 34 35 36 Residents at the home are supported by a committed staff team who are aware of their roles and responsibilities. Recruitment procedures are robust and staff members receive supervision and training. EVIDENCE: Staff members all receive a detailed job description and also have to agree to the mandate of the organisation. Many team members have worked for the L’Arche organisation in other parts of the world. New staff members receive a comprehensive induction programme designed around the needs of people with a learning disability, during which time they attend mandatory training. A further ongoing programme of training is also undertaken. A team meeting was taking place and an NVQ assessor, present in the house carrying out observations spoke highly of the commitment and skills of the people working in the home. As English is not the first language for many of the staff working for L’Arche a “paperless” NVQ programme has been accessed where the assessor records all observations and produces the portfolio. This has proved to be very successful and staff members were very enthusiastic about the process. Jericho H60-H11 S14587 Jericho V230657 250705 Stage 4.doc Version 1.30 Page 20 Staff members spoken to demonstrated a good knowledge of the needs of the people they support and were observed being respectful and friendly in their interactions with residents. Staff members confirmed that supervision sessions are carried out on a monthly basis. The sessions, which are recorded, involve discussion around work practice and personal development. Residents said they liked the staff team very much and were sad when they moved on. Robust recruitment procedures are in place, four staff files were seen and all contained the required documentation to meet the standard. Jericho H60-H11 S14587 Jericho V230657 250705 Stage 4.doc Version 1.30 Page 21 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37 38 39 40 41 42 43 The home is currently being well run. Policies, procedures and working practices are in place to offer direction to staff and ensure the protection of the people living there. EVIDENCE: The manager’s post is currently vacant. Jericho is being run by an acting manager Carmen Benea who has worked for the L’Arche organisation for some time. Mr. Bemrose said that plans were in place to replace the registered manager as soon as possible. Some of the comment cards received from families, detailed personal difficulties experienced with the former manager of the home. The comments were followed up by the inspector via telephone calls to families during which time people said that the difficulties had now been resolved and confirmed that were now happy with the management of the home. Jericho H60-H11 S14587 Jericho V230657 250705 Stage 4.doc Version 1.30 Page 22 There are a variety of meetings available where residents have the opportunity to express their opinions, these include weekly house meetings, monthly organisational meetings and annual gatherings where families and other people involved with the home are invited. Mr. Bemrose said that there was a commitment from the organisation to further involve the families and representatives of residents in order to make ensure their opinions and suggestions are valued. Health and safety records were seen which included medication, fire, gas and electrical checks and all were in good order. A monthly health and safety check is completed, with outcomes recorded. An annual audit is also carried out in the home by a senior member of the L’Arche organisation. Providers visit forms are received monthly by the Commission for Social Care Inspection, as are any relevant accident and incidents forms. Policies and procedures in the home are introduced to new staff members during the induction period and are signed and dated by each person. Procedures in the home regarding resident’s monies are robust with all transactions being individually recorded and receipts kept on file. Only two senior staff members have access to the monies. The regional office carries out an unannounced audit on a regular basis to ensure that the financial systems are being followed and recorded. Jericho H60-H11 S14587 Jericho V230657 250705 Stage 4.doc Version 1.30 Page 23 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 3 3 3 3 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Jericho Score 3 3 3 3 Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 3 3 H60-H11 S14587 Jericho V230657 250705 Stage 4.doc Version 1.30 Page 24 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard Regulation Requirement Timescale for action 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 Good Practice Recommendations Jericho H60-H11 S14587 Jericho V230657 250705 Stage 4.doc Version 1.30 Page 25 Commission for Social Care Inspection 2nd Floor, Ridgeworth House Liverpool Gardens Worthing, West Sussex BN11 1RY 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. 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