Inspection on 03/06/05 for Jerome House

This inspection was carried out on 3rd June 2005.

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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Jerome House 03/09/07

Jerome House 30/05/06

Jerome House 07/12/05

Jerome House 04/10/04

Jerome House 02/06/04

Jerome House 05/02/04

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

CARE HOME ADULTS 18-65 Jerome House 71 Randall Avenue Neasden London NW2 7SS Lead Inspector Julie Schofield Unannounced 3 June 2005 10.40am 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. Jerome House G62-G11 S17485 71 Randall Ave v227591 3.6.05 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Jerome House Address 71 Randall Avenue Neasden London NW2 7SS 020 8450 8544 020 8452 8544 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) Mrs Lucille Rabor Care Home 3 Category(ies) of MD 3 registration, with number of places Jerome House G62-G11 S17485 71 Randall Ave v227591 3.6.05 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 04 October 2004 Brief Description of the Service: Jerome House is situated within walking distance of the shops at Neasden. Randall Avenue is close to a bus route and there is access at one end of Randall Avenue to the North Circular Road. The nearest underground station is Neasden. It is a large semi-detached house with a small area at the front of the house and a garden at the rear of the property. The house has a driveway providing on site parking. There is also parking space available on the street outside the house. The home is registered for 3 adults with mental health problems and there are bedrooms on both the ground and first floor with bathing and toilet facilities on both floors. Communal space is situated on the ground floor and consists of an open plan lounge and dining area, which leads to a small, indoor smoking area. There is an office on the first floor. At the time of the inspection two residents were accommodated in the home and one resident had recently been admitted into hospital. Jerome House G62-G11 S17485 71 Randall Ave v227591 3.6.05 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place on a Friday in June 2005 and lasted for 4 hours. The manager/proprietor was on duty. The carer on duty and the 2 residents took part in the inspection and the Inspector would like to thank them for their comments. A partial site inspection took place and case records and staff records were inspected. What the service does well: What has improved since the last inspection? The carpet in the hall and on the stairs and the landing has recently been replaced and a resident said that they liked the new carpet. Jerome House G62-G11 S17485 71 Randall Ave v227591 3.6.05 Stage 4.doc Version 1.40 Page 6 Since the last inspection staff have undertaken protection of vulnerable adults training. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Jerome House G62-G11 S17485 71 Randall Ave v227591 3.6.05 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Jerome House G62-G11 S17485 71 Randall Ave v227591 3.6.05 Stage 4.doc Version 1.40 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 standard(s) These standards were not inspected at this inspection as the 2 residents have lived in the home prior to the formation of the Commission for Social Care Inspection and the National Care Standards Commission. EVIDENCE: Jerome House G62-G11 S17485 71 Randall Ave v227591 3.6.05 Stage 4.doc Version 1.40 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 standard(s) 6,9 Evaluating and reviewing care plans on a regular basis ensures that changes in the needs of residents are identified and can be addressed. Staff support residents to take responsible risks so that residents can enjoy an independent lifestyle. EVIDENCE: Two case files were examined. Each file contained a comprehensive care plan, which addressed personal, health and social care needs. Monthly evaluations of the care plans had been completed in May on one of the files and had been completed either in April or in May on the other file. The evaluations had been signed by the residents. There were also minutes of CPA review meetings and minutes of reviews convened by the home on file. Each of the case files contained risk assessments, which were tailored to the individual needs to the residents. Risk assessments had been drawn up for the non-provision of a front door key, smoking cigarettes, aggressive behaviour, excessive consumption of soft drinks etc. The risk assessment included risk management strategies. Jerome House G62-G11 S17485 71 Randall Ave v227591 3.6.05 Stage 4.doc Version 1.40 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 standard(s) 12, 13, 14, 15, 17 Residents have access to a resource centre, which provides an opportunity to develop their social and communication skills. Residents are knowledgeable about what facilities the community has to offer and they make decisions about what they want to do each day. The support of staff enables residents to maintain family contact. Residents are offered a balanced and varied diet, with dishes to satisfy cultural needs. EVIDENCE: Both residents attend an African Resource Centre on 2 days per week although they were given the opportunity to attend on other days when the centre increased their days of opening. Residents confirmed that they enjoyed attending the centre and one of the residents said that they liked to play pool when they were there. The manager said that there are board games in the home, including scrabble, for residents to use and sometimes residents go out walking to the local park. The member of staff on duty tried to encourage one of the residents to take part in a game of cards but the resident refused. Residents go out to the local Jerome House G62-G11 S17485 71 Randall Ave v227591 3.6.05 Stage 4.doc Version 1.40 Page 11 shops for small purchases and may go to Kilburn or Brent Cross for clothes shopping. A resident said that a member of staff sometimes arranges outings and that the resident had taken part in trips to the West End, Brent Cross and Wembley. Although a holiday had been planned in 2004 the residents declined to take part. Residents have contact with their families and confirmed that members of staff make their relatives welcome if they visit the residents at the home. A resident said that they visited their family on a regular basis. Residents said that they were satisfied with the meals provided and that the content of the menu was discussed during residents’ meetings. They confirmed that changes have been made to the menu as a result of feedback from the residents. An African resident said that there was a member of staff who cooked African food for them. The African-Caribbean resident said that the menu included foods that satisfied his cultural needs. The menus were examined and they provided a varied and balanced diet. Food records for the individual residents were available. Jerome House G62-G11 S17485 71 Randall Ave v227591 3.6.05 Stage 4.doc Version 1.40 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 standard(s) 19 Residents’ health care needs are met through access to health care services in the community. EVIDENCE: Both case files were examined. There was a record of appointments with the dentist, the GP, the psychiatrist, the psychologist, the optician and the chiropodist. There was a record of outpatient appointments. The manager said that an escort was provided for appointments, as required. Jerome House G62-G11 S17485 71 Randall Ave v227591 3.6.05 Stage 4.doc Version 1.40 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 standard(s) 22, 23 Residents are aware of their right to complain if the care that they receive is not satisfactory. An adult protection policy, familiarity with the interagency guidelines and protection of vulnerable adults training for staff contribute towards the safety of residents. EVIDENCE: The manager said that no complaints have been recorded since the last announced inspection and residents confirmed this. The residents said that they would speak to the manager if they wished to raise concerns or make a complaint. There is a complaints procedure in place. It is simple to understand and includes timescales for each stage of the process. There is a protection of vulnerable adults policy in place. The home has a copy of the local authority’s interagency guidelines. Staff have received protection of vulnerable adults training and management of aggressive behaviour training. The manager said that no allegations or incidents of abuse have been recorded since the last announced inspection. Jerome House G62-G11 S17485 71 Randall Ave v227591 3.6.05 Stage 4.doc Version 1.40 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 standard(s) 28, 30 If residents are to enjoy comfortable and pleasant communal areas the open plan lounge and dining area and the separate smoking area need to be refurbished. Residents live in a home where standards of cleanliness are good. EVIDENCE: Communal space consisted of an open plan lounge and dining area, which leads to a small designated smoking area. The varnished flooring in the lounge area was marked with burns, particularly in front of seating areas, where residents have stubbed out cigarettes. The cushions on the 2 seater settee were marked and both the 2 seater and the 3 seater settees were shabby in appearance. The seating in the designated smoking area consisted of 2 “milkmaids’ stools” and there were cracks in the plasterwork on the walls. The communal areas were clean and tidy and at the start of the inspection the member of staff on duty was cleaning the home. The laundry area is situated on the ground floor. Access to this is through the open plan lounge and dining area or from the garden. Residents are encouraged to do their own laundry and during the inspection one of the residents was taking clothing from the machine. The manager said that the home does not service incontinent laundry. Staff have received infection control training. Jerome House G62-G11 S17485 71 Randall Ave v227591 3.6.05 Stage 4.doc Version 1.40 Page 15 Jerome House G62-G11 S17485 71 Randall Ave v227591 3.6.05 Stage 4.doc Version 1.40 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32,33,35,36 Staff working with residents who have mental health problems need training that will enable them to understand the particular needs of residents and to provide the residents with appropriate support. The rota demonstrated that there were sufficient staff on duty to support the residents. The home lacks a training and development plan for ensuring that training provided enables staff to meet the objectives contained in the Statement of Purpose and is tailored to meet the individual and changing needs of residents. Individual supervision sessions enhance the overall support available to staff and is an opportunity to encourage personal development. EVIDENCE: The manager has provided the CSCI with details of the experience and training courses completed by members of staff. At present the majority of staff are undertaking NVQ training or LDAF training. The member of staff on duty said that they had worked in the home for approximately 2 years and that this was their first post working in a care home. Not all staff have undertaken training in mental health issues. At the start of the inspection 1 carer was on duty. A copy of the rota was examined. The period covered included the day of the inspection. Post titles were included. There was a telephone number included on the rota for staff to use to contact an on call manager. The manager’s hours were included on the Jerome House G62-G11 S17485 71 Randall Ave v227591 3.6.05 Stage 4.doc Version 1.40 Page 17 rota although as she is the registered manager for 2 of the company’s care hours her hours are divided between the 2 homes. (The other care home is a minute’s walk away). The home was maintaining agreed staffing levels. The rota included a minimum of 1 carer on duty at all times and that at night the carer undertakes waking night duties. The member of staff confirmed that staff meetings took place on a regular basis. They said that they were able to raise matters, if they wished. The manager said that the home was in the process of formulating a training and development plan. Records are kept of training courses undertaken by members of staff. Individual supervision sessions took place and staff confirmed that they received support on a day-to-day basis from the managers, who were available to give advice. Jerome House G62-G11 S17485 71 Randall Ave v227591 3.6.05 Stage 4.doc Version 1.40 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 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) 37,42,43 Continuing development of knowledge and skills contributes towards an effective manager and the manager has identified this as a priority. The training that staff receive in safe working practice topics enable them to safeguard the health, safety and welfare of the residents. The home lacks a business plan to demonstrate the home’s financial viability and sound management. EVIDENCE: The manager said that she is continuing to study for her NVQ level 4 qualification. She already holds a nursing qualification and is an experienced manager of care homes for adults with mental health problems and care homes for adults with learning disabilities. The member of staff said that they had undertaken training in safe working practice topics including food handling, first aid and infection control. Hazardous substances were kept in a locked cupboard. There are recorded risk assessments for key safe working practice topics. The fire alarm system is Jerome House G62-G11 S17485 71 Randall Ave v227591 3.6.05 Stage 4.doc Version 1.40 Page 19 tested on a weekly basis and a fire drill, including the residents, accompanies this. Documentation confirmed that the fire precautionary equipment in the home is checked on a regular basis. There were valid certificates for the testing of the electrical installation, the portable electrical appliances and the Landlords Gas Safety Record. A new style accident record book, where sheets may be detached, is needed. A previous inspection had identified the need for a financial and business plan for the home. At the last announced inspection the home had begun to draft a plan but no costings had been identified for individual budget codes. The manager said that the plan had not been completed. A valid certificate of insurance for public liability cover, up to a minimum of £5 million, was on display in the home. Jerome House G62-G11 S17485 71 Randall Ave v227591 3.6.05 Stage 4.doc Version 1.40 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 x x x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 x x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score x x x x 1 x 3 Standard No 11 12 13 14 15 16 17 x 3 3 3 3 x 3 Standard No 31 32 33 34 35 36 Score x 2 3 x 2 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Jerome House Score x 3 x x Standard No 37 38 39 40 41 42 43 Score 2 x x x x 3 2 G62-G11 S17485 71 Randall Ave v227591 3.6.05 Stage 4.doc Version 1.40 Page 21 Yes 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. 2. 3. Standard YA28 YA32 YA35 Timescale for action 16.2&23.2 That the communal areas in the 01 home are refurbished November 2005 18.1 That staff receive training in 31 supporting residents with mental December health problems. 2005 18.1 That the home has a training and 01 development plan. (Previous November timescale of 01 June 2004 not 2005 met). 9.2 That the registered manager 31 achieves an NVQ level 4 December qualification in management and 2005 care. 25.2 That the home has a financial 01 and business plan, with costings November for each budget code. (Previous 2005 timescale of 01 January 2005 not met). Regulation Requirement 4. YA37 5. YA43 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 YA6 Good Practice Recommendations That the evaluations of the care plans are undertaken and recorded on a monthly basis. G62-G11 S17485 71 Randall Ave v227591 3.6.05 Stage 4.doc Version 1.40 Page 22 Jerome House Jerome House G62-G11 S17485 71 Randall Ave v227591 3.6.05 Stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection 4th Floor Aspect Gate 166 College Road Harrow HA1 1BH 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 Jerome House G62-G11 S17485 71 Randall Ave v227591 3.6.05 Stage 4.doc Version 1.40 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!