Inspection on 11/07/05 for Jomar House

This inspection was carried out on 11th July 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 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

Jomar House 24/03/09

Jomar House 05/03/08

Jomar House 11/04/07

Jomar House 04/10/06

Jomar House 24/04/06

Jomar House 18/01/06

Jomar House 04/01/05

Jomar House 21/06/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Jomar House 38 Townhouse Road Old Costessey Norwich NR8 5BS Lead Inspector Ann Catterick Announced 11 July 2005 13:30 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. Jomar House I55 s27579 Jomar House v230542 (an) 110705 stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Jomar House Address 38 Townhouse Road Old Costessey Norwich Norfolk NR8 5BS 01603 745974 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 Joy Cocker Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Jomar House I55 s27579 Jomar House v230542 (an) 110705 stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 04 January 2005 Brief Description of the Service: Jomar House is a care home providing personal care and accommodation for 3 adults with learning disabilities. The Proprietors are Mrs Joy Cocker and her son Mr Mark Cocker. Mrs Joy Cocker lives on the premises and is the manager. The home is located in Old Costessey on the outskirts of the city of Norwich. The Home is close to shops, pubs and all other local amenities. The accommodation is provided on two floors and all service users have single bedroom accommodation. The Proprietor, Joy Cocker lives in the home and shares all communal facilities with the three services users that live in the home. The home has an attractive garden with a covered patio area. The Proprietor has three dogs and a cockatoo that live as part of the family. The home has steps to the back and front and would not be suitable for adults with mobility difficulties. Jomar House I55 s27579 Jomar House v230542 (an) 110705 stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was announced and took place over a period of 4 hours on the 11th of July 2005. The inspector was able to speak with the manager and service users, tour part of the home and look at care plans and other documentation. This is a small family run home with the manager being the only member of staff and she lives within the home sharing all communal facilities with the service users. If Norfolk County Council had an Adult Placement Scheme this home would have been part of that scheme. The overall impression of the home is that it is run in an “old fashioned way” and this has meant that although the physical care is good and the environment of good quality, other aspects of care such as privacy, dignity, choice and independence have not been promoted as much as they could be. The manager has been in the caring profession for some time and has not kept up to date with modern thinking, through further professional training, and this is reflected in the type of care provided within the home. What the service does well: What has improved since the last inspection? Since the last inspection the manager has improved the way medication is stored and how the administration of this medication is recorded. Service users have a clear contract of the statement and terms and conditions of their placement. Jomar House I55 s27579 Jomar House v230542 (an) 110705 stage 4.doc Version 1.30 Page 6 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. Jomar House I55 s27579 Jomar House v230542 (an) 110705 stage 4.doc Version 1.30 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 Jomar House I55 s27579 Jomar House v230542 (an) 110705 stage 4.doc Version 1.30 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) 1, 2 and 5 The home has a basic Service Users Guide and Statement of Purpose offering relevant information to service users and prospective service users. Assessments have been received from placing professional for all service users. The manager makes her own assessment prior to admission. All service users have a statement of terms and conditions of their placement. EVIDENCE: The home has a Statement of Purpose and Service User Guide that give relevant information to prospective service users and this information is available to the three service users who live in the home. Assessments are in place on service users files although these could be more comprehensive. Statements of terms and conditions of placement were seen within the service users personal files. Jomar House I55 s27579 Jomar House v230542 (an) 110705 stage 4.doc Version 1.30 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) 6,7,8,9 and 10 Care planning was limited and not always reviewed on a regular basis. Service users do not always appear to be actively involved in decisions about their lives. Service users are consulted about aspects of life within the home but it was felt that this consultation was rather limited. The way that risk has been assessed and dealt with was not always seen as good practice. In a particular situation a physical restraint was used as a way of protecting a service user from becoming lost when out and this was seen as not necessarily the best method of ensuring safety. Some of the records within service users files were not written in a way that promoted good record keeping. Jomar House I55 s27579 Jomar House v230542 (an) 110705 stage 4.doc Version 1.30 Page 10 EVIDENCE: The philosophy of Jomar House could be described as “old fashioned” and the manager’s knowledge and skills relating to empowerment and person centred planning is limited. The home is very much run as a family unit with the manager being the matriarch of the family. The consequence of this is that service users, although well cared for are not given all of the opportunities available to ensure that they lead as independent and fulfilled lives as possible. Care plans are in place but are limited and not used as “live documents”. They are descriptive but not fluid. They need to be meaningfully reviewed on a regular basis. The main decisions within the home are made by the manager and although consultation is had with service users it appears that service users will “go with the flow.” The reason for this may be that the manager prefers to eliminate any risk to service users and this does, at times, take away their right to make choices and decisions. The service users within Jomar House have the right to take informed risks. The balance between the assessment of risk and removal of choice seems to be unbalanced weighing more towards removal of choice. Some of those written records seen were written in an unprofessional way and included language and information that was inappropriate. The manager needs to ensure that any information written within a file or care plan is factual accurate and non-biased being signed and dated at the time of writing. Jomar House I55 s27579 Jomar House v230542 (an) 110705 stage 4.doc Version 1.30 Page 11 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 and 17 There is opportunity for the further development of the service users within the home. All service users are employed and have the opportunity to become involved in some other community activities. There is some opportunity for service users to be involved in leisure activities but further opportunity could be made in this area to increase their social opportunities. Contact with family and friends would be encouraged and supported. Daily routines appear to be rather rigid and led by the manager although the intent is to meet the needs of those living in the home. The food provided within the home appears to be varied and nutritious meeting the needs and preferences of service users. Jomar House I55 s27579 Jomar House v230542 (an) 110705 stage 4.doc Version 1.30 Page 12 EVIDENCE: The personal development of service users could be better met. Service users attend day centres and work placements but there does not appear to be much time spent on personal development and achievement. All service users spend the weekdays within assisted employment situations. The manager said that one of the service users was often left without work within the day believing him to be sitting in the workplace with very little work or stimulation. This is an area that the manager could investigate to ensure the service user is receiving the best service possible. Another service user was hoping to change his work programme to do what was his preference. Service users have holidays away with the manager and spend time some social time in social clubs during the week and are often taken to the coast at weekends. There are no staff in the home and all social activities take place with the manager. The daily routines appear to be led by the manager, as she feels responsible for ensuring that all within the home runs well. Discussion with service users takes place on an informal basis at meal times or when watching television. There would be opportunity to involve the service users more within the daily routines of the home. The teatime meal was served at the end of the inspection and this looked nutritious and appetising served well in comfortable surroundings. The manager works to an informal menu that takes into consideration service users preferences. Service users are weighed on a regular basis to monitor their weight and well -being. Jomar House I55 s27579 Jomar House v230542 (an) 110705 stage 4.doc Version 1.30 Page 13 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 and 20. Those service users within the home are quite independent and need very limited assistance with personal care. The policy for the care of medicines needs revising but the procedures for storing, recording and administration of medicines have improved. EVIDENCE: The three service users that live at the home are relatively independent and need very little, if any, assistance with their personal care. The medication of service users is now locked in a secure container and is stored appropriately. All administration is recorded and medication cassettes are correctly labelled. The written policy and procedures about medication needs to be rewritten. Jomar House I55 s27579 Jomar House v230542 (an) 110705 stage 4.doc Version 1.30 Page 14 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) 23 The manager has the local guidelines for the protection of vulnerable adults. The manager has had limited training in this area and would benefit from further training in this area. EVIDENCE: This outcome was part inspected on this occasion and will be further looked at within the next inspection. The home has the local guidelines and policy and procedure relating to abuse and the manager may benefit from, and have a clearer understanding of this if she had further training in this area. Jomar House I55 s27579 Jomar House v230542 (an) 110705 stage 4.doc Version 1.30 Page 15 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 and 30 The home provides a comfortable, safe environment that is clean and hygienic offering good quality accommodation. EVIDENCE: The home is a family run home with the manager and the service users sharing all communal facilities. The home and gardens are well cared for and pleasantly furnished. Access to the home by the front and back door involves steps and this home would not be suitable for people with limited mobility. One of the service users is in a small bedroom as this was felt to suit his individual needs more. This was arranged by changing the downstairs office and bedroom around. If a new service user were to be accommodated downstairs the rooms would need to return to there original use. Jomar House I55 s27579 Jomar House v230542 (an) 110705 stage 4.doc Version 1.30 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) The Proprietor/manager is the only person working within the home. EVIDENCE: Jomar House I55 s27579 Jomar House v230542 (an) 110705 stage 4.doc Version 1.30 Page 17 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 and 42 The home is well run although it could be described as being well run in an “old fashioned way.” In the area of health and safety inspected there was some area of concern. This outcome will be fully inspected at the next inspection. EVIDENCE: The manager aims to run the home in best possible way and is committed and dedicated to the needs of the service users. The manager has been involved in the care of vulnerable adults for many years but has not kept up with modern professional training and thinking. She does not have her Registered Managers Award and has no intention of completing this training at this time within her career. The only area of health and safety looked at was the information given to service users with regard fire procedures. This was not accurate and these guidelines and instructions need to be revised. Jomar House I55 s27579 Jomar House v230542 (an) 110705 stage 4.doc Version 1.30 Page 18 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 2 x x 3 Standard No 22 23 ENVIRONMENT Score x 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 2 2 2 2 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 3 Standard No 11 12 13 14 15 16 17 2 3 2 2 3 2 3 Standard No 31 32 33 34 35 36 Score x x x x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Jomar House Score x x 2 x Standard No 37 38 39 40 41 42 43 Score 2 x x x x 2 x I55 s27579 Jomar House v230542 (an) 110705 stage 4.doc Version 1.30 Page 19 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 6 Regulation 15 Requirement The Registered Provider must ensure that care plans include all of the relevant information needed and are reviewed on a regular basis. The Registered Provider must ensure that no service user is subject to physical restraint unless this is the only practicable means of securing the welfare of the service user. The Registered Provider must ensure that service users are given the opportunities to be provided with facilities for recreation, training and activities that meets with their needs and preferences. The Registered Provider must ensure that service users are given accurate information about what to do in the event of a fire. Timescale for action 01/09/05 2. 9 13.7 01/08/05 3. 11 16.2n 01/09/05 4. 42 23.4e 01/08/05 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 Good Practice Recommendations I55 s27579 Jomar House v230542 (an) 110705 stage 4.doc Version 1.30 Page 20 Jomar House 1. 2. Standard 10 37 That the manager ensure that all records relating to service users are written in a professional way including only relevant factual information. That the manager consider doing some training around promoting the privacy, dignity and independence of service users. 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