Inspection on 18/01/06 for Jomar House

This inspection was carried out on 18th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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 9 statutory requirements (actions the home must comply with) as a result of this inspection.

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 11/07/05

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 Norfolk NR8 5BS Lead Inspector Ann Catterick Unannounced Inspection 18th January 2006 15:15 Jomar House DS0000027579.V272079.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 Jomar House DS0000027579.V272079.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. Jomar House DS0000027579.V272079.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Jomar House Address 38 Townhouse Road Old Costessey Norwich Norfolk NR8 5BS 01603 745974 NO FAX # 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) Mr Mark Cocker Mrs Joy Cocker Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Jomar House DS0000027579.V272079.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 11th July 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. 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 DS0000027579.V272079.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place over a 2.5 hours on the 18th of January 2006. The inspector was able to speak with the manager and the service users as well as look at part of the home and view care plans and some other documentation. This is a small family run home with the proprietor/manager being the only member of staff. The proprietor lives within the home sharing all communal facilities with the service users. If Norfolk had an Adult Placement Scheme this home would have been part of that scheme. The inspection has highlighted that it is very difficult for one member of staff to meet all of the needs of service users and the proprietor should consider the appointment of at least one additional staff member. 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 of service users is good and the environment is comfortable there have been increasing concerns in other areas. Privacy, dignity, choice and independence are not promoted as much as they could be and the ability to follow chosen leisure preferences is limited. The manager has been in the caring profession for some time and has not kept up to date with modern thinking, through professional training, and this is reflected in the type of care provided within the home. At the time of the inspection it was clear that one service user’s needs were not being met and the proprietor is in negotiation with the health and social care departments to have this person’s needs reassessed with view to finding an alternative placement. What the service does well: The environment is comfortable with good quality furniture and fittings. The manager offers good quality food that appears nutritious and appetising. Service users have regular holidays with the proprietor. Jomar House DS0000027579.V272079.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? 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 DS0000027579.V272079.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 Jomar House DS0000027579.V272079.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): None of these standards were inspected on this occasion. EVIDENCE: Jomar House DS0000027579.V272079.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): 6 and 9 Care planning continues to be limited although some improvement has been made in this area. Service users are not always supported in taking risks as part of an independent lifestyle. EVIDENCE: There have been no admissions to the home since the last inspection. All service users have care plans but these are limited and do not appear to be working documents. However one service user’s needs have changed and the proprietor has referred this to the appropriate social and health service to ensure that his needs can be reassessed and his needs met. One service user has a health problem that is exasperated if he eats inappropriately. The proprietor identified that this problem occurred more when he went to a day centre. The proprietor saw the solution as stopping the service users attendance at the day centre for a period of time. This was not seen as the best option as it deprived the service user of his day care and did not address the issue of individual managing his own eating. He now attends Jomar House DS0000027579.V272079.R01.S.doc Version 5.0 Page 10 another day centre twice a week. It is not good practice to eliminate risk by taking choices away from service users and a requirement has been made in this area. The balance between the assessment of risk and removal of choice seems to be unbalanced weighing more towards the removal of choice. Jomar House DS0000027579.V272079.R01.S.doc Version 5.0 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 the following standard(s): 11 and 14 Service users do not appear to have many opportunities for personal development. The opportunity for service users to engage in appropriate leisure activities is limited. EVIDENCE: The proprietor is the only person working within the home and unless service users can develop leisure activities independently or becomes involved in activities when at their day centres the only opportunity to become involved in leisure activities is with the proprietor. This is not always satisfactory. For example, one service user enjoys watching Norwich City Football and would like to go on a regular basis to see them play. The other two service users do not wish to watch Norwich City and as there would be no staff to look after them whilst their peer and the proprietor went to the football he can no longer attend. One service user likes bowling and at one time had a befriender to take him. He no longer has a befriender and cannot go bowling as much as he Jomar House DS0000027579.V272079.R01.S.doc Version 5.0 Page 12 would like. The only leisure activities that service users can become involved in when at home are those activities that they can all do. At the time of initial registration both proprietors lived on the premises whereas now only Mrs Joy Cocker lives on the premises and Mr Mark Cocker lives independently and does not have a formal work role within the home. The social and emotional care needs of service users are not always being met and the proprietor needs to address this issue. A requirement has been made in this area. Jomar House DS0000027579.V272079.R01.S.doc Version 5.0 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 the following standard(s): 19 and 20 Not all service users physical and emotional care needs are being met. The policy and procedures relating to medication could be improved. EVIDENCE: The proprietor is aware that the needs of one service user can no longer be met within the home. The service user has physical and emotional needs that are not being met. Norfolk County Council placed the service user in the home. The service users needs are being reassessed with the view of a new placement being found. Health care professionals are also involved in the reassessment. It was clear, at inspection, that this service user’s needs could no longer be met within the home. The recording of medication is made on medicine administration records (MAR sheets). The way that the most recent months medication had been recorded was not following the guidelines of the medication sheet and was not clear. All recording needs to be clear and accurate and a requirement has been made in this area. Jomar House DS0000027579.V272079.R01.S.doc Version 5.0 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 the following standard(s): 22 and 23 Service users have basic information with regard the complaints procedure for the home on their contracts but this is not really adequate. The home has a basic adult abuse policy but the proprietor has little knowledge and experience in this area. EVIDENCE: Some information about the complaints procedure was seen within the statement of terms and conditions in the service users’ files. Clear more accessible information needs to be given to service users and their families to ensure that all are aware what to do and with whom to speak to if they have any concerns. A recommendation has been made in this area. The home has a basic adult abuse policy. The proprietor would benefit from some up to date training in this area. This is especially pertinent as the proprietor works on her own and has no feedback about her own practice. Recently the proprietor and two service users went on holiday and a person who works with the PHAB organisation stayed in the home to care for the service user who did not go on holiday. The proprietor did not inform the agency who placed the service user in her care nor followed correct recruitment procedures that are there to protect service users. A requirement has been made in this area. Jomar House DS0000027579.V272079.R01.S.doc Version 5.0 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 the following standard(s): 24 and 30 The home provides a comfortable and safe environment that is clean and hygienic offering good quality accommodation. EVIDENCE: Some decoration was taking place on the day of inspection. 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 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 their original use. Jomar House DS0000027579.V272079.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): 35 The proprietor/manager is the only person working in the home and this means that not all service users needs are being met. EVIDENCE: There is some concern that the social and emotional needs of service users cannot always be met by just one staff member, the proprietor. It limits the options of social and leisure activities for individuals and has some impact on their independence. The proprietor needs to ensure that she can meet the individual needs of those accommodated within the home. Recently when the proprietor took two of the service users on holiday she left the third service user a home and arranged for a person who worked at his day centre to stay in the home in her absence. No recruitment process took place and service users were not safeguarded by a recruitment procedure. A requirement has been made in this area. The Proprietor needs to consider that she may need additional staff to meet the needs of service users. Jomar House DS0000027579.V272079.R01.S.doc Version 5.0 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 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): 39 and 42 The home has no quality assurance system in place and there is no evidence to suggest that service users views underpin the service and development of the home. The manager aims to provide a safe environment. EVIDENCE: The home is small and run as a family home. This is done in an old fashioned way and the manager does not keep up with current thinking and practice. Service users are consulted with regard holidays but generally it is the proprietor who makes all major decisions in the home. However, it should be noted that service users appear satisfied with this arrangement although it does not empower service users or encourage independent thinking. Since the last inspection the proprietor has completed clear fire evacuation procedures and service users now have a copy of these. Jomar House DS0000027579.V272079.R01.S.doc Version 5.0 Page 18 Medication and chemicals are stored safely. The proprietor does not have a current first aid certificate and as she is the only staff member a requirement has been made in this area. Jomar House DS0000027579.V272079.R01.S.doc Version 5.0 Page 19 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 Score 2 1 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 1 x x 1 x Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 3 LIFESTYLES Standard No Score 11 2 12 x 13 x 14 1 15 x 16 x 17 Standard No 31 32 33 34 35 36 Score x x x x 1 x CONDUCT AND MANAGEMENT OF THE HOME x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Jomar House Score x 1 1 x Standard No 37 38 39 40 41 42 43 Score x x 1 x x 2 x DS0000027579.V272079.R01.S.doc Version 5.0 Page 20 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 YA2 Regulation 14.2 Requirement The Registered Person must ensure that the needs of service users can be met within the home. The Registered Person must ensure that care plans include all of the relevant information needed and are reviewed on a regular basis. Previous time scale was 01/09/05 The Registered Person must ensure that service users are enabled to take responsible risks as part of encouraging an independent lifestyle. The Registered Person must ensure that service users are given the opportunities to be provided with facilities for recreation, training and activities that meet with their needs and preferences. Previous timescale was 01/09/05 The Registered Person must ensure that the any recording relating to medication is accurate and properly recorded. The Registered Person must ensure that there are enough staff on duty to meet the needs DS0000027579.V272079.R01.S.doc Timescale for action 01/03/06 2 YA6 15 01/03/06 3 YA9 12 (1)a 01/03/06 4 YA11 16.2n 01/03/06 5 YA20 13.2 01/03/06 6 YA33 18.1(a) 01/03/06 Jomar House Version 5.0 Page 21 of service users. 7 YA34 19.1 The Registered Person must not have anyone working within the home unless they have been recruited using the correct policy and procedures as identified in standard 34 of the National Minimum Standards. The Registered Person must ensure that the quality of service is reviewed on a regular basis and the views of service users underpin the development of the home. The Registered Person must ensure that there is always a person on duty who has had up to date training in first aid. 01/03/06 8 YA39 24.1 01/03/06 9 YA42 13.4 01/03/06 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. 2. 3 Refer to Standard YA10 YA37 YA22 Good Practice Recommendations That the Proprietor ensures that all records relating to service users are written in a professional way including only relevant factual information. That the Proprietor considers doing some training around promoting the privacy, dignity and independence of service users. That the Proprietor ensure that the complaints procedure is understood by service users and the have information about the complaints procedure written in a way that they understand. Jomar House DS0000027579.V272079.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF 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 Jomar House DS0000027579.V272079.R01.S.doc Version 5.0 Page 23 - 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. 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