Inspection on 24/04/06 for Jomar House

This inspection was carried out on 24th April 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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 15 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 18/01/06

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 Mrs Judith Huggins Unannounced Inspection 24th April 2006 01:15 Jomar House DS0000027579.V291750.R01.S.doc Version 5.1 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.V291750.R01.S.doc Version 5.1 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.V291750.R01.S.doc Version 5.1 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.V291750.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18th January 2006 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 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. At the time of the inspection there were two people living at the home, and one vacancy. The charge for each person is £1364 per month. It includes food and domestic services (laundry, heat and light), and also transport in the provider’s car. Residents are required to fund their own personal expenditure and holidays. Jomar House DS0000027579.V291750.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The proprietor – Mrs Cocker - was given some short notice of the inspection rather than it being wholly unannounced. This is because she is the sole carer for the two people living in the home, given her son is no longer actively involved in operating the home. It started at 1.15 in the afternoon, and lasted about four and a half hours. The GP completed a comment card and a representative of the people who fund placements at the home contacted the inspector. The proprietor did not complete the pre-inspection questionnaire and so did not provide information herself in advance of the visit, which could be used in evaluating how well the service is performing. Other professionals connected with the residents provided some information. During the visit, some care records and medication records were checked. The proprietor and both of the existing residents were spoken to. The inspector saw the shared areas of the home but did not visit residents’ individual rooms. What the service does well: What has improved since the last inspection? The proprietor is now better able to care for the remaining residents following a reduction in numbers. Mrs Cocker has revised her complaints procedure so that it is clear she will deal with these, but now needs to ensure it is properly explained to residents. The system for recording the administration of medication has improved. Jomar House DS0000027579.V291750.R01.S.doc Version 5.1 Page 6 What they could do better: Overall standards of record keeping are poor. This means that Mrs Cocker finds it difficult to provide evidence of some of the things she says are happening, or have happened in the home. Mrs Cocker must improve the way she records the skills, abilities and goals of each person living at the home, so that she can show how she is helping people to meet their needs, goals and achieve their potential. As part of this she also needs to record the risks to which residents are exposed and show how she minimises these without unnecessarily restricting the opportunities open to them. The recording of medication administration and management, although improved, must be accurate, reflect all occasions on which medication is given, and the strength of this. This is so that she can ensure processes for safekeeping, recording and administering medication are safe. Requirements made regarding these issues at the last inspection, have not been met. Mrs Cocker must show how residents are consulted, and about what issues. Residents are not always, given their cognitive abilities and level of expectations, able to take the initiative in these areas for themselves, and need her encouragement. This includes taking into account their views when making sure that she takes action to improve the quality of the service. She has not yet developed a system for doing this, to ensure that the service she provides to the people living at the home continues to improve and is better able to meet the needs of residents. Residents are not clear about how they should make complaints, so Mrs Cocker needs to ensure this information is communicated properly to them. She must then record all complaints, the investigation she has made, and her findings, together with the feedback she gives to people making complaints. This is so that she can show there is rigour in investigating concerns and – where necessary – improvements are made in the best interests of residents. Mrs Cocker has not kept her knowledge up to date, and so is not aware of current philosophy and practice in caring for people who have learning disabilities. She must take action to ensure that she participates in relevant training on appropriate issues so that she is able to fully meet the needs of those to whom she offers a service. Overall, there are many issues that have not been addressed, despite the national minimum standards having been in place since April 2002. Without adequate progress towards meeting these and the outstanding requirements, the registered persons may be subject to enforcement action. Jomar House DS0000027579.V291750.R01.S.doc Version 5.1 Page 7 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.V291750.R01.S.doc Version 5.1 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 Outcomes Statutory Requirements Identified During the Inspection Jomar House DS0000027579.V291750.R01.S.doc Version 5.1 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 the following standard(s): 2 Quality in this outcome area is poor and there is little evidence that the needs of residents (including existing residents) are fully assessed and recorded. EVIDENCE: There is information for residents about the service and what it can offer. Both the proprietor and the residents already living at the home sign this. Mrs Cocker does not have any checklist or assessment format to use, to prompt her to gather relevant information or clarify issues arising in social work assessments if this information is unclear or inadequate. She is aware that this had resulted in her admitting someone in the past, whose needs she found difficult to meet, because she had not fully explored what was meant by comments in the information she was provided with. The skills and abilities of existing residents are not assessed and recorded in care plans. Restrictions imposed are subject to limited discussion and not documented as agreed as part of the assessment or review process. Jomar House DS0000027579.V291750.R01.S.doc Version 5.1 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 the following standard(s): 6, 7 and 9 Quality in this outcome area is poor. The individual needs and choices of residents are not adequately addressed, and restrictions are imposed without proper consideration and consultation regarding possible interim measures. EVIDENCE: It should be acknowledged that the proprietor does not employ staff and so the need to formally set out the care and support needs of each person in order to ensure consistent care, are reduced. “Care plan” files have improved in that they include a monthly record of some of the activities or appointments for residents. However, they do not record the skills, abilities, personal aims or goals of each person. There is little evidence that the issues raised and agreed at reviews with social workers are progressed, for example the possibility of one person living independently. There are no “plans” setting out how this will be done or the work that needs to be done (and is being acted upon) to ensure the person achieves their full potential. Jomar House DS0000027579.V291750.R01.S.doc Version 5.1 Page 11 Social workers carry out reviews approximately annually, involving the resident. The filing of review notes is disorganised and one showed no evidence of review during the last year. Mrs Cocker says that there was a review in September but that no notes have been provided. Some of the information that the proprietor has compiled does set out some limited areas of need, and of risk, but this information is not consistently dated so evidence of review is limited. Residents sign the service user guide but there is no further evidence of their involvement in the record keeping process. Requirements made at the last two inspections have not been met, meaning that enforcement action may be taken. Records show that residents are unable on occasions to continue to participate in activities, because the proprietor has identified a particular risk. This was also noted at the last visit to the home. There are no documents supporting that the risk cannot be minimised and made acceptable by other means. It is not good practice to assume the only way to eliminate risk is by taking choices away from service users. This means that it is difficult for the proprietor to show that decisions limitations on opportunities/choice are appropriately made, in consultation with residents and other professionals. There are risks to which residents continue to be exposed and for which there are no underpinning risk assessments - for example, self-administration of medication, and remaining in the house alone. Requirement has been made in this area. One person confirms involvement in the decision about where to go for holidays. Another says that the owner made the decision. Both say that the owner makes decisions about the food. Requirement has been made in this area. Jomar House DS0000027579.V291750.R01.S.doc Version 5.1 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 the following standard(s): 11, 12, 13, 14, 15, 16 and 17 Quality in this outcome area is adequate. There is room for improvement in increasing opportunities available, as residents may not have access to the information to suggest how their lifestyles might be improved. EVIDENCE: On person has been withdrawn from a daytime activity because the proprietor has identified health risks. See risk assessment issues covered previously. She agrees that having three days a week at the home was not very stimulating for the person, who currently is only occupied in structured opportunities on two days. There are no opportunities on offer for example to attend college. However, the proprietor has made some efforts to identify suitable swimming facilities. The educational, social and recreational needs or interests of residents are not recorded in care plans and so it cannot be demonstrated that these are met. Documentation of activities, preferences and needs may not do justice to what is happening for residents. One person has some employment and says he enjoys this. Jomar House DS0000027579.V291750.R01.S.doc Version 5.1 Page 13 Residents do use local facilities for example for coffee out, or for shopping trips. They also clearly enjoy the weekend day trips to the seaside and their holidays. This is reflected in some of the notes and confirmed by residents. They say they also participate regularly in bingo sessions at local clubs. One person says that they do go to the pub sometimes but one could not confirm this. Records do not clearly show opportunities in this area (one person liking to play pool). Requirement has been made in these areas. One resident is in their early thirties and another in their mid-forties. It is not clear from records (given the absence of recorded assessments of need or personal goals) that age appropriate leisure or educational opportunities are always offered. Residents do not have keys for their bedrooms, but do have a key for the front door of their home. One person likes to play music and enjoys “club” music. This is played in the person’s room on Saturday mornings, but on headphones in the kitchen during the evenings. Asked whose idea this was, it is said to be “Joy’s”. Requirement has been made in this area – under standard 7. Neither resident was able to identify anything that they would like to change to make things better for them. Residents and the proprietor say that they have regular contact with their families. This is confirmed in the brief records made. The residents say that the food is very good. This standard has been consistently met, with food identified as good quality and nutritionally appropriate. Residents say that they choose the fillings that they have in their sandwiches when they take lunches out to their day care provision. The proprietor says that she knows what people like. However, residents say that the proprietor decides what they will have for the main meal. The proprietor agreed there was room for improvement in consultation for menu planning. Residents do not have any specific religious or cultural requirements. Mrs Cocker caters for a diabetic diet with recent improvement in stability of blood sugar levels but has had no specific training in this area. Mrs Cocker had kept a record until the end of last year, showing what was served for the main meal each day. However, she has not maintained the record. Requirement has been made in this area. Jomar House DS0000027579.V291750.R01.S.doc Version 5.1 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 the following standard(s): 18, 19 and 20 The quality of outcomes in this area is adequate. However, there is room for improvement in the way health appointments, issues and medication are recorded. EVIDENCE: Care needs are not clearly set out, although residents feel well cared for and like living at the home. Issues about residents exercising independence and control, and expressing preferences have been commented upon elsewhere in this report. Residents cannot have any choice about who works with them, as the proprietor is the sole carer. However, they say they like living at the home and get on well with Mrs Cocker. Interactions between Mrs Cocker and both residents were heard at various points during the inspection, and showed good humour. Notes show some input for one person from the consultant psychiatrist. There is some evidence in care notes of involvement of community nurses, use of the diabetic clinic, and attendance at the GP. One health professional confirms that they consider the health care needs of residents to be appropriately addressed. Jomar House DS0000027579.V291750.R01.S.doc Version 5.1 Page 15 One person says that they have not seen the dentist for a long time. The method of recording makes it difficult to see when routine health monitoring appointments such as the dentist, have taken place although identified problems are referred. One person’s health condition has caused some concerns in the past but is now much more stable. However, the proprietor cannot consistently show how she has exercised her duty of care in relation to this, having adopted a course of action in response to a complaint, which she did not agree with and which led to further problems. One resident manages his own medication and was able to explain to the inspector how this was done. However, Mrs Cocker has no risk assessment regarding this (or supporting why the other person cannot manage part or all of theirs), and there is no formal system for monitoring and review to ensure that the practice remains safe. Recording systems have improved for the person for whom the proprietor retains responsibility for administering medication. However, there are a few omissions. The record is also incomplete in that the strengths of medicines are no longer recorded. Although improved, the requirement made at the last inspection cannot be shown as fully met. Jomar House DS0000027579.V291750.R01.S.doc Version 5.1 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 the following standard(s): 22 and 23 The quality of outcomes in this area is adequate, but there is room for improvement in empowering residents to raise concerns. EVIDENCE: Neither resident was able to say who they would speak to if they had concerns but both identified that they had social workers and would probably try to talk to them. The proprietor has revised the complaints procedure to show how these would be dealt with but has not explained this to residents so that they could say who they would speak to. One complaint, made via a day centre, has not been recorded, and the investigation, discussion or liaison needed to resolve this appropriately has not been recorded. The proprietor said she adopted a solution with which she did not agree and which had repercussions (now resolved). This could have been avoided if she had responded fully and appropriately to the concerns. Both residents say they feel safe at the home and both of them say that they are happy there. Neither had any concerns they wished to discuss with the inspector. However, the proprietor’s lack of understanding regarding risks has led to restrictions on people’s freedom without supporting documentary evidence that this is necessary, and without full liaison and discussion with other professionals. Some professionals consider that she may not have a good understanding of learning disability issues. See management standards. Jomar House DS0000027579.V291750.R01.S.doc Version 5.1 Page 17 The proprietor no longer needs anyone to “sit” with residents, given the change in clientele at the home. Residents are not therefore at risk from those without appropriate checks working at the home. Jomar House DS0000027579.V291750.R01.S.doc Version 5.1 Page 18 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 Quality in this outcome area is good. Residents live in a homely, comfortable and clean environment. EVIDENCE: Communal areas on the ground floor were seen, including the small “office” area, living room, front garden, hall and kitchen. Residents were not keen on the inspector visiting their rooms. Areas seen were clean, well furnished and well equipped. The quality of the décor was good. Residents say they like their rooms and help in some cleaning. The proprietor indicates that this might not be to the expected standard and so that she will do much of this herself. There are pets living at the home which residents clearly enjoy, but there was no evidence that these have affected the quality or cleanliness of the environment. They are not allowed upstairs. The proprietor says that the smoke detection system is “hard wired”. Both residents were able to say what they would do in the event of fire. The wiring system itself has not been checked according to the proprietor, although appliances are serviced she says, according to contracts. Jomar House DS0000027579.V291750.R01.S.doc Version 5.1 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 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): None There are no staff employed at the home against which to evaluate the standards. EVIDENCE: At the last inspection it was noted that Mrs Cocker had employed someone to sit with a resident while she was on holiday with the remaining two people. This situation has been resolved and there are now two people living at the home. She says that she no longer needs to call upon anyone else for assistance given the change. Residents say that they feel well cared for. Jomar House DS0000027579.V291750.R01.S.doc Version 5.1 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 Quality of outcomes in this area is poor. The proprietor has not ensured that her knowledge and practice is up to date so that the home is conducted and managed properly, with due regard to developing the quality of the service. EVIDENCE: Mrs Cocker is involved in running the home alone. She has not kept up to date with changes in philosophy and practice and has not had any recent training. Professionals in contact with the home have commented that she does not appear to have a good understanding of learning disabilities and its impact upon individuals. She does not have access to the Internet and says she is not able to use computers, meaning that she misses out on the opportunity to do research into relevant issues. Mrs Cocker agrees that she has not made any progress to develop a system for monitoring the quality of the service she offers, and for consulting residents and other interested parties for their views on this. The requirement made at the last inspection has not been met. Jomar House DS0000027579.V291750.R01.S.doc Version 5.1 Page 21 Mrs Cocker has not undertaken the first aid training required at the last inspection in order to ensure that residents are safe. Comment has also been made elsewhere in the report regarding the lack of relevant risk assessments. Jomar House DS0000027579.V291750.R01.S.doc Version 5.1 Page 22 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 Standard No Score 1 x 2 1 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 1 23 2 ENVIRONMENT Standard No Score 24 3 25 x 26 x 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 N/a 32 N/a 33 N/a 34 N/a 35 N/a 36 N/a CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 1 1 x 1 x LIFESTYLES Standard No Score 11 2 12 2 13 2 14 2 15 3 16 2 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 2 1 x 1 x 1 x x 2 x Jomar House DS0000027579.V291750.R01.S.doc Version 5.1 Page 23 Are there any outstanding requirements from the last inspection? YES 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 Outstanding requirement The registered persons must have a method of gathering all relevant information about the needs of prospective residents before admitting anyone to the home. Timescale for action 01/07/06 2.. YA6 15 This is to ensure that the registered persons ensure that the needs of service users can be met within the home. Timescale of 01/03/06 has not been met. Outstanding requirement 01/07/06 The registered persons must ensure that care plans include all of the relevant information needed and are reviewed on a regular basis. Timescales of 01/09/05 and 01/03/06 have not been met. Outstanding requirement The registered persons must ensure that service users are enabled to take responsible risks as part of encouraging an independent lifestyle. Timescale of 01/03/06 has not been met. 01/07/06 3. YA7 12 1a Jomar House DS0000027579.V291750.R01.S.doc Version 5.1 Page 24 4. YA9 12 1a 5. YA7 12, 15 Outstanding requirement The registered persons must ensure that service users are enabled to take responsible risks as part of encouraging an independent lifestyle. Timescale of 01/03/06 has not been met. The registered persons must ensure that care plans and other documentation show how residents are involved in decisions about their care. The registered persons must ensure that activities such as remaining in the home alone, and self-administration of medication are subject to risk assessments involving the resident and other professionals, and that decisions are kept under review. 01/07/06 01/07/06 6. YA9 13.4 31/05/06 7. YA11 16.2n Outstanding requirement 01/07/06 The registered persons 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. Timescales of 01/09/05 and 01/03/06 have not been met. Outstanding requirement 01/07/06 The registered persons 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. Timescales of 01/09/05 and 01/03/06 have not been met. Outstanding requirement 01/07/06 The registered persons must ensure that service users are given the opportunities to be DS0000027579.V291750.R01.S.doc Version 5.1 Page 25 8. YA12 16.2n 9. YA14 16.2n Jomar House 10. YA17 17.2, Sch 4, 13 13.2 11. YA20 provided with facilities for recreation, training and activities that meet with their needs and preferences. Timescales of 01/09/05 and 01/03/06 have not been met. The registered persons must 16/06/06 maintain a record of all meals served with details of any special diets. Outstanding requirement 31/05/06 The registered persons must ensure that the any recording relating to medication is accurate and properly recorded. Timescale of 01/03/06 not met. The registered persons must record and fully investigate all complaints, and respond appropriately to complainants with the findings. The registered persons must identify relevant training to ensure that her knowledge of learning disability issues and good practice is up to date and to guide a change in overall practice and culture. This must then be undertaken in a timely manner. Outstanding requirement The registered persons 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. Timescale of 01/03/06 has not been met. Outstanding requirement The registered persons must ensure that there is always a person on duty who has had up to date training in first aid. Timescale of 01/03/06 has not been met. 01/07/06 13. YA22 22, 17.2, Sch 4, 11 14. YA37 9, 10, 12 01/07/06 15 YA39 24.1 01/07/06 16. YA42 13.4 01/07/06 Jomar House DS0000027579.V291750.R01.S.doc Version 5.1 Page 26 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 YA17 Good Practice Recommendations The registered persons should increase consultation with residents about meal preferences and provide evidence of this. The registered persons should undertake training in the management of diabetes. The registered persons should review the way that health care appointments are recorded so that it can be clearly shown the need for routine check ups is met. The registered persons should 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. The registered persons should consider doing some training around promoting the privacy, dignity and independence of service users. 2. 3. YA17 YA19 4. YA22 5. YA37 Jomar House DS0000027579.V291750.R01.S.doc Version 5.1 Page 27 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.V291750.R01.S.doc Version 5.1 Page 28 - 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!