Inspection on 24/03/09 for Jomar House

This inspection was carried out on 24th March 2009.

CSCI found this care home to be providing an Adequate service.

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

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 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 09/07/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Jomar House 38 Townhouse Road Old Costessey Norwich Norfolk NR8 5BS     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Judith Last     Date: 2 4 0 3 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 29 Information about the care home Name of care home: Address: Jomar House 38 Townhouse Road Old Costessey Norwich Norfolk NR8 5BS 01603745974 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mrs Joy Cocker,Mr Mark Cocker Name of registered manager (if applicable) Provider/Manager Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The registration of two people with a learning disability refers solely to the two people currently accommodated at Jomar House and who are named in the Commission`s files. Only these people can be accommodated at Jomar House. Date of last inspection Brief description of the care home Jomar House is a care home providing personal care and accommodation for 2 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 people have their own rooms. 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 patio area. Care Homes for Adults (18-65 years) Page 4 of 29 care home 2 Over 65 0 2 Brief description of the care home The Proprietor has 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. There are no vacancies at the home. It costs from £1468 per month to live at the home. Fees include food and domestic services (laundry, heat and light). People make a contribution to mileage for outings in the owners car. Residents are required to fund their own personal expenditure and holidays. The provider has inspection reports in the room used as an office, which is accessible to people at the home. Care Homes for Adults (18-65 years) Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: Before we visited Jomar House we looked at all the information we had about it. This includes the history of the home, the information the manager sent to us and written comments from two of the people living there. We gave Mrs Cocker short notice of our visit. This is because she runs the home on her own and people have busy lives so they are not always there for us to speak to. When we visited, the main method of inspection we used is called case tracking. This means that we look at records and try to find out from observation and discussion how well peoples needs are being met. Care Homes for Adults (18-65 years) Page 6 of 29 We used all the information we gathered and the rules we have, to see what outcomes were being achieved for people in their daily lives. What the care home does well: What has improved since the last inspection? What they could do better: Mrs Cocker needs to update some of the information she has about the home. This includes information about the number of people she can support and also information about how people can contact us if they need to. This is so people would have access to up to date and relevant information about the home. There are some other things Mrs Cocker could do to improve the home. Mrs Cocker should improve the way that she records peoples money where she is supporting them with budgeting and spending significant amounts of money - for example paying for holidays. This is so record keeping is transparent and clear about what money people take out of their bank with her support is being used for. When Mrs Cocker helps people to book their holidays she should discuss with holiday companies the arrangements for outings and any difficulties they might present for Care Homes for Adults (18-65 years) Page 8 of 29 people who are not able to walk far or climb a lot of steps. She can tell you about the things we have suggested for improvement and what improvements she has made for herself in the interests of promoting peoples independence, safety and welfare. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 29 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who might consider moving to the home would have their needs assessed so they could be met. Evidence: Information in a review meeting note and in the guide to the home says that there are three places. This is not accurate because the home is only registered for two people. Mrs Cocker is aware of this and says she will not take referrals for places and there is a mistake in the information. Mrs Cocker has not admitted anyone to the home for about 5 years. She has told us at that she has no intention of admitting anyone new. She has told us this in writing. We have not inspected this in detail because outcomes were met at the last two inspections and there have been no changes. Each of the people using the home at present, has an assessment of their needs on file so they can be sure Mrs Cocker knows what kind of support she should be offering to Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: them. Care Homes for Adults (18-65 years) Page 12 of 29 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are more involved in decisions about their daily lives and about the support they need.. Evidence: We looked at support plans for the people living in the home. As at our last visit, these continue to be maintained in an organised manner. People have signed some of their daily records showing they know what has gone into them. Both are able to read. There is limited need for more detailed information because there are no staff employed who would need to follow them to ensure peoples needs are met effectively and consistently. Records show that there are regular reviews of peoples care and that relevant parties attend these including other professionals who may be involved. One person also has an advocate and Mrs Cocker has followed up with the agency how the advocate can be Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: more effective in supporting the person at their reviews. The person told us I get on well with them when we asked about the advocate. Records show that the support people need is reviewed regularly and that they are involved in the process, in decisions about their care and what they want to achieve. Records and discussion with Mrs Cocker and people living in the home, show she has taken actions arising from care plan reviews where she has been identified as the person responsible for taking the action. One person told us about a change and says its better. Arrangements for supporting people with their money are discussed and agreed at care plan reviews with the person and other professionals. Mrs Cocker helps people with this but does not act as appointee for managing benefits. People say that they manage the money they need each day and Joy helps me with it. Records tallied with balances of money that Mrs Cocker held for people. However, the purpose of large withdrawals from bank accounts to pay for items like holidays are not shown in the records. People told us Joy helps me save when we asked about budgeting. Each person has assessments of risk on their files for activities and for specific problems. For example, one persons assessments cover ironing, using the kettle and managing their medication. They have decided to have Mrs Cocker do this for them and this is recorded. This shows that there are measures in place to help promote peoples safety in their daily lives and to record what decisions they have made. We asked about the things people do around the home. Both told us that they keep their rooms tidy, one says I do it myself. They help with things like washing up, making drinks or loading the washing machine and told us about this. People are not involved in recruiting staff (there are none), or in the reviews of policies and procedures due to the size and nature of the home. Care Homes for Adults (18-65 years) Page 14 of 29 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People feel their lifestyle suits their needs and expectations. Evidence: People told us they have lots of things to do and can decide what they want to do. One person has employment and says they enjoy this. The person told us there are baby chicks and I feed the goats. Staff bring in food for them. Another has a variety of activities, including bowling, swimming, traditional day services and a computer class. Daily records show people have opportunities to go out - for example to football, bingo, a circus and trips out. One says we went to Hunstanton last weekend. One Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: person says they all go to see friends on Sunday afternoon and play bingo. They told us that the roast dinner they used to have for Sunday lunch has been moved to Monday evening so it is less of a rush now. One person likes to look in the paper for new different places to go. One person told us I like playing pool. I play at Hotblack Road. The person with an interest in computers also uses the computer at the home to play games on and says I like it. Another has lots of music CDs in their room and says they like my music. People can spend time where they like in the home. People watch television together if they wish and have access to the lounge, dining room and office as well as their own rooms, when they wish. People have opportunities to go on holidays. One of these last year was not a success because there was too much steps and climbing. They told us they are staying in this country for their next holidays and have planned three to Torquay, the Isle of Wight and Scarborough. We discussed issues of access and suitability and how Mrs Cocker might check this out better for people before holidays were booked. Records show that people have contact with their family and friends and one person has family members to visit. People told us about meeting friends at the weekend. They told us they were looking forward to an Easter party at one of the social clubs they use. There has been continued improvement in peoples participation in daily routines. People make their own drinks and pack lunches for their day time activities. They told us about doing parts of domestic activities such as helping load their washing into the machine but Joy turns it on for me. We asked about cooking and one person told us they did not want to do that. One says I am happy with things. The owner has dogs and people tell us they like them. People say the food is good and that Joy is a good cook. Problems with eating are noted and professional advice is sought where appropriate to help address this with people. People eat their meals with Mrs Cocker at a table in the kitchen. There is a larger more formal dining room available for bigger events when there are visitors. Care Homes for Adults (18-65 years) Page 16 of 29 Care Homes for Adults (18-65 years) Page 17 of 29 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples personal and health care needs are met as they prefer and require. Medicines are managed in a way that promotes peoples safety and wellbeing. Evidence: People are independent in their personal care and do not require support from Mrs Cocker to manage this. Records show that Mrs Cocker does follow up health concerns and supports people with appointments. Outcomes of appointments are now recorded clearly together with any follow up that is needed so Mrs Cocker can show how she supports people to stay healthy. People are aware of their health conditions and of any appointments that are needed. One person told us their blood pressure is high. They thought this might be because they had been worrying about something. They say I had a blood test. I have not got the results yet. Got to go back in May sometime. This shows Mrs Cocker tries to make sure people understand what appointments are for and what might happen next. One person continues to manage their own medication and Mrs Cocker gives them this Care Homes for Adults (18-65 years) Page 18 of 29 Evidence: on a weekly basis. She also checks it from time to time to make sure the person continues to be able to manage this safely. The other person prefers that Mrs Cocker manages their medication for them. She keeps a record of when she has given it showing that it is given safely and as it has been prescribed. Care Homes for Adults (18-65 years) Page 19 of 29 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples concerns would be taken seriously and they feel safe in their home. Evidence: There have been no changes in the group of people living at the home since our last visit. As on previous visits we heard people chatting with Mrs Cocker and laughing about things indicating they were comfortable in her company. Each person has a copy of information about complaints on their file. This still does not have up to date information for people about how to contact us if they needed to. We asked them if they were happy with things. One says Im happy with it and one that they have got no complaints, no. Mrs Cocker has attended training in the protection of vulnerable adults so that she knows what she would need to do if someone expressed any concerns. Care Homes for Adults (18-65 years) Page 20 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Mrs Cocker has consistently ensured people live in a homely, comfortable and safe environment that suits their needs. Evidence: One person showed us their room and says it has been painted since we last went. (They could not remember if they chose the colour but say Im happy with it.) We also saw the lounge, kitchen, dining room and office. These were all clean and homely and people say they like living at Jomar House. We did not see any immediate hazards to peoples safety arising from the environment. There were no concerns about decor or maintenance showing people benefit from a home that is well maintained. Jomar House cannot accommodate people who have mobility problems because there are steep steps up to the front door and no assisted passage to the first floor bedrooms and bathing facilities. There is a hard wired system for detecting fires. Mrs Cocker says she tests this from time to time by pushing the button on detectors but she does not record this at Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: present. There is a fire risk assessment identifying what measures are in place to minimise the risk of a fire breaking out and of people being harmed if it did so. There are no continence issues that would present concerns for cross infection. We did not see concerns about cleanliness in the home in those areas seen, showing people benefit from a clean and hygienic home. Care Homes for Adults (18-65 years) Page 22 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are no staff employed at the home against which to evaluate key standards, but Mrs Cocker is able to support the two service users and help them meet their needs. Evidence: Past review notes confirm that purchasers are aware one person spends short periods of time alone in the home and that they consider this acceptable. At other times, people join activities together. People living at the home are happy with their lifestyles and opportunities to go out and about indicating that, at present, no additional staffing is needed to support them effectively. However, Mrs Cocker is aware that if day care arrangements change significantly she would potentially need to review the support that she is able to offer and to supplement this. This means she will need to look properly at the standards for recruitment and training that we would expect to see implemented. Care Homes for Adults (18-65 years) Page 23 of 29 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Mrs Cocker continues to look at how things can be improved and how peoples safety is promoted. Evidence: Mrs Cocker is not able to complete National Vocational Qualifications as set out in standards, due to the size and nature of the service she runs. This does not provide scope for her to complete the units she needs. However, she has identified other sources of training that will help her understand and respond to peoples needs. When we visited she had obtained information about short courses on learning disabilities and on person centred planning that she was intending to complete. This represents an improvement since our last visit and will help provide her with some additional background knowledge and skills to improve how people are supported. Mrs Cocker completed the information we asked her to send to us about service quality. She has looked at what the service does well and what she has improved. We Care Homes for Adults (18-65 years) Page 24 of 29 Evidence: agree with what she has told us about the improvements she has made. She also recognises that paperwork could be improved and says she takes into account what people want when she is thinking about making changes. (Formal systems of assessing the quality of the service are not appropriate to the size and nature of the home.) There are arrangements to ensure that gas appliances are tested regularly to make sure that they remain safe in use. There are also arrangements for the detection of fires and for minimising the risk of these. Mrs Cocker has completed basic first aid training and this is still in date. This means there are arrangements in place to help promote peoples safety. Care Homes for Adults (18-65 years) Page 25 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 26 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 1 4 Information about the home must be updated where it shows that there are three places for people. This is so information is clear about the service that is provided. 29/05/2009 2 22 22 Mrs Cocker must update information about complaints to include up to date information about how to contact the Commission. This is so people, or their representatives, can contact us directly to express any views or concerns they may have about the home. Regulation 22(7) of the Care Homes Regulations 2001 requires that the procedure set out contact details of the Commission. 29/05/2009 Recommendations Care Homes for Adults (18-65 years) Page 27 of 29 These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 7 Where Mrs Cocker supports people with large items of expenditure, the purpose of withdrawals from bank accounts should be recorded. This would help show how people are involved in the process and provide a clearer audit trail of Mrs Cockers involvement in the process. Mrs Cocker should check out with holiday companies issues of access and the types of activities that are on offer on organised trips. This would help avoid disappointment or problems for people when they arrive. Mrs Cocker should review menu arrangements, possibly with the dietitian already involved, to ensure these are suitably varied and balanced for people. Mrs Cocker should record when she tests the fire detection points. This would help ensure she takes care to make sure it will always function properly should a fire break out. 2 14 3 17 4 24 Care Homes for Adults (18-65 years) Page 28 of 29 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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