Care Home: Jericho

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What the care home does well Jericho provides a homely, safe, comfortable and friendly environment for the people who live there and people tell us that they are happy living in the home. People have their needs and wishes recorded in a plan of care, they have access to good healthcare support and medication is well managed. Service users are offered a wide range of opportunities for personal development, they attend work experience, day care facilities and craft workshops and they are also supported to follow individual interests and hobbies and be part of their local community. People tell us that the staff supporting them are kind and caring and they are protected by their being a robust staff recruitment process in place. The staff team receive an induction, training relevant to their job and they are supervised. What has improved since the last inspection? Improvements have been made to the environment by a new cooker being purchased, some service user`s bedrooms have been decorated and new carpets fitted. What the care home could do better: The home should continue with the programme of redecoration and improvements to the environment. To assist with better communication in the home it is recommended that the staff team undertaken report writing training. Service users would benefit from the continuity of there being a consistent staff team in place. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Jericho 188 Hawthorn Road Bognor Regis West Sussex PO21 2UX     The quality rating for this care home is:   two star good 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: Annie Taggart     Date: 2 1 0 1 2 0 0 8 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. the things that people have said are important to them: They reflect 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 26 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.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 26 Information about the care home Name of care home: Address: Jericho 188 Hawthorn Road Bognor Regis West Sussex PO21 2UX 01243869002 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) L`Arche Type of registration: Number of places registered: care home 6 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users to be accommodated is 6. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability (LD). Date of last inspection Brief description of the care home Jericho is a care home registered to accommodate six service users with a learning disability. The property is a detached house situated in a residential area in the town of Bognor Regis, West Sussex. The accommodation is arranged on three floors, with service users living on the ground and first floors. Staff members occupy rooms on the first and second floors. LArche, which is a voluntary organisation, owns the home and the responsible individual is Mr. Chris Bemrose. The registered manager is Post Vacant 6 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 26 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: two star good 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: In preparation for this visit we looked at the last inspection report and we also tracked information from the completed AQAA (Annual Quality Assurance Assessment). Surveys were sent to service users, staff and professionals involved with the home. Six service users and four staff surveys were returned and comments from these have been used in the report. The unannounced inspection visit was carried out by Annie Taggart at 3pm on 21st January 2009 and lasted for three hours. Two previous visits to the home had been made on 8th December and 29th December 2008. On both occasions the home was empty as people were away on a retreat or on holiday. Care Homes for Adults (18-65 years) Page 5 of 26 During the visit we tracked the care plans and all supporting documentation such as daily records for three service users and looked at the system for administering and recording medication. We looked at evidence of activities and outings for people, looked at menus and food records and saw the main meal of the day being prepared and served. Records for the running of the business including complaints, incidents and accidents, Regulation 26, Registered Provider’s visits and Regulation 37 reports, maintenance and fire records were seen and were current and in good order. The recruitment records for four new members of staff were tracked and we also saw staff training records and evidence of supervision. We spent time with the service users, either in their private bedrooms or in communal areas and they were very positive about living in the home. We also spoke to a Chiropodist who was in the home at the time of the visit. Feedback was given to the acting manager following the visit. Current fees are from six hundred and twenty eight to eight hundred and twenty eight pounds per week. What the care home does well: What has improved since the last inspection? What they could do better: 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.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 7 of 26 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 8 of 26 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. Prospective service users and their families can be confident that they will be given good information about the home and that peoples individual needs and wishes will be assessed and recorded. Evidence: There is a Statement of Purpose and Service User Guide in place that give good information about the services on offer in the home. The Service User Guide is also produced in a pictorial version that is displayed in the home and this has been updated to reflect that a new service user had been admitted. We saw that the home works with families and other professionals to assess the needs of prospective service users, people can visit the home on trial stays and a contract of terms and conditions of residency is agreed and signed. In order to ensure the compatibility of people, the home also involves current service users in the admission process for new people. Care Homes for Adults (18-65 years) Page 9 of 26 Care Homes for Adults (18-65 years) Page 10 of 26 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. In order to ensure that the staff team have the information needed to support people in the way they wish, care plans and risk assessments are completed and kept under review. Improvements are needed to the language being used in completing daily records. Evidence: For each person living in the home, there is a detailed plan of care in place that covers all aspects of peoples lives. We tracked the plans for three people and found that areas such as personal care preferences, behaviour management, risk assessments, personal relationships, nutritional needs and activities were recorded. The plans are regularly reviewed and updated but for some people this was not being carried out on a monthly basis. Full annual reviews that involve families and funders are carried out and recorded and we saw that notes are kept on peoples personal files. There is a separate daily records book for each person that is completed by the staff Care Homes for Adults (18-65 years) Page 11 of 26 Evidence: on duty twice a day. When looking at these books we saw that one of the areas being recorded was mood Some of the language being used in completing these records was judgmental, for example saying that the person is in a good mood, bad mood or grumpy. We spoke to the manager of the home about this and discussed that the language being used was not objective or respectful to service users and did not reflect what was actually happening. The records also did not reflect what we saw happening in practice as the staff on duty were kind and respectful in their dealings with service users and there was a friendly and supportive atmosphere in the home. The manager said that he would speak to the staff team at the weekly staff meeting and guide them in completing records. Care Homes for Adults (18-65 years) Page 12 of 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people living in the home are offered a wide variety of educational, community and social activities, their spiritual needs are addressed and they are involved in the running of the home. Evidence: The people living in the home tell us that they are happy living there and that they have access to their local community. There are activity plans and weekly diaries in place for each person and we saw that people attend a wide variety of day care and social activities. Examples of these are that one person works in a charity shop and another in a local garden centre. People attend day care centre or the LArche workshops and one person goes to college. From talking to service users and looking at records we saw that people regularly attend the church of their choice, they use local pubs, cafés and restaurants and also go to a club to meet their friends and dance. Care Homes for Adults (18-65 years) Page 13 of 26 Evidence: As some of the people living in the home are becoming older we saw that their programme of activities were changed to be less strenuous and that one person now attends sessions such as Relaxation Activity Therapy to address their changing needs There are very good relationships between the home and peoples families and service users visit their parents for week ends and also have an annual holiday and attend retreats with other people from the LArche community. When people came home form their various activities they told us that they had enjoyed their day and one person said, its, nice here, the staff are good and they help me to clean my room and do what I want. I like going to the sports centre and swimming. We saw that menus are agreed at the house meeting each Monday and service users each choose a meal for the coming week. We saw that peoples likes and dislikes are recorded and that allergies and food that might affect individual service users health are also recorded. Each day a fresh fruit salad is made to accompany breakfasts and we saw that people have a choice are offered fresh vegetables or salads and also have occasional meals out and take aways. Care Homes for Adults (18-65 years) Page 14 of 26 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. The people living in the home are receiving good healthcare support and medication is being well managed. Evidence: Health Action Plans have been completed for all of the people living in the home and daily records showed us that people have access to good healthcare support. We saw that people can see their own doctor, they regularly attend optician and dental check ups and are also supported to attend hospital appointments with specialist consultants. There is evidence in records that the home works with the local Community Learning Disability Team and an Occupational Therapist. During the early evening, when service users had returned from day care, there was a Chiropodist visiting the home to attend to people and we were told, I have been visiting the people here for many years, the atmosphere is always friendly, people are well cared for and the environment is clean and homely. Care Homes for Adults (18-65 years) Page 15 of 26 Evidence: There are policies and procedures in place for the storage and administration of medication. We saw that medication is kept in a locked cabinet in the office and there was a list of authorised medication handlers. MAR (Medication Administration Sheets) were current with no gaps in signing and certificates were on file of staff training. Care Homes for Adults (18-65 years) Page 16 of 26 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. The people living in the home have their concerns recorded and responded to and staff training and care practice is designed to protect people from risk of abuse or harm. Evidence: Their is a complaints procedures in place that is included in the Service User Guide and an accessible version in words, pictures and symbols is displayed in the home. Service Users in surveys and on the day of the visit told us that they would feel happy about making a complaint and told us that they would talk to a member of staff or the manager. We saw the complaints book and there were no formal complaints recorded. No complaints about the home have been received by the Commission. Staff records showed us that Safeguarding training is undertaken, the last being recorded on 18/11/08. We asked three members of staff what they would do if they suspected that any form of abuse had occurred and they told us that they would report it straight away. Care Homes for Adults (18-65 years) Page 17 of 26 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. Jericho provides a homely, comfortable and safe environment for the people who live there and there is an ongoing programme of improvements being made. Evidence: Jericho provides a comfortable and homely environment for the people who live there and people tell us that they are happy living in the home. There is a comfortable lounge area, a large dining room and kitchen and large gardens to the rear of the building. Peoples private bedrooms have been personalised to suit their individual taste and were generally clean and hygienic. Some areas of improvement were needed to one service users curtains and the downstairs bathroom blind and these were discussed with the manager. Handrails and grab rails are in place in bathrooms and on the stairs and the manager told us that when a new service user with higher support needs was admitted, an occupational therapists assessment was carried out. Improvements that have recently been made to the environment is the purchase of a new cooker, some service users bedrooms have been redecorated and new carpets purchased. Care Homes for Adults (18-65 years) Page 18 of 26 Evidence: We saw that regular health and safety checks are undertaken, water temperatures tested and recorded and risk assessments are in place regarding risk of scalding as radiators are not covered. Care Homes for Adults (18-65 years) Page 19 of 26 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. Although service users are being supported by a kind, caring staff team they would benefit from there being more consistency and stability. Evidence: From looking at records and observation on the day of the visit we saw that their are sufficient staff on duty to meet the needs of the people currently living in the home. When all six service users are at home there are three staff on duty and at night one person is on call. One service user is risk assessed as needing two to one support at times and we asked the manager if this affected the social life of other people. We were told that as their are two other LArche houses in close proximity to Jericho there were always staff and transport available to ensure that people attended their activities. The staff on duty were kind and respectful in their dealings with service users and they told us that they were made aware of service users needs by having a thorough induction period and observation of more skilled staff before providing hands on care for people. For all of the staff team English is a second language but we saw that they verbally Care Homes for Adults (18-65 years) Page 20 of 26 Evidence: communicated well with service users. However as previously recorded in this report, this does not always translate well in the written word and we discussed with the manager the need for training in report writing skills. We looked at the recruitment records for the four recently recruited members of staff and saw that all of the required documentation including an application form, current CRB (Criminal Bureau Check) and references are in place. records also showed that staff receive a structured induction, attend all mandatory training and receive supervision. The manager told us that as staff at the home only stay for a designated space of time there has recently been a high turnover of staff and all of the current staff team are relatively new to the home. In a returned survey a staff member told us, Although it is nice to have a lot of new people (assistants) and new ideas, core staff and service users also have to cope with assistants leaving and new people coming all the time. Care Homes for Adults (18-65 years) Page 21 of 26 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is being well managed, people are able to give feedback on the service being provided, records are current and health and safety issues are being addressed. Evidence: The manager of the home has worked for the LArche organisation in other homes for four years and is currently undertaking the Registered Managers Award. We are told in the AQAA and on the day of the visit that an application has been made to the Commission for the manager to be registered. We saw that Regulation 26 Providers visits are undertaken and that reports are completed and used to monitor the home. The LArche organisation carries out an annual quality assurance process and outcomes are published. We discussed with the manager how outcomes specifically for Jericho should be available in the home. Service Users and their families have opportunities to give feedback on the service being provided by weekly house Care Homes for Adults (18-65 years) Page 22 of 26 Evidence: meetings, service user representation on committees and annual reviews being held and the outcomes from all of these processes is recorded and published in an annual agreed Mandate for the home. We saw records for the running of the business including the fire risk assessment, Health and Safety checks, incident and accident recording, and the management of service users monies and all were current and in good order. Regular environmental checks are undertaken and recorded and health and safety issues in the home are being addressed. Care Homes for Adults (18-65 years) Page 23 of 26 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 24 of 26 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 Recommendations 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 35 To further develop the staff teams communication skills, training should be provided in record writing. Care Homes for Adults (18-65 years) Page 25 of 26 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.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. Care Homes for Adults (18-65 years) Page 26 of 26 - 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!