Latest Inspection
This is the latest available inspection report for this service, carried out on 28th May 2010. CQC found this care home to be providing an Adequate service.
The inspector found no outstanding requirements from the previous inspection report,
but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.
For extracts, read the latest CQC inspection for Joseph House.
What the care home does well The manager has been working hard to continue to improve the environment at the home so that this enhances people`s quality of life and provides adaptations that will meet their needs. A visiting professional says `the service is making good progress in updating the environment and not causing upsets to the residents during this time.` They say the person they are responsible for `is happy with the involvement she has had in choosing her decor.` The staff team have worked hard to ensure that the quality of records they keep is clearer in the way it shows how people are supported and that the care they delivermatches what the support plans say is needed. They follow up any concerns about people`s health care promptly and act upon the advice that they have been given. One visiting professional says `Joseph House offers person centred support to meet the needs of each resident, be it long term care or respite. I feel they offer good standards of care.` Another says the service does well in that it `caters for the needs of older clients, physical disabilities and dementia`, in `addressing medical needs and providing in house activities.` All of the eight people living in the home who completed surveys feel that the home `always` makes sure they get the medical care they need and `always` has fun things for them to do if they want. People are offered choices of food and the home caters successfully for people to have specific needs, for example in relation to weight loss, diabetes or swallowing difficulties. Drinks are available to help ensure people are always properly hydrated. Comments from relatives include that `I feel Joseph House gives a very good service.` Another says there is `always a welcoming atmosphere. Joseph House meets [name] needs entirely, which helps alleviate any worries of [name] being in care.` `I am always informed of any problems that arise and the owner is always available to discuss any action that needs to be taken.` `They do an excellent job caring for sometimes very difficult clients.` What the care home could do better: The manager must ensure that she has the specified information in place about people`s suitability to be appointed before they start work at the home (albeit on induction). She needs to check more carefully what regulations say and make sure that she always takes up references promptly. There are some other things that the manager should think about doing to enhance the quality of the service and she can tell people what action she is taking about this report. Random inspection report
Care homes for older people
Name: Address: Joseph House The Old Rectory Reedham Norwich Norfolk NR13 3TZ one star adequate service The quality rating for this care home is: The rating was made on: 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 review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Judith Last Date: 2 8 0 5 2 0 1 0 Information about the care home
Name of care home: Address: Joseph House The Old Rectory Reedham Norwich Norfolk NR13 3TZ 01493700580 01493700994 Josephhouse@hotmail.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Beverley Mary Terry Type of registration: Number of places registered: Conditions of registration: Category(ies) : Joseph House (Reedham) Ltd care home 35 Number of places (if applicable): Under 65 Over 65 35 learning disability Conditions of registration: 35 Any person must, on admission, be at least 45 years of age. One person, named in the Commissions records and less than 45 years of age, can be accommodated. The total number of pepople accommodated must at no time exceed 35. Date of last inspection Brief description of the care home Joseph House is a care home currently registered to provide personal care and accommodation to 35 people with learning disabilities, who may be over 65. The service, located in the village of Reedham, approximately 20 miles from Norwich,
Care Homes for Older People Page 2 of 10 Brief description of the care home is a large period house, which has been extended. Joseph House is on a no through road so there is little passing traffic and stands in large grounds. There is off-road parking. There are also two other small units providing accommodation adjacent to the main house. The home has a total of 21 single bedrooms, most of which are en-suite, and 7 shared rooms, all of which have en-suite facilities. The main house has accommodation on the ground and first floors, which residents can also access by the lift. At our last key inspection, charges for living at the home ranges from £367 to £2,198 per person per week according to their assessed needs. There are additional charges for hairdressing, chiropody, newspapers and magazines, outings and personal spending. The manager says she ensures that inspection reports are made available to residents or their representatives. Care Homes for Older People Page 3 of 10 What we found:
The last key inspection of this service took place on 18th June 2009 when it was rated as adequate. However, the manager has continued to make improvements to the service since then. Before we visited the service we looked at all the information we had about it, including the past history of the service and our visits, information the manager sent, and information we received in surveys. This includes the views of seven service users, eight of their relatives or friends, seven staff and four visiting professionals. The views expressed in these surveys were overwhelmingly positive. We offered one person the opportunity to talk to us further if they felt the issues they raised had not been resolved but they have not done so. There have been lots of improvements to the environment since our last visit. Redecoration has taken place to a number of rooms, including the lounge at the front of the home. Ceiling track hoists have been fitted where these are considered useful, and some rooms have been provided with en-suite facilities. We looked at individual support plans for four people to see what these said about the support people need and are offered. This was so we could be sure that the requirement we made at the last key inspection had been met. At that time daily records did not show that care required to meet peoples health needs, was delivered as individual support plans directed. Each of the plans seen contain clear information about peoples needs and problems and how their health is to be monitored or promoted. Daily record sheets now show what has happened. One persons plan says they need careful monitoring of their food intake due to problems in this area. Daily records show that staff record what the person has had to eat and drink, monitor weight regularly and offer supplements where these are needed. The persons recorded weight has stabilised. A relative comments that the food provided in Joseph House is of a high standard and there is always a choice and even the most difficult palates are catered for. Choices are displayed on a board in the dining room and people can see what is on offer at the serving area. The home is signed up to the good hydration charter to make sure people always have access to enough to drink. Although one person says they sometimes like the meals at the home, six say they always like them. (One says usually.) Another plan shows that monitoring of glucose levels is required and gives a clear indication of what levels would lead to concerns and what staff should do about it. We were able to see from daily records that staff had followed up concerns and acted upon the advice given to them by the emergency G.P. (However, staff had not recorded some of the twice daily readings on the persons daily record chart.) In another file we could see additional support and advice had been secured from the
Care Homes for Older People Page 4 of 10 district nurse because of developing problems. We could also see that the G.P.s advice regarding an infection and subsequent monitoring had been followed up. One support plan shows that the person occasionally refers to themselves as good girl. During our visit, two people used this phrase to the service user in quick succession. Efforts have been made to make some information accessible to people with communication difficulties so they can understand their care better. For example, there is a book of pictures to enable discussion about choices and about medical appointments. The manager also says that the service users guide is now available in audio format so that people would be more easily able to understand information about the home. Medicines records were looked at to ensure the requirement for these to be full and accurate was met. These show staff follow good recording practices. The audit processes the management team have put in place have proved themselves able to identify anomalies promptly and take action to address them. The manager has improved records held about staff. Sometime staff start their induction on the premises but without any contact with service users, before a full range of information is obtained. They are informed that their appointment is subject to satisfactory information about criminal records and checks. However, although checks were made in one case to ensure that the person was not barred from working with vulnerable adults (and obtained in February), one reference was not supplied until 26th April. The manager was reminded staff can start work in emergency situations if they are supervised, if the initial disclosure against the vulnerable adults register has been made, and pending enhanced criminal records bureau checks. However, full and satisfactory information must be obtained in respect of full employment histories and references. The frequency with which staff are supervised has improved as has recording to show what issues have been discussed. However, actions arising from supervisions are not always clearly recorded and followed up. Information from someone connected with the service shows that they feel a complaint was properly responded to, investigated and recorded showing that concerns are taken seriously and addressed. However, comments from two relatives or friends of people living in the home suggest they feel more could be done to improve communication. One says I do have real concerns about Joseph Houses ability to keep us informed of important meetings and another feels that communication is an area that could be improved. What the care home does well:
The manager has been working hard to continue to improve the environment at the home so that this enhances peoples quality of life and provides adaptations that will meet their needs. A visiting professional says the service is making good progress in updating the environment and not causing upsets to the residents during this time. They say the person they are responsible for is happy with the involvement she has had in choosing her decor. The staff team have worked hard to ensure that the quality of records they keep is clearer in the way it shows how people are supported and that the care they deliver
Care Homes for Older People Page 5 of 10 matches what the support plans say is needed. They follow up any concerns about peoples health care promptly and act upon the advice that they have been given. One visiting professional says Joseph House offers person centred support to meet the needs of each resident, be it long term care or respite. I feel they offer good standards of care. Another says the service does well in that it caters for the needs of older clients, physical disabilities and dementia, in addressing medical needs and providing in house activities. All of the eight people living in the home who completed surveys feel that the home always makes sure they get the medical care they need and always has fun things for them to do if they want. People are offered choices of food and the home caters successfully for people to have specific needs, for example in relation to weight loss, diabetes or swallowing difficulties. Drinks are available to help ensure people are always properly hydrated. Comments from relatives include that I feel Joseph House gives a very good service. Another says there is always a welcoming atmosphere. Joseph House meets [name] needs entirely, which helps alleviate any worries of [name] being in care. I am always informed of any problems that arise and the owner is always available to discuss any action that needs to be taken. They do an excellent job caring for sometimes very difficult clients. 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 2. Care Homes for Older People Page 6 of 10 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, Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 7 of 10 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, 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 29 19 The manager must ensure 18/06/2010 that she takes up references promptly and has all the necessary information to take staff into the home, whether supervised or otherwise. This is so the manager has all the information the law requires, in order to take staff on before the full enhanced criminal records bureau disclosure is obtained. This is so she can take staff on in an emergency, but also show she has done what she needs to, to ensure they are appropriate to work in the home. Care Homes for Older People Page 8 of 10 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 8 Checks should be made to ensure staff record blood glucose levels each time they are tested to show effective monitoring. Staff should always use appropriate language in their communication with or praise for service users. Language used should be age appropriate and promote dignity. If not already underway, the manager should expore via quality assurance processes, whether each persons relatives or friends feel that communication could be improved. If this is shown to be so, she should look to see how this would be in the persons best interests and enhance their support networks. Actions arising from discussions in supervision should be more clearly recorded and followed up. These records should include goals set for improving performance where this is not satisfactory, or where an agreement has been made that staff will take responsiblity for a particular task. This is so the management team can be sure performance is robustly monitored should they need to take further action, and to ensure staff are consistently clear about their roles and the expectations of the management team. 2 10 3 33 4 36 Care Homes for Older People Page 9 of 10 Reader Information
Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got 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 Helpline: Telephone: 03000 616161 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. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for noncommercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. Care Homes for Older People Page 10 of 10 - 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!
