Background to this inspection
Updated
25 September 2015
This inspection took place on 21 July 2015 and was announced. The inspection was carried out by one inspector. The provider had a short amount of notice that an inspection would take place. This was because the office of the service was not always open. We needed to ensure that the manager or provider would be available to answer any questions we had or provide information that we needed.
We reviewed the information we held about the service. Providers are required by law to notify us about events and incidents that occur; we refer to these as notifications. We looked at notifications that the provider had sent to us. We asked local authority staff about the service, they told us that they did not have any significant information to provide.
We had received information which highlighted that there was a shortage of staff and we planned to look at staffing levels during our inspection.
With their prior permission, we met and spoke with two people who used the service and spoke with four relatives by telephone. We spoke with two staff and the manager. We looked at the care files for three people, medication records for two people, recruitment records for three staff who had been employed within the last year, the training matrix, complaints and safeguarding processes.
Updated
25 September 2015
Our inspection took place on 21 July 2015. The provider had a short amount of notice that an inspection would take place. This was because the office of the service was not always open. We needed to ensure that the manager or provider would be available to answer any questions we had or provide information that we needed. We also wanted the manager or provider to ask people who used the service if we could visit them in their homes. At the time of our inspection 17 people received support and personal care from the provider. People who used the service had needs associated with living with a mental health condition and/or a learning disability.
Services delivered at the time of our inspection by Jensen House were personal care and support to adults who lived in their own flats within two ‘supported living’ facilities within the community. Supported living enables people who need personal or social support to live in their own home supported by care staff instead of living in a care home or with family.
At our last two inspections, a planned inspection in February 2014, and a responsive inspection that we carried out due to information we received in September 2014, the provider was meeting the regulations that we assessed.
Over the last six months the provider has realigned the services that they deliver. Previously Jensen House registration included, and had legal responsibility for, a number of services located near London. There had been a number of concerns and allegations of abuse within those services which were looked into by the local authority. The provider now has registered an office where those services are managed from and no longer are managed from Jensen House. The service also previously provided care to people with a range of needs who lived within the community. These services have now been moved to a different provider.
The provider had not been meeting the law as they did not have, and had not had, since February 2015, a manager who was registered with us. A new manager had been appointed in June 2015 who told us that they had started the process to register with us. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
There were systems in place to protect people from the risk of abuse and staff followed the systems to prevent people from being placed at risk of abuse and harm. People and their relatives told us that they were not aware of any incidents of abuse. Staff knew how to report any concerns that they may have.
Recruitment processes needed some improvement to reduce the risk of potentially unsuitable staff being appointed.
Systems did not always confirm that people had been given their medicines as they had been prescribed by their doctor.
Staffing levels at the time of our inspection were not placing people at risk of not receiving the care and support they needed or at the right time. However, relatives raised issues regarding the lack of consistency of staff allocated to their family member. The manager knew that there was a problem with staff consistency and was recruiting more staff and taking other action to resolve the issue.
Staff told us that they felt adequately supported on a day to day basis in their job roles. However, they and the manager told us that they were aware that some improvement was needed as formal supervision were not offered regularly to staff.
Some staff refresher training was needed and the provider had secured resources to ensure this was arranged.
People who used the service described the staff as being nice and kind. Staff showed an interest in people and showed them respect.
Staff had some understanding and knowledge regarding the Mental Capacity Act and the Deprivation of Liberty Safeguarding (DoLS). This ensured that people who used the service were not unlawfully restricted.
The provider had not ensured that staff met peoples cultural needs regarding diet and practising their preferred faith.
We found that a complaints procedure was available for people to use. However, as concerns and issues had not been recorded people and their relatives could not be confident that any dissatisfaction would be looked into or dealt with effectively.
Management systems and the quality monitoring of the service did not give assurance of a well led service. Relatives were not aware of whom the manager was and highlighted concern about the number of changes with managers there had been. The provider had not ensured that they informed us of incidents that they should and there was a lack of evidence to determine that regular audits and checks had been undertaken. The new manager was aware of these shortfalls and was working to improve the situation.
You can see what action we told the provider to take at the back of the full version of the report.