This unannounced inspection of Jerome House took place on the 27 April 2017. Jerome House is a care home registered to provide personal care and accommodation for four people who have a range of mental health needs. The service supports people to develop their skills and well-being to empower them to move to more independent living arrangements if and when that meets their needs. On the day of our visit there were four people living in the home. Public transport and a range of shops are located within walking distance of the service.At our last inspection on 1st April 2015, we found the provider met the regulations we inspected and the service was rated good.
There was a registered manager in place. 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 assess, monitor and improve the quality of the services provided for people. However, we found some areas of the premises were not clean and some records of quality checks of the service were incomplete. This indicated audit processes were not robust enough to fully identify all the deficiencies of the service and so facilitate improvement in the quality of care being provided.
People received the care and support they needed from staff who knew them well. People were treated with respect and staff engaged with people in a friendly and courteous manner. Throughout our visit we observed positive interaction between staff and people using the service. Staff respected people’s privacy and dignity and understood the importance of confidentiality. People were supported to choose and take part in activities of their choice that supported them with the development of their skills and the promotion of their well-being.
Staff respected and supported people's right to make their own decisions and choices about their care. People were supported by staff to develop their skills and independence and were provided with the support they needed to maintain and develop links with their family and others important to them.
People were supported to maintain good health. They had access to a wide range of appropriate healthcare services that monitored their health and provided people with treatment and specialist advice when needed. People’s spoke in a positive manner about the meals they were provided with, and staff made sure people’s individual dietary needs were met.
Staff understood how to keep people safe and they helped people to understand risks. Medicines were managed safely by staff who were trained to administer medicines.
Systems and processes were in place to help protect people from the risk of harm. Procedures were in place to safeguard people. Staff knew how to recognise and report abuse and minimise risks of people being harmed.
Arrangements were in place to make sure sufficient numbers of trained staff were deployed at all times. People’s individual needs were identified and managed as part of their plan of care and support. Accidents and incidents were addressed appropriately.
Staff were only employed after all essential pre-employment safety checks had been satisfactorily completed. Staff were supported to provide people with individualised care and support. Staff received supervision and a range of training so they were skilled and competent to carry out their roles and responsibilities. Staff told us they enjoyed working in the home and received the support and training they needed to provide people with the care and support they needed.
Staff understood the legal requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). People were encouraged and supported to make decisions for themselves whenever possible. Staff knew about the arrangements for making decisions in people’s best interest when they were unable to make one or more decisions about their care, treatment and/or other aspects of their lives. People's permission was sought by staff before they helped them with care and other tasks
People knew how and to whom they could raise their concerns. They told us they felt able to discuss concerns with staff and were confident they would be addressed.
We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the registered manager to take at the back of the full version of this report.