Background to this inspection
Updated
13 November 2019
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
The inspection was carried out by one inspector.
Service and service type
Jemini Response at 17 Jerome Close is a ‘care home.’ People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
We gave the service 24 hours’ notice of the inspection. This was because the service is small and people are often out and we wanted to be sure there would be people at home to speak with us.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
During the inspection-
People had complex communication and support needs. We spoke with and observed all three residents of 17 Jerome Close. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who found it difficult to talk to us. We spoke with nine members of staff including the provider, the registered manager, the deputy manager, four care staff and two administration staff.
We reviewed a range of records including two people’s care plans and medication records. We looked at two staff files in relation to recruitment and supervision and a variety of records relating to the management of the service for example, policies, procedures and audit processes. We pathway tracked two people. This is where we check that the records for people match the support they receive from the service.
After the inspection
We continued to seek clarification from the registered manager to validate the evidence we found. We spoke to three relatives and three professionals who regularly visit the service.
Updated
13 November 2019
About the service
Jemini Response Limited at 17 Jerome Close, Eastbourne, is a residential home providing personal care for up to three people. At the time of the inspection there were three people living at the service. People living at 17 Jerome Close were younger adults with learning disabilities, who had lived there since they were teenagers.
17 Jerome Close is a house in a residential area and had two floors. Bedrooms were on both floors and on the ground floor there was also communal living areas and an office. The home had a rear garden with a large, heated, outhouse that was used by staff and people.
The service has been developed and designed in line the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.
People’s experience of using this service and what we found
The outcomes for people using the service reflected the principles of Registering the Right Support by promoting choice, control, independence and inclusion. People’s support focussed on them having opportunities to maintain relationships, engage in activities of their choice and maintain their independence.
People were not able to tell us they felt safe however we observed staff interacting with people and spoke to staff about their understanding of safety issues, for example safeguarding. Relatives and professionals told us that they felt the service was safe. Staff knew people well and knew their care and support needs. Risk assessments were in place, specific to people’s needs. Staff were recruited safely and there were enough staff working each shift to meet people’s needs. There was a comprehensive induction process. Medicines were ordered, stored, provided and disposed of safely.
People were supported to have maximum choice and control in their lives and staff supported them in the least restrictive way and in their best interests. Staff had received training that was relevant to help them support people. This included mental capacity, challenging behaviour and safeguarding. People’s nutritional needs were met and people were offered choice. People received support from health and social care professionals.
Staff were attentive to people’s needs and were caring. People’s privacy, dignity and independence were respected and promoted. People’s differences under the Equalities Act 2000 were considered and respected.
Support received was person-centred and focussed on individual needs. Care plans were regularly reviewed with people, relatives, staff and professionals. People had routines which were important to them and a range of activities both inside and outside the home were provided. Strong links with the local community had been established. A robust complaints process was in place.
The registered manager was well thought of and staff, relatives and professionals told us they thought the home was well led. People reacted in a positive way with the registered manager who was a visible presence throughout the home. Audit processes were in place and were overseen by the registered manager. Feedback was sought from people, staff, relatives and professionals. Regular staff meetings were held.
The Secretary of State has asked the Care Quality Commission (CQC) to conduct a thematic review and to make recommendations about the use of restrictive interventions in settings that provide care for people with or might have mental health problems, learning disabilities and/or autism. Thematic reviews look in-depth at specific issues concerning quality of care across the health and social care sectors. They expand our understanding of both good and poor practice and of the potential drivers of improvement.
As part of thematic review, we carried out a survey with the registered manager at this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people. The service used positive behaviour support principles to support people in the least restrictive way. The home used some physical restraint only.
For more details, see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspectionThe last rating for this service was requires improvement with one breach of regulation. (Published December 2018). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.