CQC report explained · a residential care home
What the CQC found at Jerome House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People felt safe and staff understood safeguarding, risk management, fire safety and medicines. One bottle of liquid medicine did not have its opening date recorded, and the home was taking action to remind staff.
- Effective?
- Good
- Staff were trained and supported, and people’s health and dietary needs were met. Some refresher training was still due, although arrangements had been made for it.
- Caring?
- Good
- Staff treated people with kindness, knew them well and respected their privacy, dignity, choices and differences. People were supported to develop independence and maintain relationships.
- Responsive?
- Good
- Care plans were personal, regularly reviewed and updated when needs changed. People could choose activities and knew how to complain, but reviews did not always record their feedback about care and the service.
- Well-led?
- Good
- Management had improved quality checks and acted on shortfalls. Some maintenance matters had taken time to resolve, and staff meetings had not taken place regularly.
What inspectors found, September 2018
Rated Good; inspectors found safe, kind and personalised care, with clear improvements since the previous inspection.
Inspectors made an unannounced, comprehensive visit on 7 June 2018. They spoke with all three people living in the home, staff and managers. They also looked at care records, staff files, audits and policies.
The home was rated Good overall and Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. People said they felt safe, were satisfied with the care and could make choices about their lives.
The home had improved since the previous inspection in April 2017. Inspectors found that earlier problems with the premises, equipment and quality checks had been addressed, so the home was no longer breaching those requirements.
Improved safety and premises
The home had addressed earlier problems with cleanliness, maintenance, fire doors and risk assessments. Inspectors found the communal areas clean and safety checks in place.
“The provider had taken appropriate action to address the shortfalls we found during the previous inspection and was no longer in breach of regulation relating to the premises.” from the report
Personalised care
Care plans described people’s health, personal, social and behavioural needs. They included guidance for staff and goals to help people become more independent.
“People's care plans were personalised and developed from the initial assessment.” from the report
Kind and respectful staff
Staff knew people well and supported privacy, dignity, choice and independence. Inspectors saw respectful and positive interactions.
“People were treated with kindness from staff who knew them well.” from the report
Support with health needs
People were supported to see healthcare professionals, including doctors, psychiatrists, dentists and chiropodists. Their medical needs were monitored.
“People were provided with the support that they required to access advice and treatment from a range of healthcare professionals including, GPs, psychiatrists, dentists and chiropodists.” from the report
Better quality monitoring
Daily, weekly and monthly checks covered areas such as medicines, fire safety, cleanliness and temperatures. The home acted when checks found shortfalls.
“We found at this inspection that the provider had acted to improve their practice by carrying out more effective checks of the service provided to people.” from the report
Refresher training
needs fixingSome staff were due refresher training in some subjects. Management said this had been arranged and would take place shortly.
“Some staff were due refresher training in some areas. Management had taken steps to address this issue.” from the report
Medicines recording
needs fixingThe opening date was missing from one bottle of liquid medicine. Management said staff would be reminded to record this in future.
“We noted that the opening date of one bottle of liquid medicine had not been recorded on it.” from the report
Care plan feedback
minorCare plan reviews showed people were involved, but did not always record that people had been asked for feedback about their care and the service.
“However, records of these reviews did not include information that showed each person had been asked for their feedback about their care and the service.” from the report
Personal equality information
minorCare plans and assessments contained little information about people’s religious, cultural, sexuality and other needs. Management said this would be improved.
“However, people's care plans and assessments included little information about these needs and how they were being met by the service.” from the report
Maintenance and staff meetings
minorSome maintenance issues were not resolved quickly, and staff meetings had not taken place regularly. Management said some improvements were being made.
“Maintenance issues were addressed. However, records showed that at times there was a delay in resolving maintenance matters.” from the report
- 01How do you make sure all staff complete refresher training on time?
- 02How do you check that medicine bottles are labelled with their opening dates?
- 03How will you record people’s feedback during care plan reviews?
- 04How are people’s religious, cultural, sexuality and other personal needs recorded and supported?
- 05How quickly are maintenance problems dealt with, and how are staff kept informed when regular meetings are not possible?
This was an unannounced comprehensive inspection covering all five key questions and the premises and care provided. This explanation was written from the published report of 22 September 2018 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, June 2017
Jerome House was rated Requires Improvement; inspectors found kind, effective care but concerns about cleanliness and quality checks.
This was an unannounced inspection on 27 April 2017. One inspector spoke with all four people living in the home, relatives, staff, managers and a health professional. The inspector also reviewed care files, staff records, audits, policies and other records.
People were treated respectfully and received care from staff who knew them well. The home supported people's health, independence, activities, family links and everyday choices. Medicines, staffing, recruitment and care planning were generally managed safely.
The main problems were that some communal areas were not clean or well maintained. Some safety and monitoring records were incomplete or inaccurate. The checks used by managers had not found or dealt with these issues, so the home was rated Requires Improvement for Safe and Well-led.
The other three areas were rated Good: Effective, Caring and Responsive. At the previous inspection on 1 April 2015, the service had been rated Good and had met the regulations inspected.
Staff knew people well
People received individual support from staff who understood their needs. Inspectors observed friendly and positive interactions.
“People received the care and support they needed from staff who knew them well.” from the report
Respect and independence
Staff respected people's choices, privacy and dignity. People were supported to make decisions and develop everyday living skills.
“Staff respected and supported people's right to make their own decisions and choices about their care.” from the report
Personalised activities
People were offered activities and outings that matched their interests and helped develop their skills and well-being.
“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.” from the report
Cleanliness and maintenance
seriousThe kitchen, bathroom and toilet areas had cleanliness and maintenance problems. The report also noted worn flooring, cracked tiles, an uncovered light fitting and doors left open that could allow fire to spread.
“The kitchen was 'tired' looking, the kitchen worktops were worn, paintwork in several areas was chipped, cobwebs were seen located next to a fridge” from the report
Weak quality checks
seriousSeveral audits were incomplete and did not identify important problems with cleanliness, fire safety, medicines, radiators, weights and other records. This was a breach of Regulation 17.
“The current systems in place were not robust to effectively assess, monitor and mitigate the risks relating to the health, safety and welfare of people using the service” from the report
Incomplete medicines checks
needs fixingThe report found no written detail showing what medicines competency assessments covered. One bottle did not have its opening date recorded, although this was corrected during the inspection.
“However, we found no written details of what the staff medicine competency assessment had covered, so were unable to determine how the member of staff was judged to be competent” from the report
- 01What has been done to improve cleanliness and maintenance in the kitchen, upstairs bathroom and toilet?
- 02How have you dealt with the worn kitchen floor, uncovered light fitting, cracked tiles, uncovered radiators and propped-open doors?
- 03What new checks are in place to make sure audits and daily housekeeping records are completed fully?
- 04How do you check and correct weight records when there is an unexpected change?
- 05How do you record staff medicines competency assessments and the opening dates of medicines?
This was an unannounced inspection covering all five CQC questions and the overall quality of the service, with records and the care of all four people reviewed. This explanation was written from the published report of 9 June 2017 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Jerome House
3 rated inspections over 3 years: the service has held its Good rating throughout.
- September 2018Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2017Requires improvementdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- May 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2013
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- May 2012
Registered with the Care Quality Commission on 16 May 2012.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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