All inspections: Jenson House - Care Quality Commission

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.

We carried out this inspection over two days. No-one knew we would be visiting on the first day as our inspection was unannounced.

We carried out this inspection in response to information that had been brought to our attention which highlighted that some people's needs, due to their complex physical conditions, may not be being met. Evidence that we gathered determined that this was not correct.

42 people received personal care packages from the service on the day of our inspection. A small number of those people received support that did not involve personal care provision for example, house cleaning and shopping. With their permission, we visited two people in their own home within a supported living facility, to determine their experience of the care provided. We also spoke with ten other people who used the service or their relatives and a professional healthcare worker by telephone. We met and spoke with six staff.

We carried out this inspection so that we could answer our five questions;

Is the service safe?

People who used the service told us they felt safe. One person said, 'The staff are all very kind'. A relative said, 'I have no concerns at all'.

Generally where concerns regarding abuse or harm were identified referrals were made to the appropriate agencies so that people would be protected.

Staff we spoke with knew about the Deprivation of Liberty Safeguard (DoLS) processes. DoLS is a legal framework that may need to be applied to vulnerable people who lack capacity and may need to be deprived of their liberty in their own best interests to protect them from harm and/or injury.

Is the service effective?

People who used the service and their relatives told us that they were happy with care and support provided. One person said, 'I am absolutely happy with everything. There is nothing that needs to be changed'. A relative said, 'I am very happy with the care and support'.

Is the service caring?

All of the people and their relatives we spoke with told us that staff were polite and showed respect.

The people we spoke with told us staff supported them in the way that they wanted to be cared for and supported. People told us that the staff were, 'Kind', and, 'Good'. One relative said, 'I cannot fault the care staff at all they are very good'. We observed staff speaking with two people who used the service in a kind considerate manner.

We found that people were supported to live their lives as independently as possible. Staff supported people to retain their daily living skills.

Is the service responsive?

The provider had a system in place so people could share any comments they had about the service. People told us they were able to share their views.

We found that there were systems in place to ensure that care calls were not missed and for managers to be alerted if care calls were late.

The new manager had identified that care plans needed to be updated and had made plans for this to be addressed.

Is the service well-led?

A new management team was in the process of being developed. A new manager and area manager had been appointed within the month of our inspection. The team was complemented by a care co-ordinator and a senior carer was in the process of being employed.

The manager and area manager told us plans they had to support staff which included one to one supervision and showed us documents to confirm that refresher training had been secured. These actions would promote a well led service.

During this inspection we held telephone interviews with three people who use the service and one relative. We also spoke with the acting manager of the service, a coordinator and two care workers.

People that we spoke with said that they and their relatives were involved in agreeing and planning their care. One person said, 'My daughter was involved with the care plan to stop me worrying.'

People told us that their needs were being met. One person told us, "I feel my needs are well met, the carers are lovely people." We found that people's needs were assessed and care and treatment was planned and delivered in line with their individual care plan.

People told us they felt safe using the service and with the staff that visit them. We found that people who use the service were protected from the risk of abuse. One person told us, 'I feel very safe with the carers I have.'

We found that staff were supported to undertake their job role. People told us that they were treated well by the staff that supported them. One person told us, "They are very caring and I can't fault them." We found that people were cared for by staff that were trained and supported to do their job well.

There were systems in place to monitor how the service was run to ensure people received a quality service.

Archived: Jenson House

All Inspections

21 July 2015

During a routine inspection

22, 29 September 2014

During an inspection in response to concerns

14 February 2014

During a routine inspection