Jericho Lodge

Jericho Lodge provides residential accommodation for up to three males with mental health needs. At the time of our inspection there were two people using the service.

People’s experience of using this service and what we found

People using the service told us they liked living at Jericho Lodge and considered it their home, they told us they felt safe living there. Although there were enough staff employed to meet their needs, some of the staff recruitment checks needed closer scrutiny as one of the staff files we saw did not contain the required recruitment checks. People were supported to take their medicines on time. The provider assessed risks and prepared management plans which help to keep people safe from harm and staff supported people to take their medicines as prescribed.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Staff received training that was appropriate for their role. However, we found that individual staff supervision was not being carried out by the provider. People’s dietary needs were met. Some of the records in relation to people’s healthcare support needs were not up to date. needed updating.

The service was caring and this was reflected in the feedback we received from people. People were supported to maintain relationships that were important to them and they lived independent lives where staff promoted their independence.

Care plans for people reflected their individual needs and people took part in community and individual activities according to their preferences. They told us they had no complaints but knew who to speak with if they did.

People and staff told us there was an open culture in the service and they felt comfortable approaching the manager if they had any concerns. Quality assurance checks took place to ensure the service was managed well.

We have made some recommendations to the provider in relation to quality assurance checks are more robust.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was good (published 13 November 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Jericho Lodge on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

We found the following examples of good practice:

The provider was following best practice guidance to prevent visitors to the home spreading the Covid-19 infection. Visitors entered the premises through the front door and staff checked the vaccination and Covid-19 status of visitors, recorded vaccination or exemption status and provided assurance of meeting vaccination requirements. On entry to the home, there was a visitors book and information displayed on the wall about infection prevention and control (IPC) and personal protective equipment (PPE). All visitors were screened for symptoms of acute respiratory infection before being allowed to enter the home. Visitors were supported to wear a face covering when visiting. The provider requested that visitors call in advance of visiting and staggered visits. Visitors had no contact with other residents and minimal contact with staff. The provider supported alternative forms of maintaining social contact for friends and relatives; for example, keeping in touch using video calls, visiting in the communal garden in the summer months and using a telephone to communicate. The provider supported the residents in outside visits and had a process for monitoring of residents for Covid-19 symptoms and lateral flow testing on their return.

The provider had not had any residents who had tested positive for Covid-19, however, it told us of the process it would follow if a resident did test positive. The provider had completed risk assessments for residents where it considered the risks of Covid-19 and how risks could be mitigated. The provider had a process in place to be followed if a staff member tested positive for Covid-19.

The provider had not had any recent admissions. It had a process for admissions which it would follow if a resident was being admitted to the home. The provider would check the Covid-19 status for the resident, ensure testing was completed and would isolate the resident for the prescribed time before allowing the resident to mix with other residents.

Use of PPE was in accordance with current government guidelines. The provider had explained to residents about why PPE was necessary and had supported their knowledge of Covid-19 through communicating with them.

The provider ensured that the home was well ventilated, with windows and doors opened where appropriate to facilitate ventilation. The good practice for linen and laundry guidance was followed.

Further information is in the detailed findings below.

Jericho Lodge is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The home provides care for up to three people who misuse drugs and alcohol and need support to maintain their mental health. It is located in the Morden area of London.

The service had a registered manager. 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 and associated Regulations about how the service is run.

At the last inspection in March 2016, the home was rated overall good with a good rating for all five key questions.

The home’s environment was a safe one to live and work in with a welcoming and friendly atmosphere. People enjoyed living at the home and were happy there. Staff supported them to make choices, including a variety of activities at home and in the community. People were comfortable with the manner in which staff provided care and support for them. Positive interactions took place between staff and people and each other throughout our visit.

The home kept up to date records that covered all aspects of the care and support people received. People’s care plans were individualised to them and contained regularly reviewed, comprehensive information. This enabled staff to support people efficiently and professionally. People were encouraged to discuss their health needs with staff and had access to GP’s and other community based health care professionals. They were encouraged and supported to choose healthy and balanced diets that also met their likes, dislikes and preferences, whilst protecting them from nutrition and hydration associated risks. They told us they chose what they ate and were happy with the quality of meals provided.

People were given constructive support, knew the staff that supported them well and staff were fully aware of people’s needs, routines and preferences. Relatives said that staff worked well as a team, had appropriate skills and provided care and support, in a professional and friendly way. This was conducted within agreed boundaries and focussed on people and their individual needs. The staff were well trained and made themselves accessible to people and their relatives. Staff said that the home was a good place to work and they enjoyed working there. They received good training and support.

Relatives said the registered manager and staff were approachable, responsive, encouraged feedback and consistently monitored and assessed the quality of the service.

Jericho Lodge is a small care home that provides support and care for up to three people with mental health issues. At the time of this inspection the home was full.

There was a registered manager employed at the service. 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.

One person we spoke with told us that this was a good, safe service and said they were quite happy with it. Relatives told us that the staff who supported people knew them and how to provide the care and support to meet their needs.

Appropriate risk assessments were in place that helped protect people and staff in the delivery of care and support.

We were told there were sufficient numbers of staff who helped support people in the way they needed to be cared for. We saw the service had sufficient staff available to support people. Safe systems were used when new staff were recruited to ensure they were suitable to work in the care homes.

We saw evidence that people received their medicines safely and appropriately. Medicines were stored safely.

The person we spoke with indicated they were happy with the care and support they received from the service. They told us staff were helpful and were respectful of their needs. Relatives told us they thought people received good effective care.

Staff had access to a wide range of training that they said helped them with their role of providing good, effective care to people in the home. Staff told us they received good, effective support through regular supervision. We saw the home was comfortable, clean and had a homely feel that people felt relaxed in.

There was provision of healthy, good food that people had been able to make their own choices about eating. People’s physical and mental health was closely monitored by staff. There was evidence that people had appropriate access to healthcare professionals such as the GP and psychiatrist.

People were treated with kindness and care. We saw that staff understood people well and involved them in planning their care and support. We saw people’s views were sought when decisions needed to be made about how they were cared for.

Staff treated people with respect and dignity. Advocacy services were available for people to use as necessary.

Relatives we spoke with said they felt welcomed when they visited their family members.

People said they felt that the service responded to their needs and individual preferences. Staff supported people according to their personalised care plans. Care plans were reviewed six monthly or earlier if people’s needs changed.

We saw there was an appropriate complaints policy in place that people were aware of. People told us that the registered manager encouraged people to raise any concerns they had and responded to them positively and in a timely manner.

The registered manager asked a wide variety of people for their views about the care provided to people living in the home. The responses we saw were all positive. Where suggestions or comments were received the registered manager used the information to develop and improve the service.

People gave positive feedback about the management of the service. The registered manager and the staff were approachable and fully engaged with providing good quality care for people who used the service. The provider had systems in place to continually monitor the quality of the service. Action plans were developed where required to address areas for improvements.

At our previous inspection we found that people could not be confident that the quality of the service was robustly monitored. We therefore asked the provider to make improvements to the way the quality of the service was being monitored and assessed. During this inspection we found that the provider had made the necessary improvements.

We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask:

' Is the service caring?

' Is the service responsive?

' Is the service safe?

' Is the service effective?

' Is the service well led?

Below is a summary of what we found. If you want to see evidence supporting our summary please read the full report.

Is the service safe?

People using the service told us they felt safe and that they were cared for individually. Assessments were carried out by staff to make sure that people's needs were identified and met. Risks were assessed and reviewed regularly to make sure people's changing needs were met in ways that maintained their independence. People were supported to take their medicines in a safe way.

Staff had undertaken training in the Mental Capacity Act 2005 and were aware of their responsibilities in relation to the Deprivation of Liberty Safeguards (DoLS); although no application has needed to be submitted to the local authority. People using the service were aware that they were free to come and go as they wished.

Is the service effective?

People received effective care from staff that were trained and supported by the manager. People were involved in assessments of their health and care needs and in writing their plan of care so they understood the information they included.

Staff encouraged and supported people to keep healthy and well through regular monitoring of people's general health and making sure they attended scheduled medical and healthcare appointments.

Is the service caring?

People were involved in making decisions about how they wanted to be cared for. People were supported by attentive and patient staff. We saw staff give encouragement to people and these interactions were caring and compassionate. Staff respected people's privacy, dignity and right to be involved in decisions and make choices about their care and treatment.

All the people we spoke with gave us positive feedback on the care and support they received in the home. Comments we received included, "they look after me very well' and 'good staff, they look after my needs'.

Is the service responsive?

People regularly completed a range of activities in and outside the service and these were constantly being reviewed so people's individual recreational needs were being met.

People using the service met with their key-worker on a regular basis to discuss the care and support they received. People's preferences and choices for how they wanted to be cared for and supported were well documented in their care plans and staff were given appropriate guidance on how to meet these needs.

People told us they knew how to make a complaint if they were unhappy. One person told us, 'I talk to the staff especially the manager'.

Is the service well led?

The provider carried out regular checks to assess and monitor the quality of the service provided. In this way the provider could ensure that the quality of the service was maintained.

Staff told us they were clear about their roles and responsibilities. Staff felt well supported to raise concerns and said that their manager was approachable and would act on concerns raised

We found that the member of staff on duty knew how to communicate with and support people at the home. This member of staff told us that they knew the people's needs well as they had lived at Jericho Lodge for a long time.

We found that people's needs were assessed and regularly reviewed and that their care plans were available to guide staff how to best support them. Their health was monitored and the staff supported them to attend medical appointments. Records related to people using the service and staff were up to date and managed securely.

We found that the home was adequately maintained and it was also clean and tidy during our visit. We saw that people personalised their rooms.

We found that while the quality of most parts of the service was monitored adequately some received less attention. This meant that people who used the service were not fully protected against the risk of receiving inappropriate or unsafe care.