Inspection Report on

Inspection Report on

Jah Jireh Charity Homes (Wales) JAH JIREH CARE HOME

LLWYDCOED ABERDARE

CF44 0LX

Date Inspection Completed

26th November 2019

Description of the service

Jah Jireh is located in the outskirts of Aberdare and is owned and run by Jah Jireh (Charity) Homes. The home provides faith based accommodation specifically to members of the Jehovah Witness community from across the UK. The home is registered to provide personal care and accommodation for up to 51 people. The nominated Registered

Individual (RI) is Mr Edward Delaney who has overall responsibility of the service. There is also a manager in place who is registered with Social Care Wales (SCW) and oversees the daily running of the service.

Summary of our findings

1. Overall assessment

People appear relaxed, content and satisfied with the care they receive. Assistance is provided in a timely manner and people have opportunities to take part in social activities and maintain their faith. The home environment is spacious, clean and comfortable. Staff appear caring and supportive and the management team demonstrate a commitment to providing good quality services. There are a range of policies in place to support positive care and support. However, supervision, recruitment checks and quality reviews all require further strengthening.

2. Improvements

This was the first inspection following the homes re-registration under the Regulation and Inspection of Social Care (Wales) Act (RISCA) 2016. Improvements made by the service will be considered at the next inspection.

3. Requirements and recommendations

Section five of this report sets out our recommendations to improve the service and the areas where the care home is not meeting legal requirements, these include RI reviews, recruitment files and supervision.

1.

Well-being

Our findings

People are able to make choices and have their individual routines recognised and valued.

Personal plans were created and reviewed in consultation with individuals. Legal rights were recognised and policies were comprehensive and up to date. People were given choices about the structure of their day and were positively occupied to do things that mattered to them. We found evidence the service sought feedback from a number of sources to ensure the care provided was positive. However, we noted some aspects of quality assurance required strengthening. In conclusion we found individual circumstances are considered and people can contribute to decisions related to their care.

Practices and processes in the service support physical and emotional well-being. People benefit from care that was delivered in a person centred manner by a knowledgeable staff team. We observed throughout the inspection individuals were treated with dignity and respect and residents appeared generally content and occupied. We found the service had an understanding of people’s needs, particularly those with a diagnosis of dementia, and supported independence. Medication practices were safe and people had access to appropriate health and social care professionals when required. People’s spiritual needs were recognised and fully met. Therefore we conclude, people are supported to remain as healthy as they can be, and are able to occupy their day with activities that make them happy.

The service offers a safe and suitable environment which supports individual well-being and a sense of belonging. The home was warm, welcoming and provided a safe clean

environment for residents. Bedrooms were personalised to individual tastes. Policies and procedures were in place to ensure safety was maintained through the use of appropriate security checks, fire safety measures and an ongoing programme of maintenance and repairs. Therefore we can conclude people’s well-being is enhanced by having access to a safe and pleasant space to live.

There are mechanisms in place to ensure people are protected from abuse. Staff received training which ensured they were appropriately skilled to carry out their duties to safeguard and protect vulnerable adults. People knew who to speak with if they had any concerns. Up to date policies and procedures were in place to ensure the service followed national

guidance and current legislation. However, some recruitment files lacked sufficient information and staff did not always receive supervision in line with their supervision contracts. Therefore we can conclude people are safe and protected however further improvements are required in the recruitment and supervision of staff.

2.

Care and Support

Our findings

People receive positive care and support which is planned for, monitored and reviewed in a timely manner. We viewed a selection of personal plans and found them to be robust and reviewed regularly. Plans were reflective of the person being cared for. Files contained detailed information on people likes and dislikes, life histories and relatives and friends they wished to maintain contact with. Personal plans recognised the importance of people’s religious faith and we saw evidence advanced directives were in place in relation to medical treatment. Personal plans were signed which indicated people participated in reviews and were in agreement with the care being provided. We also observed daily practices mirrored the information recorded in people’s plans. We saw people were referred to appropriate health and social care professionals as and when their needs changed and were supported to attend routine health appointments. We had the opportunity to speak to a visiting health professional who confirmed referrals were made in a timely manner and professional guidance was always followed appropriately. We saw the home ensured any restrictions such as Deprivation of Liberties Safeguards placed upon individuals were legal and proportionate. Supporting documentations such as monitoring of people’s weight and dietary intake were completed as and when required. Risk assessments were used effectively to reduce risks, maintain existing skills and maximise independence. This was evidenced by the fact people were supported to maintain their self-care routines and medication management when appropriate. Based on the above, we conclude people can feel confident they receive the right care at the right time.

Safe medication management systems are in place. We viewed medication administration processes and found them to be safe and robust. Medication was stored safely and

securely and controlled drugs stored appropriately. We viewed a selection of medication administration records (MAR’s) and saw all administered medication was signed for accurately. However, we noted one MAR chart lacked information on an individual’s medication allergy, this was discussed with the manager who agreed to address this immediately. People’s abilities to self-medicate was assessed and individuals were

supported to self-medicate when possible. We found regular medication audits were carried out and positive action had been taken to address any errors. Overall, we conclude there are safe systems in place to ensure medication is managed safely and effectively.

People are happy because they have positive relationships with staff and can do things that matter to them. Staff knew residents well and were familiar with their needs. We saw that staff interacted in a friendly and kind manner and people were able to choose where and how they wished to spend their day. People living in the home commented “they are lovely here I can’t fault them”, “I am the happiest here” and “I have everything I need”. We found activities offered by the home reflected those identified on people’s support plans. We saw a spacious activities room was used to hold various social events, craft activities and

games. We were informed people had access to a number of social events based within the home as well as the local community. We were shown photos of individuals positively

engaged in activities which further evidenced their enjoyment. People told us their spiritual needs were met through the provision of bible studies and ministry, participating in

Watchtower and attending an on-site kingdom hall. Several people stated they were happy to be at a home where their religious beliefs were understood and shared. This evidence indicates that people’s spiritual and emotional needs are fully considered and enhanced.

Meal times are a positive experience and people’s nutritional needs are being met. We saw meals were attractively presented and people we spoke with were complimentary about the standard of food they received. People also commented the food was “appetising” and that they were given a range of meal options. One person stated “The food is excellent which is very important to me”. The day’s menu was visible on notice boards and people were supported to decide on their choice of meal. We observed the lunchtime experience as a whole was pleasant and unhurried and people were supported in accordance with their personal plans. Kitchen staff we spoke with told us menus were changed regularly to

ensure variety and choice. They also appeared knowledgeable about those individuals with food allergies or those who required a specialist diet. Therefore we can conclude people’s dietary needs are understood and met.

3.

Environment

Our findings

People can be assured they live in an environment which is suited and meets their needs.

We toured the home and found it to be pleasant, clean and decorated to a high standard.

People were cared for in single rooms which were warm, well maintained and personalised.

There was access to ample communal space which supported group activities and social interaction with other residents. Bathrooms and toilets, were clean, clutter free and

contained appropriate equipment to promote safety. Consideration had been given to people living in the home with a dementia diagnosis. We found communal areas benefitted from a colour coding system which supported better orientation for people with dementia.

The use of tactile fabrics, resident’s art work and religious themed wall scenes in communal corridors also provided sensory stimulation and a homely atmosphere. Based on our

findings, we conclude people’s well-being is enhanced by having access to a pleasant environment.

Mechanisms are in place to ensure the environment is safe and well maintained. On arrival we found the home was locked and our identification was requested, these measures ensured unauthorised visitors were unable to access the property. The home was clutter free which enabled safe use of mobility aids. We saw harmful chemicals were locked away safely and securely, and all windows had restrictors in place. We found Personal

Emergency Evacuation Plans (PEEP) had been completed, which ensured people received the correct support in the event of an emergency. We saw evidence fire alarms were tested regularly and evacuation drills took place periodically. We viewed the homes maintenance file and saw gas and electricity safety tests had been completed and all serviceable

equipment had certificates to confirm they had been serviced appropriately. Therefore, we conclude people’s safety is maintained at Jah Jireh.

4.

Leadership and Management

Our findings

People can be assured they are cared for by sufficient staff who are supported and valued.

We observed positive staff practices within the home and saw that staff appeared to work well as a team with clear roles and responsibilities. Rotas demonstrated staffing levels were in line with the homes statement of purpose, during the inspection we saw sufficient

numbers of staff on duty, and witnessed people being responded to in a timely manner.

People told us they were happy working at Jah Jireh and positive comments were made about the management team, which included the manager “is incredible” and “supportive”, and the manager “is excellent with us, any problems we feel we can go to her”. Therefore we can be confident that appropriate levels of staff are in place and staff feel supported by an approachable management team.

Staff training is provided however the frequency of supervision requires improvement.

Evidence found in the training matrix verified staff were up to date with mandatory training and that refresher training was being offered. However, we also discussed with the

manager how refresher training in some areas were not always provided in a timely manner and may benefit from some improvement. We were advised the management team had recently undertaken intensive dementia training to inform and improve the care provided to those individuals with dementia related needs. Staff we spoke with told us they received sufficient training and supervision to undertake their role effectively. However, records we looked at evidenced not all staff members received supervision sessions in line with their supervision contracts. These sessions are important to support good practice and staff development, therefore, we informed the manager improvement was required in this area.

This evidence indicates adequate training is available to ensure staff are skilled to

undertake their role effectively however supervision arrangements require further attention.

The service has arrangements in place for monitoring the quality of care provided. We saw the three monthly RI visits were being completed in line with regulations and care was being delivered as outlined in the Statement of Purpose. However, further discussion with the RI evidenced six monthly quality reviews were not being undertaken in line with regulations and required improvement. We viewed a selection of policies and procedures and found them to be comprehensive and up to date. We found processes in place to ensure that safeguarding referrals and Deprivation of Liberty applications were managed effectively.

We also saw evidence the management team took action to address and report any practice issues or incidents. We conclude management within the home is effective and continually striving to provide a good service however the RI’s quality assurance reviews require further improvement.

Barring Service (DBS) certificates had been applied for in a timely manner. However, we also noted several files did not contain full previous employment history, photographic identification or information on educational qualifications. This is important information, which should be used to determine the suitability of a person to work with vulnerable people, and is a regulatory requirement. On discussion with the manager we were advised photographic identification had been sought for all employee’s but had not been retained on file. We advised the above areas would need to be addressed. We conclude recruitment practices require strengthening to ensure staff are appropriately vetted prior to beginning employment.

5.

Improvements required and recommended following this inspection

5.1 Areas of non compliance from previous inspections

This was the first inspection of the home under the Regulation and Inspection of Social Care (Wales) Act 2016

5.2Areas of non compliance from this inspection

We advised improvements are needed in relation to the following areas in order to fully meet the legal requirements. We have not issued non-compliance notices on this occasion, as there was no immediate or significant impact for people using the service:

Regulation 80 : This is because we found the six month quality reviews were not being completed by the RI.

Regulation 35(2)(d) : This is because we found recruitment files did not contain photographic identification and there were gaps in staff’s employment history.

Regulation 36(2)(c) : This is because we found supervision was not being offered in line with supervision contracts.

5.3 Recommendations for improvement

 Statement of purpose would benefit from the including the frequency of supervision.

 Ensure refresher training is provided in a timely manner.

6.

How we undertook this inspection

This was the first inspection under RISCA. This was a full inspection undertaken as part of our inspection programme. We made an unannounced visit to the service on 26 November 2019 The following regulations were considered as part of this inspection:

The Regulated Services (Services Providers and Responsible Individuals) (Wales) Regulations 2017.

The following methods were used :

 We spoke with the responsible individual and manager.

 We spoke with four staff members.

 We spoke with five people living in the service.

 We spoke with relatives.

 We looked at personal plans and associated records.

 We looked at minutes from meetings.

 We examined the statement of purpose.

 We considered information held by CIW about the service.

 We looked at medication records.

 We observed interactions between staff and individuals.

 We considered arrangements to review the quality of care provided.

 We looked at staff rotas.

 We looked at staff training.

 We looked at a sample of policies.

 We looked at four recruitment files.

 We looked at five care files.

 We undertook a SOFI observation tool.

 We spoke with one health professional.

 We looked at supervision records.

Further information about what we do can be found on our website:

www.careinspectorate.wales

About the service

Type of care provided Care Home Service Service Provider Jah Jireh Charity Homes Responsible Individual Mr Edward Delaney Registered maximum number of

places

51

Date of previous Care Inspectorate Wales inspection

This is the homes first inspection since RISCA re-registration.

Dates of this Inspection visit(s) 26/11/2019 Operating Language of the service English Does this service provide the Welsh

Language active offer?

This service is working towards a Welsh active offer

Additional Information:

Date Published 10/02/2020