Jemini Response 52 Summerheath Road

We found the following examples of good practice.

Staff spent time with people reassuring them about the need for staff having to wear personal protective equipment (PPE). Staff would usually reveal their face at the door to people’s rooms and say hello before putting the facemask back on. This helped reassure people and helped them to recognise staff.

The registered manager had adopted various measures to encourage social distancing. For example, people had two sittings at mealtimes and a separate room had been added where people could eat. Space had been created between tables. Dedicated areas of the home had been put aside for specific activities for example, arts and crafts. People enjoyed following routines and careful timing ensured there was no overlap. A large garden contained three separate out houses that were used by people for different activities.

The registered manager had followed government guidelines for visitors. Some family members had been able to meet their loved ones and join them on walks to a local park. One resident whose family were not able to visit received a letter or a poem on the same day each week which they enjoyed and helped to reduce anxiety. The home used iPad’s and helped some people to facetime and video call relatives.

Staff worked exclusively at the service and were all involved in cleaning the home. A regime involving two hourly cleaning of high touch areas for example, door handles and tabletops, was in place and the whole home was deep cleaned weekly. The service was clean throughout.

A robust training schedule was in place for all staff which included PPE, infection prevention and control and Covid-19 specific training. Training was provided both from an internal trainer and from an external source. Staff were kept up to date about changing guidelines by regular bulletins from the local authority. The registered manager provided daily welfare support to staff through conversations and an ongoing programme of supervision meetings. An external life coach had been made available to staff if needed.

An annex at the front of the building served as the point of entry and exit for all visitors including staff. Temperatures were taken and PPE put on in this area. There were PPE stations and bins for disposal of used PPE throughout the home although these were kept out of the corridors to help prevent trips and falls.

Jemini Response 52 Summerheath Road is a residential care home that provides accommodation and personal care for up to seven people who have learning disabilities and autism. There were five people using the service at the time of inspection. Some had specialist needs related to Autism and behaviours that challenged. People had different communication needs. Some people had limited verbal communication, and other people used gestures and body language to make their needs known. The organisation also runs two other care homes locally.

The service has been developed and designed in line with 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 provider, registered manager and service manager had very good oversight of the service. The registered manager was also the manager of the organisation’s other two homes and he divided his time between each home. The service manager was responsible for the day to day running of the home. There was very good communication between the senior management and there were good systems to ensure everyone was kept up to date with accidents and incidents, complaints, medicines, recruitment and health and safety matters.

The service applied the principles and values of Registering the Right Support and other best practice guidance. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent. They were encouraged to take part in daily living tasks with support from staff in areas such as laundry, taking dishes to the kitchen and putting their laundry away. One person liked to make their own sandwich at lunchtime. Two people had work placements where staff supported them; one at the local library and one at a café and washing cars at a local garage.

People had complex needs and were funded to receive a high level of staff support. There had been an unsettled period when some people’s needs had increased, and this had an impact on people and staff. At the time of our inspection, the ‘crisis period’ had passed and life was slowly returning to normal. Staff, relatives and professionals complimented the management team on the support that had been provided throughout this period.

A relative told us the service manager, “Is amazing!! She supports staff and makes them feel valued. They are encouraged to keep up to date and to learn. She leads by example, good care has to come from the top and it does. We have great respect for her.” Another said, “I cannot praise the level of care and the high level of input from the Manager and her staff highly enough.”

People received support from staff who knew them well as individuals. Staff turnover was low, and relatives valued the consistency this gave people as it helped them to feel safe. People’s care and support needs were assessed and reviewed regularly. This meant people received care that was person-centred and reflected their needs and choices.

People were supported to maintain their own interests. Staff supported people to take part in choosing activities to meet their individual needs and wishes. This included, swimming, bowling, using cafes and restaurants, walking and trips to places of interest. A relative told us, “At Jemini, the staff really listen to (Person). In other places they didn’t listen. It’s refreshing, they encourage him to make decisions. Before he was deprived of this type of learning.”

People were protected from the risks of harm, abuse or discrimination because staff knew what actions to take if they identified concerns. The home was clean and tidy throughout. There were enough staff working to provide the support people needed, at times of their choice. Recruitment procedures ensured only suitable staff worked at the service.

Staff understood the risks associated with the people they supported. Risk assessments provided further guidance for staff about individual and environmental risks. People were supported to receive their medicines safely.

Staff received training that helped them to deliver the care and support people needed. This included specialist training in autism and positive behavioural support to meet people’s complex needs. They attended regular supervision meetings and told us they were very well supported by the manager. Staff told us they felt, “Completely supported,” and “really helpful, it’s a good time to talk about any worries and to share ideas.”

People's health and well-being needs were met. Where appropriate, staff supported people to attend health appointments, such as the GP or dentist and appointments for specialist advice and support. A visiting professional told us, “I am always impressed by the calm and friendly atmosphere that pervades when I visit although there are occasional outbursts which are always effectively and calmly handled by the staff team.” People’s nutritional needs were assessed. They were supported to eat a wide range of health, freshly cooked meals, drinks and snacks each day.

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. There was a detailed complaint procedure, and this was displayed so anyone wanting to raise a concern could do so.

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

Rating at last inspection

The last rating for this service was Good. (Published 11 January 2017).

The overall rating for the service has remained Good. This is based on the findings at this inspection.

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.

Jemini Response Limited – 52 Summerheath Road provides accommodation for up to seven young adults who have a learning disability and autistic spectrum disorder. There were seven people living at the home at the time of our inspection. People had a range of complex care needs associated with their condition. Jemini Response Limited – 52 Summerheath Road is owned by Jemini Response Limited and has two other homes in the South East.

The home was a house in a residential street. There were several communal areas people could use which included two lounge areas, a dining area, a garden with outbuildings and the kitchen. Each person also had their own bedroom.

A requirement of the provider’s registration is that they have 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. There was an experienced registered manager in post at the time of our inspection visit who had been at the service for several years. We refer to the registered manager as the manager in the body of this report.

Staff received training in safeguarding adults and understood the correct procedure to follow if they had any concerns about people’s safety. All necessary checks had been completed before new staff started work at the home to make sure, as far as possible, they were safe to work with the people who lived there. The manager and staff identified risks to people who used the service and took action to manage identified risks and keep people safe.

There were enough staff employed at the service to care for people safely and effectively. People were supported by a staff team that knew them well. New staff completed an induction programme when they started work to ensure they had the skills they needed to support people effectively. Staff received refresher training and had their practice observed to ensure they had the necessary skills to support people. Staff had regular meetings with their manager in which their performance and development was discussed and development plans were agreed.

People’s care was planned with them, and the support of their relatives and staff at 52 Summerheath Road. This helped to ensure care matched people’s individual needs, abilities and preferences.

People were supported to maintain their purpose and pleasure in life. Activities, hobbies and interests were based around each person's interests. Events and activities were organised both inside and outside the home. Staff offered people ways to maintain and develop their independence and increase their life skills.

People were actively encouraged to maintain links with friends and relations. Staff were caring and involved people in developing their environment to meet their life and support needs.

The manager and staff understood their responsibilities under the Mental Capacity Act (MCA) and the Deprivation of Liberty Safeguards (DoLS) to ensure people were looked after in a way that did not inappropriately restrict their freedom. The manager had made applications to the local authority where people’s freedom was restricted, in accordance with DoLS and the MCA.

People were supported with their health needs and had access to a range of healthcare professionals where a need had been identified. There were systems in place to ensure medicines were administered safely. People were encouraged to eat a balanced diet that took account of their preferences and nutritional needs.

People who used the service and their relatives, were encouraged to share their views about how the service was run. People knew how to make a complaint if they needed to. Feedback gathered by the provider from people and their relatives was used to drive forward improvements at the home.

Good quality assurance procedures were in place to ensure the quality of the service was maintained, these included regular checks of people’s care plans, medicines administration and staff’s practice. Accidents and incidents were monitored and investigated, and actions were taken to minimise the risks of a re-occurrence.