We carried out an unannounced inspection of Jerome House on 7 June 2018. At our previous inspection on the 27 April 2017 we rated the service 'requires improvement' and identified two breaches of legal requirements relating to the premises and equipment, and governance. At this inspection we found the provider had taken sufficient action to address the breaches of regulation identified at our previous inspection and to be rated good overall and for the key questions safe, effective caring, responsive and well-led.

Jerome House is a care home. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection. Jerome House provides care and support for up to four people who live with mental health conditions. At the time of our inspection three people were using the service. Public transport and a range of shops are located close to the home.

The service has a registered manager. A registered manager is a person who has registered with the CQC 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.

All the people using the service told us that they were satisfied with living in the home and with the care and support that they received from staff.

People told us that they felt safe at the service. Risk assessment and management processes were in place. Staff knew about the risks to people’s safety and how these were managed by the service.

Staff received relevant training and the supervision and support that they needed to undertake their roles. Some staff were due refresher training in some areas. Management had taken steps to address this issue.

The provider had improved the arrangements to regularly monitor health and safety and the quality of the care and support provided for people who used the service.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. Staff asked people for their agreement before providing them with assistance.

People's care plans included details about each person’s personal needs, and the information staff needed to ensure people were provided with the care and support they needed in the way that they wanted. Care plans were reviewed regularly with people using the service and were updated when people's needs changed.

People told us that staff were courteous and respected their privacy. Staff knew people well and had a caring approach to their work and understood the importance of treating people with dignity and respecting their differences.

People chose what they wanted to do and their independence was supported by the service.

Appropriate recruitment procedures were in place so that only suitable staff were employed to provide people with the care and support that they needed. Staffing levels and skill mix provided people with the assistance and care that they needed.

People told us that they felt listened to and they knew how to raise a concern about the service. They were confident that complaints would be addressed appropriately by management.

People’s healthcare needs were assessed and met by the service. Management liaised with healthcare and social care agencies to ensure people’s needs and preferences were met. People’s dietary needs were met by the service.

There were systems in place to monitor the quality of the service and to make improvements when needed. Review and development of the quality monitoring arrangements was being carried out by management.

This unannounced inspection of Jerome House took place on the 27 April 2017. Jerome House is a care home registered to provide personal care and accommodation for four people who have a range of mental health needs. The service supports people to develop their skills and well-being to empower them to move to more independent living arrangements if and when that meets their needs. On the day of our visit there were four people living in the home. Public transport and a range of shops are located within walking distance of the service.

At our last inspection on 1st April 2015, we found the provider met the regulations we inspected and the service was rated good.

There was a registered manager in place. 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 assess, monitor and improve the quality of the services provided for people. However, we found some areas of the premises were not clean and some records of quality checks of the service were incomplete. This indicated audit processes were not robust enough to fully identify all the deficiencies of the service and so facilitate improvement in the quality of care being provided.

People received the care and support they needed from staff who knew them well. People were treated with respect and staff engaged with people in a friendly and courteous manner. Throughout our visit we observed positive interaction between staff and people using the service. Staff respected people’s privacy and dignity and understood the importance of confidentiality. 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.

Staff respected and supported people's right to make their own decisions and choices about their care. People were supported by staff to develop their skills and independence and were provided with the support they needed to maintain and develop links with their family and others important to them.

People were supported to maintain good health. They had access to a wide range of appropriate healthcare services that monitored their health and provided people with treatment and specialist advice when needed. People’s spoke in a positive manner about the meals they were provided with, and staff made sure people’s individual dietary needs were met.

Staff understood how to keep people safe and they helped people to understand risks. Medicines were managed safely by staff who were trained to administer medicines.

Systems and processes were in place to help protect people from the risk of harm. Procedures were in place to safeguard people. Staff knew how to recognise and report abuse and minimise risks of people being harmed.

Arrangements were in place to make sure sufficient numbers of trained staff were deployed at all times. People’s individual needs were identified and managed as part of their plan of care and support. Accidents and incidents were addressed appropriately.

Staff were only employed after all essential pre-employment safety checks had been satisfactorily completed. Staff were supported to provide people with individualised care and support. Staff received supervision and a range of training so they were skilled and competent to carry out their roles and responsibilities. Staff told us they enjoyed working in the home and received the support and training they needed to provide people with the care and support they needed.

Staff understood the legal requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). People were encouraged and supported to make decisions for themselves whenever possible. Staff kn

This unannounced inspection of Jerome House took place on the 1 April 2015. Jerome House is a care home registered to provide personal care and accommodation for four people who have mental health needs. On the day of our visit there were three people living in the home. Public transport and a range of shops are located within walking distance of the service.

At our last inspection on 16 September 2013, we found the provider met the regulations we inspected.

There was a registered manager in place. 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.

Throughout our visit staff interacted with people in a friendly and courteous manner. People told us they were happy living in the home, and a person using the service said they felt mentally and physically better since their admission.

Staff received a range of relevant training and were supported to obtain qualifications related to their work. Staff understood people’s needs and worked as a team to provide people with the support and care they sought and needed. Staff were positive about working in the home and were knowledgeable about each person’s needs. They told us they received the support they needed from management staff to enable them to carry out their roles and responsibilities. The staffing of the service was organised to make sure people received the care and support they required. People using the service spoke highly about the staff and said they were approachable, kind and listened to them.

People were involved in a range of decisions about their care and support and their independence was promoted and respected. People were not restricted from leaving the home and regularly accessed local community facilities and amenities. People told us staff respected their privacy and they received the support they needed to maintain good health. People’s health was monitored and they received the advice and treatment they required from a range of health professionals. People told us they also felt well supported by social care professionals who visited them regularly.

People had the opportunity to participate in a range of activities, and to participate in the local and wider community. People’s individual leisure interests and preferences were respected. Staff respected people’s decision when they chose not to participate in an arranged activity. When people wanted to maintain contact with family, friends and others important to them this was encouraged and supported by staff.

People told us they generally enjoyed the meals and were provided with an alternative if they wished. Meals and other refreshments met their preferences and dietary needs. Referrals were made to a dietitian when needed.

People told us they felt safe. Staff understood how to safeguard the people they supported. People’s individual needs and risks were assessed and identified as part of their plan of care and support. People’s support plans were personalised and contained the information and guidance staff needed to provide each person with the care they needed and wanted.

Staff knew about the legal requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). They had an understanding of the systems in place to protect people who were unable to make particular decisions about their care, treatment and other aspects of their lives. Staff knew a restriction on people’s freedom needed to be lawfully authorised.

There were effective systems in place to monitor the care and welfare of people and improve the quality of the service.

During the inspection we spoke with all the people who used the service, an art therapist, two care staff, an assistant manager, an administrator and the general manager.

Each person who used the service had a plan of care that had been regularly reviewed, and included information about the individual support and care that the person needed. People told us that they were involved in decisions about their lives and provided their consent about matters to do with their care and treatment.

Staff received appropriate support, appraisal and training. They knew about their roles and responsibilities in meeting the needs of the people who they supported. People approached staff without hesitation. Staff interacted with people who used the service in a positive manner. People accessed their bedrooms and the communal areas of the home freely.

People’s health, safety and welfare were protected as they received the advice and treatment that they needed from a range of healthcare and social care professionals.

Staff and people who used the service were aware of the importance of ensuring that appropriate standards of cleanliness and hygiene were maintained. The décor in some areas of the home was ‘tired’ looking.

People were asked for their views about the service and there were systems in place to make improvements to the service when needed.

We spoke to all the people living in the home. They told us that they received the care they needed and wanted and they were positive about the staff that supported them. Staff had a good understanding of the varied needs of people living in the home.

People told us they made decisions about their lives. We saw people make a number of choices. These included deciding what they wanted to eat and drink, and what they wanted to do.

People had been involved in the assessment of their needs and were central to their individual plan of care and support. People received treatment and advice from a variety of health and social care professionals.

People told us about how they were supported by staff to develop their independence. Staff spoke of their role in encouraging and motivating people to develop their skills and to lead an independent lifestyle.

People told us they felt safe and knew who to talk to if they had any worries or concerns. Policies and the training received by staff protected people from abuse.

There were sufficient numbers and skill mix of staff to meet people’s varied needs.

Records were up to date, accurate and stored securely.