Job's Close Residential Home for the Elderly Limited

We found the following examples of good practice.

¿ Staff had shared information with people to help them understand the pandemic and stay safe. People had been given ‘Covid-19 information packs’ which advised them what they needed to do if they felt unwell or displayed symptoms.

¿ People had been supported to maintain links with their community. Some people had enjoyed knitting blankets for the local dog’s home. The local church choir had visited the home to sing to people from a safe distance.

¿ One computer and three computer tablets had been purchased to help people keep in touch with others who were important to them.

¿ Staff used a variety of methods to ensure the communication between them and people was effective.

One person had a hearing impairment so staff wrote things down for them which promoted their independence.

¿ Social activities had been adapted during the pandemic to keep people occupied and active. For example, gentle exercise classes took place, but the numbers of attendees had been reduced and more 1-1 activities had been made available.

¿ Furniture in communal rooms had been rearranged which encouraged people to social distance. Windows throughout the home were slightly open which ensured good ventilation.

¿ Cleaning schedules had been increased and specialist cleaning equipment was used daily to complete deep cleans of the environment. Use of the equipment meant areas which were difficult to clean by other techniques were sanitised.

Since the last inspection we received information about concerns in relation to the service. The concerns related to people not receiving their medicines when they needed them, the home was unclean, the training staff received did not support them to meet people’s needs and staff did not feel supported by the registered manager.

Job’s Close 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.

Job’s Close provides residential care to older people. The home has two floors accommodating up to 35 people in one adapted building. On the day of our visit 24 people lived at the home. The home is located in Solihull, West Midlands.

The service is required to have a registered manager in post. 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 time of our visit the registered manager had been in post for 10 years.

People felt safe living at Job’s Close. There were enough staff to keep people safe and respond to their needs in a timely way. The provider's recruitment procedures minimised, as far as possible, the risks to people safety.

People’s medicines were managed safely and people received their medicines as prescribed. People received support and treatment from health professionals when needed.

Procedures were in place to protect people from harm. Staff knew how to manage risks associated with people's care. Accidents and incidents were monitored and action had been taken when required to prevent them from happening again.

The home was clean and well maintained. Staff understood their responsibilities in relation to infection control. Staff knew what action they needed to take to keep people safe in the event of an emergency such as a fire. Regular checks of the building and equipment took place to make sure they were safe to use.

New staff were provided with effective support when they started work at the home. Staff received an induction to the home and training that gave them the knowledge and skills to meet people's needs effectively.

The provider worked to the requirements of the Mental Capacity Act (MCA) (2005). Staff had received training to support them to understand the MCA and they gave examples of applying the principles of the Act to protect people's rights.

People told us staff were considerate, kind and caring. People were treated with respect and were supported them to be as independent as they wished to be.

People received information about the home in a way that they could understand. People planned and reviewed their care in partnership with the staff.

People's individual religious and spiritual needs were recognised and care records included information about people’s wishes about what should happen at the end of their lives. People chose to take part in a variety of social activities and maintained links with their local community.

People enjoyed the food provided and staff, including the cook, demonstrated a good knowledge of people's dietary requirements.

People felt listened to and felt comfortable in raising any concerns or complaints if they needed to. People were happy with how the home was run. Effective systems were in place to monitor and review the quality of the home.

Staff enjoyed working at the home and spoke positively about the registered manager and their leadership style. The registered manager understood the responsibilities and the requirements of their registration.

Job’s close provides care and accommodation for up to 35 older people. There were 34 people living at the home at the time of our inspection.

A registered manager was in post. 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.

Staff were available at the times people needed them and had received training so that people’s care and support needs were met. Staff understood their responsibility to safeguard people from harm. Where risks associated with people’s health and wellbeing had been identified, there were plans to manage those risks. Risk assessments ensured people could continue to enjoy activities as safely as possible, access the community and maintain their independence.

People were involved in decisions about their care and told us that they received support in the ways they preferred. People told us that staff encouraged them to remain as independent as possible and that they were supported to pursue their hobbies and interests. People were supported to maintain relationships with people important to them and visitors were welcomed at the home.

People received a nutritious diet, had a choice of food, and were encouraged to have enough to drink. People were referred to external healthcare professionals to ensure their health and wellbeing was maintained. Medicines were managed so that people received their medication as prescribed, however improvements were needed to ensure that medicines and creams administered were accurately recorded.

Staff understood the principles of the Mental Capacity Act (MCA), and care workers gained people’s consent before they provided personal care.

There were processes to monitor the quality and safety of the service provided and to understand the experiences of people who lived at the home. This was through regular communication with people and staff, surveys, checks on care workers to make sure they worked in line with policies and procedures and a programme of other checks and audits. Arrangements were in place so that actions were taken following concerns raised, for the benefit of people who lived at the home.

Below is a summary of what we found. The summary describes the records we looked at and what people using the service and staff told us.

If you want to see the evidence that supports our summary, please read the full report.

Is the service safe?

Staff understood their role in safeguarding the people they supported. This meant people were kept safe. We saw people were cared for in an environment that was safe and clean. There were enough staff on duty to meet the needs of people who lived at the home. There were procedures in place to safeguard people from abuse. The staff and manager had a good understanding of whistle blowing policies.

The Care Quality Commission monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. We saw that proper policies and procedures were in place. The manager had an understanding of these safeguards which ensured people's rights and choices were protected.

Risk assessments and health and safety measures were in place to keep people safe. A general practitioner (GP) told us, 'There are no issues. I have no concerns from the home. People appear well looked after and the staff are friendly.'

Is the service effective?

The service worked well with other agencies and services to make sure people received their care safely and effectively. We saw that people were treated with dignity and care. Care plans specified people's individual needs, for example, a person's mobility, or food requirements. One member of staff told us, 'The manager has been terrifically supportive. I feel I have complete support.' All the people we spoke with told us they were satisfied with the care and support they received.

Is the service caring?

A visiting health professional told us, 'I think the care is very good, people here seem really happy.' We saw the staff and manager were patient and gave encouragement when they supported people. All staff were aware of peoples choices, preferences and support needs. We found the care and support was delivered with dignity and respect. A relative told us, 'Staff are kind and considerate. The managers are absolutely fine and they are completely up front. The manager is excellent. She's very caring and active.'

Is the service responsive?

There were enough staff on duty to provide adequate care and support. There were cooks and domestic staff to ensure good food was provided and the environment was clean. We saw clear and detailed recording that ensured the manager could make timely and informed decisions about a person's care and support. A visiting nurse told us, 'If I ask them to do something, they are keen on helping. The manager is very proactive, they always phone us or the doctor.'

Is the service well-led?

The manager was aware of her responsibilities in meeting the essential standards of quality and safety. We looked at quality assurance systems. The systems in place to ensure the quality of the service was regularly assessed and monitored were robust. There was a clear structure of supervision responsibilities within the staff team. Staff had regular training and learning opportunities. Staff we spoke with told us they thought the manager was approachable and provided good support. One member of staff told us, 'The manager responds quickly, it's a wonderful place and the carers really care.'

We saw care plans provided adequate information for staff to support the care needs of people living at the home. People had signed to confirm they had read and understood their care plans. The service contacted other healthcare professionals when a change in need was identified.

At the time of our visit the home was clean and well maintained. People were happy with the level of cleanliness. Comments included: "It is very clean and it never seems to get smelly!' and 'I am very impressed. I think it is very good. The gardens are spectacular.'

People we spoke with were very complimentary about the staff working in the home. One person told us, "They are very, very good.' Another said, "The staff are excellent. They do their very best.'

The home invited people and their relatives to annual reviews of their care. There were processes in place to audit the quality of care being provided by the home.