Jubilee House Care Home

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Pre-admission assessments were comprehensive and holistic. People's care plans incorporated recognised risk assessment tools and were regularly reviewed so they continued to reflect people's expectations and current needs. Staff understood the risks around poor nutrition and used screening tools to identify those people at increased risk of not eating and drinking well. People had their health and care needs met by a variety of professionals and their advice was clearly recorded so health outcomes could be evaluated, and the efficacy of treatment monitored. The provider was developing processes to ensure effective work across teams to ensure people achieved good outcomes. People were encouraged and supported to make their own decisions where possible and their consent to care and treatment was sought. However, we identified one area where staff were aware of an increased level of monitoring but had not considered the issue of consent. This was immediately addressed by the registered manager.

This service scored 71 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People or their relatives told us their needs were assessed before they moved to Jubilee House. One relative told us a manager had visited them at home prior to admission and explained, "The manager spoke to us for a long time, took very detailed notes and listened to our concerns. I know about the care plan because I’ve spoken to staff since being here and they’ve added some things to it.”

Staff responsible for assessing people’s needs before they moved to Jubilee House, described a robust process to ensure people’s expectations and outcomes could be met. One manager explained, "When I finish the assessment I discuss with [other managers] to see if we all agree we can meet the person's needs. We have to make sure we can provide the care the person needs. I never have any pressure to take people in. It would be wrong to say we can meet their needs if we can't." The registered manager explained, "It is thinking about the residents and the community we have already got and whether it is the right place for them. We do a short term care plan if they are on respite and if they are permanent residents, straightaway we do a long term care plan. The care plans are reviewed monthly under resident of the day or more frequently if needs change."

Pre-admission assessments were comprehensive and covered people’s physical, psychological and social needs. This ensured people were given the opportunity to share any specific needs in relation to their protected characteristics under the Equality Act 2010. Care plans developed from the assessments were detailed and regularly reviewed so they continued to reflect people’s expectations and support needs.

People had enough to eat and drink to maintain their health and wellbeing. People were asked if they would like to eat their meals in the dining room or bistro which encouraged people to eat and drink well and enjoy the companionship of others. People were regularly offered a choice of drinks, and these were placed within reach. One person told us they had a food allergy which had been discussed with the chef, who had then ordered special food for them. We observed staff supporting one person to eat during lunch. Staff were aware of the needs of the person and supported the person in line with their care plan. The person's food and fluid charts accurately reflected what they had to eat and drink.

Staff understood the risks around poor nutrition and the potential impact of not eating and drinking well on other areas of people's health. The chef told us, "I am updated in the heads of department daily meeting of any risks and l will cascade to my team when changes arise.” They told us they had regular meetings with people to discuss their preferences and alternative options were available if people did not like the menu for that day.

Staff used nutritional screening tools, monitored people's weights and obtained advice from people's GPs and dieticians if they were at risk of poor nutrition. People’s care records were reflective of a good standard and followed recognised good practice guidelines.

People were supported to consult with and access other healthcare professionals when they needed to. Any assessment of needs and advice was shared effectively across teams and services so people could be assured important information about their health was not missed.

Staff described robust processes to share information about people within the staff team. This included a handover between shifts and a daily huddle during the afternoon. This ensured staff had up to date information about any escalating risks to people’s health which needed to be shared with other healthcare professionals. Responsible staff understood what information needed to be shared with other healthcare professionals as people moved between services.

Healthcare professionals felt the provider was developing good processes to promote effective work across teams and ensure people achieved good outcomes. One healthcare professional told us, “Generally what is decided on a ward round is followed through. There have been a few occasions when it has not happened but there is a new system in place where once I have completed my notes, the team will get a copy of exactly what I have put in the notes." They described a developing process to ensure referrals were appropriate and contained all required information to enable a robust assessment of the person's medical needs.

Daily handover records were comprehensive and gave a clear breakdown of people’s needs and their care over the previous 24 hours. Meetings were held with staff at the beginning and midway through shifts to discuss any emerging risks or changes in people’s needs. This ensured any issues were promptly identified and shared with other services for advice and guidance where required.

Most people or their relatives arranged their own medical screening appointments with healthcare professionals such as dentists or opticians. One relative told us, “I take [Name] to her appointments, so I am aware of all of them.” Where people needed support to make appointments or arrange transport, this was provided. One person told us, "The staff noticed my toenails were long and asked me if I’d like to see the chiropodist.” Another person explained, "I am booked in with the chiropodist next week and I go to the optician in town and staff arrange transport."

Staff described the importance of talking with people to ensure they understood healthcare options available to them to maintain their health and wellbeing. This included referrals to other healthcare professionals for check-ups and advice. The registered manager told us staff supported people with monitoring or screening tests to identify any deterioration in health.

Care records demonstrated people had their health care needs met by a variety of professionals such as the dietician, speech and language therapists, podiatrists and tissue viability nurse. The GP visited the home every week which meant any changes in people's medical needs could be addressed quickly and effectively. Oral health care plans met best practice guidance and detailed what support people required to maintain their oral health.

People were positive about their care and felt their needs and expectations were being met. One relative spoke positively about staff adapting care plans to improve outcomes for their family member. They told us, "The staff are very much on the same page as us (family). They put different things in place to try and make it better.” Another relative told us, "The staff seem to monitor [Name’s] health well. Staff are proactive and speak with [Name] about any changes.”

Staff described the checks they carried out to ensure outcomes were positive for people. For example, a clinical member of staff described the checks and monitoring they carried out to ensure the health of people with a catheter. The registered manager explained, "If we saw a deterioration in an area, it would make us question what we are doing and whether we are doing enough. Are we all talking about it and are we all on the same page? For example, does the chef know about any weight loss and it is then about bringing all those key people in."

Advice from healthcare professionals was clearly recorded so health outcomes could be evaluated, and the efficacy of treatment monitored. The results of monitoring records were shared with others involved in people’s care so further investigations could be completed to improve people's outcomes.

People were encouraged and supported to make their own decisions and their consent to care and treatment was sought. During our assessment we saw occasions when people declined support, and this was respected by staff. We saw staff knocking on doors and asking for consent before entering. Some people had signed consent to acoustic monitoring at night so they would not be disturbed by staff checking on them while they slept. However, we found two people with capacity to make their own decisions were subject to an increased level of monitoring they had not consented to. This was immediately addressed by the registered manager and monitoring ceased.

Staff understood the importance of offering people choices and seeking consent before providing care or support. Where people declined support, staff respected that decision but discussed it with people to ensure their immediate needs were met. Our observations confirmed staff practice generally reflected their understanding of the importance of seeking people's consent. However, we identified one area where staff were aware of an increased level of monitoring but had not considered the issue of consent.

Where there was reason to question a person's capacity to understand information related to their care and support, their care plans included a mental capacity assessment relating to the decision that needed to be made. Where it had been assessed people did not have capacity to make a decision, 'best interests' meetings had been held with others involved in the person's care. This meant the rights of people assessed as lacking capacity were fully protected and any decisions made on their behalf were in their best interests. Where people had made decisions with risk, care plans had been agreed with people to minimise those risks. However, we found checks were not effective in ensuring consent in relation to the monitoring system in the home.