Jubilee House Care Home

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Staff were able to deliver person centred care because any changes in people's needs were shared with them. This meant care could be reflective of people's needs as they presented that day. Staff understood the importance of ensuring people had information in a way they understood and involving people in making decisions and choices about how their care was delivered and needs met. People were confident they would be referred to other healthcare professionals if a need was identified. The provider was developing robust processes to ensure good communication with other services to support joined up care. Systems were being implemented to ensure people’s wishes for their end of life care were clearly recorded and they would be able to spend their final days as they wished to.

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 generally felt that staff understood and were responsive to their needs, especially permanent staff. People said they could make choices about their day and how they spent their time. This was reflected when staff described some people's preferences for when they got up in the morning, what they liked to do in the evening and what was important to them. One relative told us, "All staff are approachable and I feel staff know what they are doing.” Another relative commented, "I think it’s a very good home, sometimes things don’t go as planned, but I feel [Name's] needs are met.”

Staff told us they were able to deliver person centred care every day because any changes in people's needs were shared through daily handovers and 'huddles' during the afternoon. They told us this meant any important information was acted upon immediately and reflective of the person as they presented that day. The registered manager told us, "The afternoon huddle is more of a sit down and is in much more detail. If care needs have changed, we are not relying on staff to read the notes because we are now talking about those changes." The registered manager also explained how they promoted person centred care by encouraging staff to spend time with people so they could understand people's individual motivations and preferences. They told us, "We do a lot of meaningful activities here and the staff are part of that. The staff know the residents and know what they like and what they have done in the past. If you know the residents, then our job is easy. Whether they are reserved and don’t like talking about certain things or if they are shy and prefer 121 time. I have 38 individual residents here and there are not 2 the same."

During the afternoon we saw people being supported to engage in occupation or activities that was important to them. For some people that was playing dominoes together, for others it was sitting in social groups chatting or doing a jigsaw together. Other people preferred to spend quiet time in their rooms watching television, reading books or completing a crossword. Staff interactions during this period demonstrated they knew people well and who needed their support or more of their time. Interactions were not rushed and staff had time to ensure people's needs were met.

People were supported to make choices about who provided the healthcare they received. For example, some people chose to maintain their previous healthcare professionals when they moved to Jubilee House. This meant care was flexible to people's needs and preferences.

The regional operations director told us that as part of their governance, they reviewed local healthcare needs. This supported them in developing the service based on what people wanted and what was available locally. Leaders stressed the importance of establishing and maintaining good working relationships with other organisations and healthcare professionals to ensure joined up care as people moved between services.

Healthcare professionals told us people benefited from improving systems at Jubilee House to support joined up care. One healthcare professional told us, “We have had no issues if we ask for regular monitoring as it tends to get done.” This healthcare professional confirmed staff were supportive of their visits and added, “It is helpful to have a staff member with me. 90% of the time there will be somebody who comes in with me and the few times it hasn’t happened is because the staff member has been called away."

The provider had processes to support integrated care. This involved good record keeping to inform effective information sharing. This meant healthcare professionals involved in people's care had an overview of people’s treatment as they moved between services.

We spoke with 1 person who had difficulty communicating verbally. The person appeared content and indicated staff offered and respected their choices. We saw that when staff spoke with people, they made sure they were on the same level so people with hearing or sight difficulties could see and hear them more clearly. One relative told us, "[Name] can read well. She will ask if she struggles, and the home will help.” Another relative told us, "I think [Name] has information given in an accessible way, she would let me know if not.”

Staff understood the importance of ensuring people had information that met their preferences and in a way they understood. For example, at lunch time staff offered some people a visual choice of the meal options so they could make an informed decision about what they wanted to eat.

People’s communication needs were assessed during the pre-admission process so information could be made available to them in an appropriate format. This included larger print, pictorial aids and assistive technology. People's care plans detailed their preferences and any aids they needed to support effective communication.

Care was planned with people and reviewed regularly through the 'Resident of the Day' scheme. During the review, people were asked for their feedback about the care they received and anything they would like to change. People and relatives told us they felt able to raise any concerns or issues and were confident they would be responded to. One relative told us, "The home is usually quick to solve any problems or issues that I have.” Another relative told us, "I raised a concern once and they took action.”

Staff understood the importance of talking to people regularly and monitoring their care to identify issues before they could develop into complaints or concerns. The registered manager particularly recognised the benefit of informal opportunities that enabled people to chat and share anything that was concerning them. They explained, "I do my walkarounds and I like to say hello to everybody. You get to know the people who are quieter and would not raise something. We are lucky with our family involvement, and we have a social evening once a month and that is a good time to get their feedback."

Information was available for people and their relatives about processes for sharing feedback or raising concerns. This included planned reviews, informal meetings and the provider’s complaints process. Records demonstrated that complaints received had been managed in accordance with the provider’s policies and procedures. Complainants had been given full responses to their complaints which included any learning taken and how this was to be shared with staff to inform their future practice.

People were confident they would be referred to other healthcare professionals if a need was identified. One person told us if they felt unwell, “I’d go down to the nurses and alert them. They would listen and get the doctor if they thought I needed it.” Another person told us, "If I wasn’t well, I would go to 1 of the carers. Without a doubt, they would arrange a GP if needed.” People told us staff took immediate action to obtain medical support if they sustained any injuries following a fall or accident.

Staff described processes in place to share information and escalate concerns about people so they could get healthcare support and treatment when they needed it. Where people had difficulties accessing the appropriate treatment, staff supported people to ensure their needs were met. For example, the registered manager explained how staff had supported 1 person who required dental treatment but needed to be transferred into the dental chair by a hoist. With the support of staff, the person had received the dental treatment they required.

Healthcare professionals did not feel there were any barriers which prevented people accessing the care and treatment they needed. One healthcare professional told us, “People can access care, treatment and support when they need to. I also noted that timely referrals were made and effective communication between the care provider and other health and social care professionals was taking place.” Another healthcare professional described staff as monitoring people and recognising when people were unwell so referrals could be made. They commented, "Quite a number of people we are asked to review it can be a bit vague, and it is a question of staff recognizing people are just not themselves. There is definitely an awareness of those people who may struggle to verbalise. They seem to be quite good at advocating for that group."

There were robust processes in place to monitor people’s health to identify when they may need referral to other healthcare professionals. This included monitoring people’s weights and checking people for any signs of skin damage. Where people had specific health conditions, there was information in their care plans of the indicators associated with a deterioration in that condition. Where people were not able to verbalise their pain, staff used a pain assessment tool to ensure discomfort was identified and addressed promptly.

People spoke positively about the care they received. They told us they had access to appointments with other healthcare professionals when needed. Where they needed support to access healthcare, this was facilitated by staff within Jubilee House. People were given opportunities to share their views and opinions to inform how their care was planned and delivered.

Staff recognised the uniqueness of each person and the importance of planning support that met their individual and diverse needs. Where people had difficulties expressing those needs, staff involved others who knew the person well. The registered manager told us, “We talk to relatives because they are the ones who know their loved ones better than us. We do a care plan review with them, and resident of the day involves speaking to relatives and the person.” Whilst most people had families who could advocate on their behalf, the registered manager told us they would refer people to an independent advocate if a need was identified during the pre-admission assessment.

Care plans focused on people’s needs and their preferences for how those needs were to be met. People had communication care plans, so staff understood how to support people to make sure their voice was heard. Where appropriate, people's relatives were consulted to ensure the support provided met the person's personal expectations.

We received mixed feedback from relatives as to whether conversations were being started about people's wishes for their end of life care. One relative told us, “I filled out a form that [Name] is not for resuscitation, but no end-of-life care planning has been discussed with me." Another relative told us, "Staff support well, end of life care planning has been discussed.” A third relative told us, "The GP raised end-of-life and planning, we were not involved. It should have been a decision we should have been involved in.”

The registered manager recognised discussions around end of life could be challenging for some people and clinical staff had received specific training in this area. Further training for non-clinical staff was planned so they felt more confident starting these conversations. Staff recognised the importance of people having the appropriate medication available to ensure they were comfortable and pain free. One healthcare professional told us, "There has been one person who I was asked to see in their final hours. The family was here, the person was comfortable and staff had asked for doctor's reviews at the right time."

Work was being undertaken to ensure every person’s care plan included an up to date and reviewed ReSPECT (Recommended Summary Plan for Emergency Care and Treatment) form. This plan provides clinicians with information about whether attempts at resuscitation should be undertaken for the person. Systems were being implemented to ensure people’s wishes for their end of life care were clearly recorded and they would be able to spend their final days as they wished to.