Jubilee House Care Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Staff understood their responsibility to maintain people's safety, challenge discrimination and report any concerns. Staffing levels enabled staff to carry out people's planned care and spend time with people. Risks to people's health were assessed and managed by staff. There were processes to ensure people's health and welfare were protected against risks associated with the handling of medicines. The provider had effective systems to prevent and control infections and maintain the safety of equipment and the environment. Information was shared and lessons learned when things went wrong.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Relatives were confident accidents and incidents involving their family member would be shared with them and they would be updated with the outcome of any investigations. Comments included: "Jubilee House always inform me of any accidents. [Name] had a couple of falls, they have always let me know" and, "I am informed of investigations and outcomes. There was one accident where [Name] fell and bumped their head. They were taken to the hospital by ambulance and the next call was to inform me.”

Staff told us they would report any accidents and incidents and that learning was taken from these events and actions taken to reduce future risks. One staff member told us, “When we were doing medicines some of the counts weren't right, so things have changed and now we count before and after. It has helped as there are not as many errors.” The registered manager was aware of their responsibility to be open and honest when things went wrong, to apologise when necessary and keep people and their relatives informed of actions taken following any incidents.

The provider had systems and processes to manage and follow up on accidents and incidents. The registered manager monitored these events, to identify possible learning and ensure action had been taken to mitigate individual and service level risks. Learning from accidents and incidents was shared with staff through regular meetings and lessons learned documentation.

Most people had family who supported them to attend planned medical appointments or who supported them during emergency admissions to hospital. However, where people needed support, staff ensured transport was available and accessible. One relative told us, “The home works well with other services, and they have good communication with me.”

Staff and leaders understood their role in ensuring other healthcare professionals had up to date information about people when they moved between services. For example, one staff member explained the information that was sent with people when they were admitted to hospital. They told us, "On [the electronic system] we have a hospital pack. It is mostly pre-populated but we put extra information into it while the paramedics are here so it stays as up to date as it can be. We include baseline observations and a summary of their care needs. They should come back with a discharge letter and if they don’t, then I will be onto the hospital. I then update the care plan if things have changed."

External healthcare professionals told us the provider promoted safe systems, pathways and transitions. One healthcare professional told us, “On my last visit I reviewed several admission assessment paperwork/care plans and felt the appropriate details were available which highlighted the resident’s dependency levels, any areas of concern and their current care needs.” Another healthcare professional described processes to ensure information shared between them and the service was accurate and contained sufficient detail to support their clinical visits.

Arrangements were in place to ensure important information was gathered about people and shared with other healthcare professionals as they moved between services. Communication systems ensured people did not miss important medical appointments and other healthcare professionals had the information they needed to provide effective care.

People described staff as being 'kind' and 'understanding'. One person told us, "I’m safe here and I can do what I want. If I didn’t (feel safe), I would try and see the lady in charge. She’d know what to do.” Another person told us, “I have this pendant I press. The staff come straight away. I feel very safe here. I don’t have any worries.” We asked 1 person if staff responded if they shared any concerns about their safety and they said, "Oh yes, they do listen.”

Staff understood their safeguarding responsibilities to keep people safe, challenge discrimination and report any concerns. Comments included: “Safeguarding is about protecting the resident from abuse and self-neglect” and, “I would go straight to [registered manager] but I have never been concerned about any staff conduct here.”

Staff approached and spoke to people in a kind and considerate way and people appeared relaxed and comfortable around staff.

Staff had training and accessible information to ensure they understood their safeguarding responsibilities. When safeguarding concerns were reported they were investigated by the registered manager, referred to the local authority safeguarding team and us, CQC. Staff worked in line with the Mental Capacity Act 2005 (MCA) and when people were identified as potentially being deprived of their liberty, applications were made to the authorising body as required. Nobody had any conditions on their DoLS at the time of our assessment.

Where possible, people were involved in discussions about any risks associated with their care and treatment. One person told us they had been involved in discussions about the timings of one of their medicines. Another person told us staff were getting them a fridge because it was their preference to keep their prescribed calorific drinks in their bedroom. Another person told us they were getting a new wheelchair and explained, "The manager has been in communication with me about which wheelchair is recommended.”

Staff responsible for developing care plans demonstrated a good understanding of the importance of talking to people about risks to their health and safety and involving them in risk management. One member of staff explained, "If a resident falls all the time, we think about what we can we do to reduce the chance of it happening. We include residents too. We might discuss with them if they might want a sensor mat or a crash mat. We sit and discuss and involve people and try to let them decide. We can encourage but cannot force." The registered manager commented, "It is about talking through what people would like to do and how we can enable that in a safe way." Other care staff described how they observed people to identify any emerging risks and understood their role in escalating concerns so actions could be taken to keep the person safe. One staff member commented, "When people first come in, they get assessed and if their mobility has got worse, then it will either go to the senior or the management on shift and we will ask for the person to be reassessed."

Our observations showed risks were managed safely. For example, people had suitable footwear and staff encouraged people at risk of falls to walk carefully. People who required pressure relieving equipment to prevent the risk of sore skin had this in place, and staff ensured walking aids were kept within people's reach.

Risks to people's health and wellbeing had been identified, assessed and were managed well. Care plans contained detailed information to direct staff on how to reduce these risks. Risk assessment tools were reviewed in line with the provider’s expectations and changes in people’s health and wellbeing were accurately reflected and planned for.

People's individual needs were met by the adaptation, design and decoration of the premises. The premises had been purpose built and were decorated to support people to move easily from their own bedroom and around the communal areas of the home.

Staff had no concerns about the care environment. One member of staff told us, “The environment is totally safe. There is nothing I am concerned about and cleaning products are never left unattended.” Another staff member explained, “There is no issue with ordering any equipment we need. It is the first place I have ever worked where I say I need this, and I get it.” Another member of staff told us they had shared concerns about the layout of the dining room and this had been listened to and addressed by the provider.

The environment was safe and supported people's mobility with no obvious slip, trip or fall hazards. One person had been assessed as 'high risk' of falls and used a walking frame. The walking frame was in good order with no defects. Emergency exits were kept clear and checks of fire fighting equipment demonstrated it had been serviced in line with the provider's expectations.

The provider had policies and procedures to ensure the safety of equipment and the premises and that people were kept safe in the event of an emergency or unforeseen situation. Planned checks of clinical equipment ensured it was in good working order and ready for use.

While most people felt there were enough staff, two people commented on the time they sometimes had to wait for their call bell to be answered. One person told us, "I sometimes have to wait half an hour when I press my bell.” Another person said, "When you press the buzzer it can take quite a while waiting for someone.” People did not raise any concerns about staff knowledge, but a couple of people mentioned some staff needed more guidance and direction when supporting them with personal care. This was reflected by our observations on the first day of the assessment when there were 4 agency staff on duty.

Staff said they were busy but there were enough staff to meet people's needs safely and effectively and spend time with them. Staff told us they were allocated a specific floor to work on and rotas were planned in advance. Comments included: "It is better for the residents having a team up and a team downstairs. It means staff get really familiar with people and people build up trust with staff" and, "I think they do have enough staff on the floor. I compare it to other jobs where staff work under pressure. Here they are not working like that. Shifts run really smooth which is good as it impacts on us and the residents if not." The registered manager told us they regularly met with senior staff to discuss staffing and increased staff numbers if a need was identified. The registered manager explained they were recruiting new staff and would not accept more admissions to the home if they did not have the staff with the right skills to meet people's needs safely.

Throughout our assessment, staff were visible and present in communal areas. Staff were not rushed and had time to sit with people and engage with them in a meaningful way. Staff interactions with people showed they had the right skills to support people in a person centred way. Staff employed through an agency needed more guidance from permanent staff members, however people's needs were met.

The provider assessed staffing levels based on people's risks and dependency levels. Agency staff, used to cover staff vacancies, were booked in advance and on a regular basis so continuity of staff could be maintained. The provider's recruitment process included references, employment history and criminal background checks to make sure staff were of a suitable character. New staff received a comprehensive induction and training was refreshed at regular intervals to ensure staff continued to work in accordance with best practice.

People and relatives told us the home was clean and tidy and a recent infection outbreak had been responded to and managed well. Comments included: "I have no concerns regarding infection control. Jubilee House had a COVID episode not long ago, and it was quickly isolated and effective action taken” and, "It’s a clean home. If there is any infection, they will tell us, take action to isolate it, and let people know.”

Domestic staff told us they had received training in infection control and followed schedules to ensure all areas of the home were regularly cleaned. They described good practice in their use of cleaning equipment and the management of soiled waste. They told us information about any infections in the home was shared with them so they could adapt their cleaning schedules to minimise the risk of infections spreading.

All areas of the home were very tidy and clean with no unpleasant odours. Staff followed good hand hygiene practices and were observed frequently washing their hands or using anti-bacterial hand gel. Staff were seen to wear appropriate Personal Protective Equipment (PPE) for different tasks in the home.

The provider had effective systems and processes to prevent and control infections and ensure any infection outbreaks were effectively managed. Regular audits ensured infection control was embedded in staff practice.

Where people wanted to manage their own medicines, this was risk assessed to ensure they were able to safely maintain this aspect of their care. During our assessment, we saw two people state they were not ready to take their medicines. This was respected by staff who returned a short time later to offer the medicines again. Generally, people were positive about medicines management in the home with one person stating, "Usually I do have my medicines at the same time every day.” Another person said, "They give me pain relief at the drug rounds, I’m not left panting for it.”

Staff had completed training and had regular checks to ensure they remained competent to manage people’s medicines. Staff told us regular medicines checks were completed and where an error was identified, this was promptly dealt with. For example, further training and checks had been put in place to support the staff concerned. Clinical staff demonstrated a comprehensive understanding of best practice around the administration of covert medicines and the management of medicines which require extra legislative checks.

The provider had processes to ensure people’s health and welfare was protected against the risks associated with the handling of medicines. Medicines were stored safely and securely and there were regular checks to ensure medication was kept in accordance with manufacturer’s instructions and remained effective. Medicine administration records showed people received their medication as prescribed. Some people required medication to be administered on an “as required” basis. There were guidelines for the administration of these medicines to make sure they were administered consistently and in line with guidance from the GP. The effectiveness of these medicines was recorded to ensure they were not given excessively or when not required.