Jubilee Court

Jubilee Court is a residential care home providing regulated activities personal and nursing care to up to 75 people. The service provides support to adults of all ages some of whom were living with dementia. At the time of our inspection there were 63 people using the service.

Jubilee Court provides care and support to people across two floors in one large purpose-built building. The home is divided into four separate units. One residential unit and one nursing unit are on the ground floor and two nursing units are on the first floor. Each unit has separate adapted facilities and there is a shared enclosed garden.

People’s experience of using this service and what we found

The provider ensured enough suitably trained staff were always deployed to safely meet people's needs. Systems and processes in place protected people from the risk of abuse and neglect. People told us they felt safe living at the service. Risks were assessed, monitored and risk reduction measures were in place to keep people safe from harm. Medicines were managed safely. Infection outbreaks were effectively prevented and managed.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People received personalised care and support tailored to their needs and preferences. People were fully supported to choose and engage in activities to ensure they lived fulfilled lives. Complaints and concerns were documented and investigated. End of life wishes had been sensitively discussed with people and their relatives.

Present, visible and embedded leadership was in place. Quality assurances systems and processes had been fully embedded, and improvements made since our last inspection. People were involved in developing the service. The registered manager worked in partnership with others to ensure people received high quality care. The provider and registered manager understood their responsibility to be open and honest with people and acted when things went wrong.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 16 February 2022) and there were two breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This inspection was prompted by information received by the local authority who identified the service as making significant improvements. As a result, we undertook an unannounced focused inspection to review the key questions of safe, responsive and well-led only.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from requires improvement to good based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Jubilee Court on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Jubilee Court is a residential care home providing personal and nursing care for up to 75 people. At the time of our inspection there were 57 people living at the home. The home is divided into four separate units. Two residential units are on the ground floor and two nursing units are on the first floor. Each unit has separate adapted facilities and there is a shared enclosed garden.

People’s experience of using this service and what we found

There was not always enough staff to ensure people were consistently monitored to reduce high number of unwitnessed falls. Improvements were needed to post falls analysis to reduce the likelihood of falls reoccurring. Staff told us there were not enough staff to provide appropriate level of support to people.

Oversight and governance systems did not identify risks so they could be proactively mitigated and people protected from potential harm. Governance at the home needed to improve to demonstrate the leadership had accurate oversight to recognise, manage and mitigate risks. This includes safe staffing levels. We received mixed feedback from relatives about the quality of care people received and staff shortages.

People’s plans of care were not always individualised, however regular staff knew people well. At the time of our inspection the registered manager was in the process of reviewing and updating people’s care plans.

Following our feedback, the provider increased staffing levels. People’s medicines were managed safely. The home was clean and tidy and infection control practices minimised the risks of infections spreading. The home followed COVID-19 government visiting guidelines. Visitors were screened for symptoms of COVID-19 and were required to show negative Lateral Flow Test (LFT) result before they were allowed to enter. There were processes in place for people to raise concerns. Complaints had been investigated and responded to by the registered manager.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was good (published12 November 2019).

Why we inspected

We received concerns in relation to infection control, staffing, management and risk to people. As a result, we undertook a focused inspection to review the key questions of safe, responsive and well-led only.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively. This included checking the provider was meeting COVID-19 vaccination requirements.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe, responsive and well-led relevant key question of this full report.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Jubilee Court on our website at www.cqc.org.uk.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to staffing and governance of the service at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Jubilee Court is a residential care home providing personal and nursing care for up to 75 people. At the time of our inspection there were 69 people living at the home.

The home is divided into four separate units. Two residential units are on the ground floor and two nursing units are on the first floor. Each unit has separate adapted facilities and there is a shared enclosed garden.

People’s experience of using this service and what we found

Relatives were complimentary about the staff and management team. Staff interacted with people in a kind, caring and patient way, and respected their privacy and dignity. Care was provided in a highly person-centred way and staff were extremely responsive to people’s individual needs and wishes.

A wide range of activities were provided, and social interaction was encouraged and promoted. Where people were unable to take part in group activities, staff spent time with people on an individual basis to help prevent people from feeling isolated. Staff had found innovative ways to help people enjoy activities that had been important to them when they were more able.

The service provided excellent end of life care. People’s end of life wishes were respected and staff supported the whole family during this difficult time.

There were systems in place to ensure only staff who were suitable to work with vulnerable people were recruited. There were enough staff to provide the appropriate level of support to people. Staff received the training, support and supervision they needed to carry out their roles effectively. Nurses received clinical supervision and were competent at nursing procedures, such as wound care and catheterisation.

People received their medicines as prescribed and there were systems in place for the safe storage, administration and management of medicines. Risk assessments had been completed. These helped identify if people were at risk from everyday harms, such as falls or choking. Where risks had been identified, there were plans in place to guide staff so that people were kept safe.

The building was maintained and decorated to a high standard throughout, with clear signs to help people find their way around. Each unit had large communal areas for people to socialise in and there was an attractive garden which provided an additional space for people to enjoy. The premises were clean, and staff followed correct infection control and prevention procedures. Equipment was of a good standard and was regularly checked and serviced annually.

The requirements of the Mental Capacity Act 2005 were being met. People were helped to make choices, if they were able. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People were supported to eat a well-balanced diet and were offered a choice and variety of meals. People had access to healthcare professionals as and when required.

The registered manager and clinical lead provided good leadership of the service. Staff and relatives told us they felt supported by a management team who were open and approachable. Audits and quality checks were undertaken on a regular basis to ensure the quality and safety of the service.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (report published 3 February 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

The service had a registered manager. 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.

People told us they felt safe living at the home and staff knew how to protect people from the risk of abuse. Risks to people’s safety, such as the risk of falling, were appropriately assessed and well managed. The building was well maintained and the required safety checks were carried out.

There were sufficient numbers of suitable staff although they were not always effectively deployed. The provider ensured appropriate checks were carried out on staff before they started work. People received their medicines as prescribed and they were safely stored.

People were cared for effectively by staff who felt well supported and received training that enabled them to provide effective care. People were asked to provide consent to the care they received. The Mental Capacity Act (2005) (MCA) was used appropriately to protect people who were not able to make their own decisions about the care they received.

People were provided with sufficient quantities of food and drink and people told us they enjoyed the food provided. Staff ensured that people had access to the healthcare professionals they required and followed any guidance that was provided by them.

There were positive and caring relationships between staff and people and staff showed an in depth understanding of the people they cared for. People and their relatives were able to be fully involved in planning their care and making day to day decisions about what they wanted to do. People were treated in a dignified and respectful manner by staff and their right to privacy was upheld.

People received care that was responsive to their changing needs and staff knew people well. Care plans gave a detailed description of people’s care needs and were regularly reviewed and updated. Some care plans contained contradictory information, however this was rectified during our inspection. There was a range of activities provided and people told us they enjoyed taking part. People knew how to complain and any complaints received were appropriately responded to.

There was a positive, open and transparent culture in the home, people and staff were encouraged to speak up and their comments were listened to. There were different ways people could provide feedback about the service they received, such as a satisfaction survey and regular meetings. The quality monitoring systems used by the registered manager and provider ensured that any areas for improvement were identified and acted upon.

The service had control measures and had recently put processes in place to implement safe procedures. However, improvements were needed.

We also spoke to four members of staff. One staff member said 'I love working here. The management provide support which helps me to be able to do my job thoroughly'.

We reviewed ten sets of care records. We found that is six sets of records risk assessments had not been reviewed monthly and some assessments had not been reviewed since March 2013.

During our inspection we found medicines were not being stored correctly. We also found that hand wash facilities for staff were inadequate.