Jah-Jireh Charity Homes Leyland

Jah-Jireh Charity Homes Leyland (Jah-Jireh) is a residential care home registered to provide accommodation and personal care for up to 36 people. At the time of the inspection 28 people were living in the service.

The home is established and run for the benefit of dedicated, baptised Jehovah's Witnesses. The home is located in a Victorian dwelling and accommodation is over two floors. Facilities include two lounges, a dining area and an enclosed rear garden.

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

People living at the home benefitted from a service that had made significant improvements since the last inspection. Further time was required to evidence that improved practices had become embedded into the running of the home.

The manager and provider encouraged an open culture of learning from incidents, accidents and other relevant events.

Although adequate systems were in place to ensure risks to people were managed and mitigated, we have made a recommendation about reviewing and updating peoples’ risk assessments, to ensure clear guidance for staff to follow.

Although people received care that was person centred and based on their individual needs and preferences, we have made a recommendation that people’s care records reflect people’s decisions and choices, including information to enable them to receive the correct support at the end of their life.

Parts of the service had been refurbished and the environment was sufficiently clean and well maintained.

Staffing levels were sufficient to ensure people received the care and support they needed in a timely way.

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.

The service involved people, their relatives and staff in a meaningful way. People's views were listened to and acted upon, meaning they had a direct say in the running of their home.

Clear and effective governance processes had been overhauled to help monitor and improve the quality and safety of the service. Processes were underpinned by a commitment to deliver high quality, safe care and support tailored to the person.

The manager acted in accordance with their legal and regulatory requirements and shared information in an open, honest and timely manner.

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 inadequate (report published 27 July 2021) and there were breaches of regulations in safe care and treatment, safeguarding, consent, staffing and good governance. 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.

This service has been in Special Measures since 27 July 2021. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

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 inspection was carried out to follow up on action we told the provider to take at the last inspection. We checked whether the Warning Notices we previously served in relation to Regulation 12 (Safe care and treatment) and Regulation 17 (Good governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 had been met, and found that they had.

The overall rating for the service has changed from inadequate 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 sections of this full report.

You can read the report from our last inspection, by selecting the ‘all reports’ link for Jah-Jireh Charity Homes Leyland (Jah-Jireh) on our website at www.cqc.org.uk.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Jah-Jireh Charity Homes Leyland (Jah-Jireh) is a residential care home registered to provide accommodation and personal care for up to 36 people. At the time of the inspection 25 people were living in the service. The home is established and run for the benefit of dedicated, baptised Jehovah’s Witnesses.

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

The service was not safe. Risks to people’s health, safety and wellbeing were not consistently assessed or planned for. We reviewed seven care files and found inconsistencies or missing information in all of them. We found concerns with the cleanliness and maintenance of the environment. We observed staff not following good practice guidance around infection prevention and control including the use of Personal Protective Equipment (PPE). We found recruitment records were not always complete and we have made a recommendation around this.

The service was not always effective. Not all staff had completed the necessary training to keep people safe. People were not supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice. We found a lack of signage and adaptations to orientate people to the building, we have made a recommendation around this.

The service was not well-led. At this inspection we found failures in the provider's quality and assurance systems. Records relating to care and the management of the service were either incomplete, inaccurate and/or not kept up to date. This could have compromised the quality and safety of the service provided.

We found the management team receptive to feedback and keen to improve the service. There have been some changes in the staff team, roles and responsibilities since the inspection. Following the inspection visit a change was made to the nominated individual. They, along with the newly appointed chief executive officer took immediate action to start addressing shortfalls we identified.

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 (18 July 2019).

Why we inspected

We received concerns in relation to quality assurance, risk management and people’s safety. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has changed from good to inadequate. This is based on the findings at this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe, effective and well led sections of this 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 Jah-Jireh Charity Homes Leyland 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 discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to safe care and treatment, consent and good governance at this inspection.

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

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will request an action plan from the registered provider to understand what they will do to improve the standards of quality and safety. We will work alongside the registered provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning

information we may inspect sooner.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe. And there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it. And it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

Jah-Jireh Charity Home Leyland (Jah-Jireh) is a residential care home registered to provide accommodation and personal care for up to 36 people. At the time of the inspection 33 people were living in the service. The home is established and run for the benefit of dedicated, baptised Jehovah’s Witnesses.

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

People were safe living at Jah-Jireh. The practices adopted by the home protected people from harm. We identified some minor shortfalls with the management of medicines, but these were rectified immediately. Enough staff were on duty to meet the needs of people and acceptable recruitment practices were in place. People looked relaxed in the company of staff and relatives confirmed they felt people were safe living at Jah-Jireh.

A wide range of training had been provided for the staff team, which helped to ensure people received the care and support they needed. Community health and social care professionals had been involved in the care and support of those who lived at the home and people’s dietary needs were being met.

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

People received good care. Their preferences and wishes were respected by the staff team. People were treated with dignity and respect and were involved in the decision-making process. Care files were person-centred. Clear guidance was available about how to communicate with people effectively and independence was promoted. People were supported to achieve their goals in life and a range of activities were provided.

The registered manager understood her role and responsibilities and she was open and transparent with the inspection process. There was evidence of community engagement taking place. A range of audits and monitoring was seen. We received positive feedback about the registered manager and the staff team.

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

Rating at last inspection

The service was rated good at the last inspection (Published on 08 December 2016).

Why we inspected

This was a scheduled inspection based on the previous ratings.

Follow up

The service will be re-inspected as per our inspection programme. We will continue to monitor any information we receive about the service. The inspection may be brought forward if any risks are identified.

Jah-Jireh Charity Homes Leyland provides accommodation for up to 36 people who require personal care. There were 33 people living in the home at the time of our inspection. The home is in a residential area of Leyland, close to local shops and facilities.

The home is provided by and for people who are baptised Jehovah’s Witnesses. It is one of four homes provided by Jah-Jireh Charity Homes. The provider describes their objective as, ‘Our sole purpose is to provide loving, spiritual and physical care for those in the community of Jehovah’s Witnesses who find themselves needing to be cared for by others, due to old age or infirmity.’

At the time of our inspection the home provided permanent accommodation and planned short-term care for people who required it.

There was a registered manager employed at the home. 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.

Everyone we spoke with told us that this was a good home and said they would recommend it to other people. People told us the home was a “lovely” place to live and said living at the home was “like being cared for by family”. People received safe, compassionate care that met their physical and emotional needs and they had a choice of activities to support their spiritual needs. People were cared for in a manner that met the registered provider’s stated purpose for the service.

People made choices about their care and maintained their independence and control over their lives. They agreed to the care they received and their rights were protected. Where people had made advance decisions about their care, these were clearly recorded and known to the staff in the home.

The registered manager was knowledgeable about the Mental Capacity Act 2005 and how to protect people’s rights.

There were enough staff to provide the support people needed. The staff had the skills and knowledge to provide a high quality of care. The staff took time to spend with people and understood this was an important part of their role.

Visitors were made welcome in the home and people could see their friends and relatives as they wanted. The home had a guest room and visitors could stay in the home to be close to their relative or friend if they needed.

People were supported to maintain good health. They received their medicines as their doctor had prescribed and received support from appropriate health care services.

People received a choice of meals, snacks and drinks that they enjoyed. Mealtimes were pleasant and sociable occasions. Visitors could enjoy a meal with their relatives if they wished.

The home was well managed to ensure people were safe and received a high quality of care. The atmosphere in the home was friendly and inclusive. The registered manager set high standards and assessed the quality of the service to ensure these were met. People were asked for their views about the service and actions were taken in response to their comments.

The registered provider had a procedure for receiving and responding to concerns or complaints. People knew the registered manager and could speak to her if they had any concerns about their care. People could be confident any concerns or complaints would be investigated and action taken to resolve them.

A number of residents were taking part in a spiritual coffee morning. We were told that these were held on a daily basis and designed to facilitate spiritual discussion and reflection. Daily worship was also conducted at the home.

Some residents were enjoying board games and jigsaws in the games room and others were having their hair done in the home's hair salon.

There were a number of visitors to the home, throughout the day, who clearly knew staff well and were made to feel welcome.

We observed staff interacting with residents in a kind, respectful and cheerful manner. It was apparent that they got along well and that residents felt comfortable in the company of carers. We spoke to five residents who all made very positive comments about life at the home. These comments included:

'We are so very lucky. We are loved and cared for in such a wonderful way.'

'I could not be in a better place!'

'Everything I need is here. We are all one family who love and care for each other.'

During this inspection we assessed standards relating to the care and welfare of people who used the service and procedures for protecting people from cross infection. We looked at how the service selected and recruited staff. The areas of quality assurance and complaints management were also inspected. We did not identify any concerns in the areas we assessed.

Comments we received included;

'What makes this place special is the love, the care and the comfort. There is more than enough of those things.'

'We are well loved and well looked after!'

'This is more than just a care home. It is like a family and everyone takes care of each other.'

We observed staff going about their duties and saw that their approach was very kind and respectful. Staff appeared to have plenty of time to respond to people's needs and spend time with them.

We looked at a number of areas during the inspection, which included how the home promoted the care and welfare of people using the service and how they safeguarded people from abuse. We found that the service was compliant in all the areas we assessed.