We carried out a review of the data available to us about Jean Garwood House on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Jean Garwood House, you can give feedback on this service.
People’s experience of using this service and what we found
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it. The service was able to demonstrate how they were meeting some of the underpinning principles of Right support, right care, right culture.
Right Support:
The service provided people with the right support overall. However, medicines management required improvements and the provider was aware of this and implementing new systems. Infection control practices were suitable overall although staff did not always follow current guidance on wearing masks. Risk assessments were in place relating to the premises with clear guidance for staff to follow.
Right Care:
Risks to each person were assessed and monitored regularly to ensure risks were reduced as far as possible. People were safeguarded from abuse and neglect due to systems in place. Staff were recruited following robust processes and there were sufficient numbers of staff to care for people safely.
Right Culture:
The registered manager and provider had oversight of the service through a range of checks and audits, although these had not identified the issues we found relating to staff wearing masks to reduce the risk of COVID-19. The registered manager was experienced and understood their role and responsibilities, as did staff. The registered manager sought feedback from people, relatives and staff as part of monitoring and improving 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 and update
The last rating for the service was requires improvement, published on 8 February 2020. At this inspection we found the provider had improved in relation to the concerns we identified previously.
Why we inspected
We undertook this focused inspection to check the provider had improved following our previous inspection.
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.
The overall rating for the service is good. This is based on the findings at this inspection. For those key questions not inspected, we used the ratings awarded at the last comprehensive inspection to calculate the overall rating.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Jean Garwood House on our website at www.cqc.org.uk.
Follow up
We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
At the time of the provider’s registration in 2011, Registering the Right Support best practice guidance was not in place. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice and independence. However, we found care was provided in line with these principles and values. People received planned and co-ordinated person-centred support that was appropriate and inclusive for them.
People’s experience of using this service and what we found
Safe recruitment practices were not always followed. The registered manager took action following our inspection to address the concerns raised. Whilst staff were aware of safeguarding adults’ procedures we found on one occasion these procedures had not been followed. The registered manager assured us this would not happen again and they would learn from the incident. Risks to people’s safety were reviewed and management plans were in place to reduce risks to people’s welfare. Safe medicines management processes were in place and infection control procedures were followed to reduce the risk of cross contamination.
We found at times robust quality assurance processes were not always in place and did not always consider current regulations and best practice guidance. An improvement plan was in place which was based on incorporating best practice into service delivery. People, relatives and staff were asked for their views about the service. People and relatives confirmed they felt comfortable speaking with the registered manager and felt their views and opinions were listened to. The registered manager adhered to their CQC registration requirements and submitted statutory notifications about key events that occurred at the service.
Staff were supported by skilled and knowledgeable staff who had received appropriate training and supervision. Staff assessed people’s needs and used this information to produce personalised care plans. Staff supported people at mealtimes in line with their dietary requirements. People had access to healthcare professionals and staff took on board advice provided in order to support people’s health needs. 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 told us they had good relationships with staff. Staff supported people in line with their wishes, this included in relation to their cultural and religious preferences. Staff respected people’s decisions and supported them in line with those decisions, including a person’s decision to refuse care if they did not want to receive support at a particular time. Staff respected people’s privacy and maintained their dignity.
Personalised care plans were developed and people’s care needs were regularly reviewed to ensure people’s records contained up to date information about people’s health and support needs. Staff were aware of people’s communication needs and provided information in a format that was understandable to the people using the service. People were encouraged and supported to maintain fulfilling lives, engaging in a number of activities at the service and in the community. Staff discussed with people their preferences in regard to end of life care in line with the hospices ‘steps to success’ initiative. A complaints process was in place to ensure any complaints made were appropriately investigated.
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 (published 27 April 2017).
We have found evidence during this inspection that the provider needs to make improvements. Please see the safe and well-led sections of this full report.
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.
At the last inspection in January 2015, the service was rated Good. At this inspection we found the service remained Good. The service demonstrated they continued to meet the regulations and fundamental standards.
People received a personalised service and staff had the information they required to meet people's needs. Care records were individual and kept updated according to any changes in people’s health and wellbeing.
Staff were aware of the values of the service and the care they provided was centred on each individual. They had developed positive, caring relationships with people based on their individual preferences and choices. People’s independence was recognised and encouraged; they led their chosen lifestyle and had the opportunity to make the most of their abilities.
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. Staff showed understanding, patience and people were treated with respect and dignity.
Arrangements were in place to safeguard people from the risk of harm and abuse. Risks to people’s health and wellbeing were identified and action was taken to minimise these. There were systems for checking that people received their medicines correctly and that staff administered medicines safely.
People received effective care and support because there were enough staff to meet their needs. The recruitment and selection process helped ensure the right staff were employed. Staff received training and refresher updates relevant to their roles and had regular supervision meetings to discuss and review their development and performance.
The environment was designed and equipped with physical aids and adaptations that people needed. People's individual preferences and personalities were reflected in the decoration of their bedrooms and shared areas of the service. Health and safety checks were carried out to make sure the premises and equipment was safe for people to use.
People and relatives were positive about the conduct and skills of staff who worked at Jean Garwood House. Staff showed insight and understanding of people's different needs and knew how to keep them safe. They worked well with external health and social care professionals to ensure people received the services they needed.
People took part in a variety of social events and activities in the home and the wider community. Where they had friends or family they were supported to maintain those relationships in a meaningful way.
The registered manager continued to provide good leadership and led by example. Staff felt supported and there was open communication.
The provider carried out regular audits to monitor the quality and health and safety of the service and to plan improvements. People were involved in reviewing and providing feedback on the care and support they received. People and their families felt listened to and that their opinions mattered.
This inspection took place on 23 January 2015 and was unannounced.
Jean Garwood House provides accommodation and personal support for up to 14 adults with physical disabilities. The home also caters for those with additional learning disabilities and sensory impairments. There were 11 single bedrooms on the ground floor; the first floor has been converted into a semi-independent living unit for three people. 13 people were using the service at the time of our inspection.
We last inspected the service on 17 September 2013. At that inspection we found the provider was meeting all the regulations that we assessed.
There was a registered manager in post at the time of our inspection. 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 were cared for in an environment that was purpose built and safe. There were procedures in place for the regular maintenance and servicing of the premises, and equipment such as the stair lift and fire fighting equipment. People had fire evacuation plans which detailed their support needs should there be a need to evacuate in an emergency.
People who used the service were well looked after by a staff team who had an in-depth understanding of each person’s needs and were familiar with how they wanted to be supported. Staff encouraged and empowered people to lead a fulfilling lifestyle; they treated them with dignity, respect and compassion.
People said they felt safe living at Jean Garwood House, they had sufficient staff to support them at the home or when they were out in the community. Staff were knowledgeable in recognising signs of abuse and the associated reporting procedures.
When new staff were recruited appropriate checks were undertaken to ensure staff were suitably vetted to work with people. People told us staff were available when they needed them and they were able to obtain the support they required.
Staff showed warmth and empathy to the people they looked after. The support provided helped people to feel comfortable and relaxed and to maintain as much independence as they were able to.
Care arrangements took account of individuals’ diverse needs, the wishes, preferences, likes and dislikes. People had opportunities to experience a variety of activities and events that met their social and physical needs and interests. The service provided people with a range of specialist equipment such as adapted wheelchairs to enable them to move around the home and in the community.
Staff were trained and competent in caring for and supporting people. People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines. People who lived in the home and their relatives said they felt involved in the way the home was run and were encouraged to express their views and opinions about the services provided.
Quality assurance processes ensured that the service aimed for a high standard by identifying any improvements that could help to maintain and raise the quality of service provided.
People spoke positively about their care and experiences. Comments included, 'I am very happy here', 'the home is good' and 'I like living here.' One person said they liked sport and to chat with staff about old television programmes.
Comments from relatives included, 'it's a nice place, they look after people very well' 'I am very happy with the home' and 'X has a wonderful social life.'
People's care records were person centred and up to date so that staff understood what people's needs were and how to support them. The staff showed understanding and insight into people's different needs and knew how to keep people safe. There were sufficient numbers of staff to meet people's needs and provide individual support. Relatives were all complimentary about the manager and staff. One relative said 'they do their job with love' and another said 'the manager is lovely.'
The care provider had effective systems for assessing and monitoring the service they provided. There was a complaints process which showed that any concerns were listened to and acted upon. There were appropriate arrangements in place to manage medicines and for recruiting suitable staff.
People talked to us about their day to day lives and their experiences of the home. Their views can be summarised as follows,' I just love it here', 'the staff are lovely and so helpful' and 'I am very happy here, the staff are wonderful.'
Comments from relatives included, 'It's homely and very friendly. I can talk to the manager about anything.' Another said, 'Feel's like a proper home and you never see anyone miserable, everyone's always happy.' A third relative told us, 'They make sure X is always happy. The place is scrupulously clean. Marvellous, I can't think more highly of it.'
People were supported by a stable staff team who have worked at the home for a number of years. We saw there were positive relationships between staff and people living at Jean Garwood House. Staff told us there was good training, teamwork and a family type atmosphere. They also felt well supported by the manager. Comments included, 'The manager is very fair and will bend over backwards for you!' and 'It's not like a residential home, more like a home from home'.
The home was clean, safely maintained and furnished to comfortable standards. People had the right specialist equipment to promote their independence and meet both their physical and sensory needs.