Julians House

Updated 20 March 2021

The inspection

This was a targeted inspection to check on a specific concern we had about safeguarding and other matters relating to people's safety and wellbeing

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

This inspection was undertaken by one inspector.

Service and service type

Julian’s House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service did not have a manager registered with the Care Quality Commission. This meant that the provider is solely legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

During the inspection

We spoke with three members of staff including the interim manager, deputy manager and a senior care worker. We reviewed a range of records. These included positive behaviour support plans, training and competency assessments and meeting minutes. A range of records relating to infection prevention and control, including policies and procedures, audits and training competencies were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We received feedback from external professionals.

Updated 20 March 2021

This inspection was carried out on the 03 October 2017 and was unannounced.

Julians House is registered to provide accommodation and personal care for up to seven people. People living at the service had a range of learning disabilities and autism. At the time of our inspection, there were five people using the service.

When we last inspected the service on 24 January 2017 we found that they were not meeting all the regulations. These were in relation to governance systems which were not consistently effective as issues they had identified were not resolved. At this inspection we found that the necessary improvements had been made and the service was meeting all the standards.

The service had a registered manager in post. A registered manager is a person who is 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 showed us thumbs up when we asked if they felt safe. There were sufficient staff employed through robust procedures to meet people’s needs at all times.

The service had safeguards in place to protect people from risk of harm. Full assessments were carried out before people moved into the service and staff were knowledgeable about how to keep people safe. People`s care plans and risk assessments improved since our last inspection. Care plans were up to date, gave clear information to the reader and people`s changing needs were promptly documented.

People were supported to access external healthcare services and staff had a good understanding of how to support people with a variety of conditions. People’s medication was managed, stored and administered safely.

Staff received training which was relevant to their role and received regular supervision and support. Interactions between people and staff were positive and friendly and staff were knowledgeable about the people they supported. Staff were able to tell us about ways in which they gained consent to give care, and had a good understanding of the Mental Capacity Act 2008 (MCA) principles. Staff were given regular opportunities to contribute to the running of the service and develop their skills and knowledge.

People were involved in planning and preparing their meals. A visual menu was in place to promote choice for people who were not able to communicate verbally.

The registered manager and the provider`s quality manager carried out audits to check on the quality of the services provided. We found that the issues they identified were addressed and followed through in a service improvement plan.

The registered manager carried out regular health and safety checks to the premises and equipment. Regular fire drills occurred to ensure people and staff knew what to do in an emergency.

We could only observe how staff were interacting with people for a very short time due to the anxiety our presence caused to the people. Staff treated people with respect and dignity. Some people were unable to communicate verbally but their needs and preferences were understood by staff who were able to support people in a personalised way.

People had the opportunity to raise concerns or ideas for improvement at regular `Your Voice` meetings with their keyworkers. There had not been any recent complaints about the service.

The registered manager and the deputy manager had a visible presence within the service and worked with staff regularly to maintain an oversight of the service. Staff were clear about what was expected of them and their roles and responsibilities and felt supported by the management in the home.