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Inspection Summary


Overall summary & rating

Good

Updated 4 November 2017

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.

Inspection areas

Safe

Good

Updated 4 November 2017

The service was safe.

There were enough staff to meet people�s needs at all times and recruitment processes were robust.

Risks relating to people�s health and wellbeing had been assessed and staff were knowledgeable about how to protect them from harm.

Staff knew how to recognise and respond to different types of abuse.

Medicines were managed safely.

Effective

Good

Updated 4 November 2017

The service was effective.

Staff followed the principles of the Mental Capacity Act (MCA) when supporting people. Best interests were held when people lacked capacity to consent to care and support they received.

People were supported to understand what a healthy balanced diet meant and were involved as much as possible in preparing their own food and drinks.

Staff received induction, training, support and supervision to support people effectively.

There was guidance in place to support people with their healthcare needs. People regularly saw relevant healthcare professionals to ensure they stayed healthy and well.

Caring

Good

Updated 4 November 2017

The service was caring

People were treated with dignity and respect and were encouraged to be as independent as possible.

Staff had a good understanding of people`s likes, dislikes and preferences even when people were unable to communicate verbally.

People`s personal information was kept confidential.

Responsive

Good

Updated 4 November 2017

The service was responsive.

People�s needs were assessed fully before they moved into the service and care plans were updated to reflect people`s changing needs.

People were supported to pursue their hobbies and interest and live fulfilling lives.

The provider had an effective system to handle complaints.

Well-led

Good

Updated 4 November 2017

The service was well- led.

Regular audits were carried out by the registered manager and quality manager and identified issues were dealt with promptly.

The registered manager and deputy manager had a visible presence in the service and staff felt supported by them.

Staff understood their roles and responsibilities and were proud of working for the provider.