Jubilee Mews

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence. At the last inspection we rated this key question good. At this inspection the rating has remained good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 67 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them. The senior management team worked closely with the placing teams when considering new admissions to the service. However, over the last few years the service the assessment process has not always ensured people were only admitted when their needs could be met and they were nearly ready to move on from hospital. Thus, the staffing compliment was based on people being stable and having the ability to manage with little input from staff. A staff member said, “Given the complexities of service users it can, and has been very difficult for 2 staff manage crisis situations due to more than 1 resident self-harming at the same time which is frequent and has been up to 4 or 5 times a week.” We discussed this with the senior management team and they recognised the service was not designed to be a service supporting people with very complex emotional needs who require more long-term intensive, crisis‑level care. They undertook to ensure people who were accepted to the service had reached a point in their lives whereby they were ready to learn the skills needed to live independently.

Care and treatment were delivered in line with current best practice and supported by evidence-based tools. Care records included detailed information about clinical needs and were redesigned by the management team to support accuracy and ease of use. Staff demonstrated strong knowledge and understanding around how to provide a rehabilitation service but currently were expected to work with people whose needs were not related to rehabilitation. Staff had asked for additional training around providing trauma informed care and working with people who had personality disorders and the provider was in the process of offering this training. A staff member said, “While I believe the team is dedicated, I do have concerns about risk management, as some residents with higher self-harm risks may not be suited for our rehab step-down unit.”

Staff worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services. Staff worked in partnership with clinical teams and sought support when needed. For example, they had requested additional training from teams who provided trauma informed services so they could more readily work with people using the service. Relatives described how staff always sought their views and ‘kept them in the loop’. The management team promoted teamwork and shared learning. A staff member said, “Issues are spoken about and the team work together to see how we can solve them or how situations that have happened could have been dealt with differently. Everybody learns from each other during the staff meetings.”

Staff supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support. Staff liaised with external health and social care professionals to ensure people received consistent care and support. They routinely engaged with wider professionals such as community mental health teams and psychiatrists. People, relatives and professionals reported individuals had experienced extremely positive outcomes since moving to the service because of the staff’s skilled approaches when supporting individuals. A person said, “It has made such a difference to my life being here and the team have helped me get to a point where I can move back home.”

The management team monitored people’s care and treatment to continuously improve it. Care plans were reviewed monthly or sooner if needed, and audits were in place to check quality and safety. Staff described a culture of learning, with themed supervision and lessons shared across services. People said concerns were addressed promptly. One person said, “Staff are really good and deal with issues straight away and know what they are doing.”

The service told people about their rights around consent and respected these when delivering person-centred care and treatment. Staff understood the requirements of the Mental Capacity Act and associated codes of practice. The service supported people who were subject to sections of the Mental Health Act 1983 (amended 2007) such as those on leave from hospital under Section 17 leave. Staff understood the requirements of this act and its associated code of practice and ensured all guidelines were followed. At times some care records incorrectly stated staff would need to contact the ministry of justice if someone did not meet the conditions of their Community Treatment Order. When we raised this, it was addressed immediately.