We carried out a review of the data available to us about JRH Support - Head Office 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 JRH Support - Head Office, you can give feedback on this service.
Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.
People’s experience of using this service and what we found
Systems were in place to protect people from harm and keep them safe. The service employed a safeguarding lead responsible for completing safeguarding investigations. Risks were assessed to manage known risks for people. Risk assessments were reviewed and updated on a regular basis. There were sufficient staff to support people. Rotas were planned in advance and robust recruitment was followed in line with the providers policy and procedures.
People were supported with their medicines in the way they wanted. Staff who administered medicines were monitored and competency tested to ensure they administered in a safe way.
Staff followed appropriate protocols for infection control. Lessons learnt were recorded for reflective learning to ensure action was taken to reduce risk and keep people safe.
People’s needs had been assessed to ensure they had their choices and preferences met. Staff received relevant training to ensure they supported people effectively. People were supported with their dietary needs in line with their support plan. People were supported to attend healthcare appointments and received relevant support to maintain their health and wellbeing. People were responsible for maintaining their own environment to ensure they had relevant support equipment and a hazard free home. 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 applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.
People confirmed the staff were kind, caring and compassionate. Staff cared for people in a person-centred way. The service supported people to share their views and arranged advocacy services when needed. People were treated respectfully and supported to lead independent lives.
People were encouraged to make choices for themselves. Each person had their communication needs met. People participated in hobbies and interests of their choice, which helped avoid isolation. Systems and processes were in place to monitor, analyse and manage complaints. People’s end of life wishes were considered.
People were supported on their journey of life by staff who were hands on, approachable and empowered to suggest change. The provider understood their legal responsibilities and completed comprehensive quality audits that helped to improve care and support for people. Relationships were built up with healthcare professionals to ensure people receive the service they require to manage their condition.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection: Good (report published 27 February 2017).
Why we inspected
This was a planned inspection based on the previous rating.
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.
On the day of our inspection there was a registered manager in place who was also the provider. 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 supported by staff who made them feel safe when they were in their home. Regular assessments of the risks to people’s safety were conducted and regularly reviewed. Care plans were in place to address those risks.
Staffing levels were adequate to meet people's needs however, we received mixed feedback about the consistency of staff. Appropriate checks of staff suitability to work at the service had been conducted prior to them commencing their role. People received the level of support they required to safely manage their medicines.
Staff received appropriate induction, training and supervision. People’s rights were protected under the Mental Capacity Act 2005. People received the assistance they required with their meals.
People’s day to day health needs were met by the staff and where appropriate referrals to relevant health services were made where needed.
People and their relatives felt staff supported them or their family member in a kind and caring way. People were provided with the information they needed that enabled them to contribute to decisions about their support. People were provided with information about how they could access independent advocates to support them with decisions about their care. People felt staff maintained their dignity when they supported them with their personal care.
People’s care plans were written in a person centred way. People and their relatives where appropriate, were involved with planning the care and support provided. People’s care records were regularly reviewed. People felt supported to take part in a range of hobbies and interests that were important to them and were provided with the information they needed if they wished to make a complaint.
The registered manager understood the responsibilities of their registration with the CQC. Staff understood the values and vision of the service and had a clear understanding of their roles and responsibilities. There were a number of quality assurance processes in place that regularly assessed the quality and effectiveness of the support provided.
Below is a summary of what we found. The summary describes what people using the service, relatives and staff told us, what we observed and the records we looked at.
If you want to see the evidence supporting our summary, please read the full report.
We spoke with three people who used the service. We also spoke with the registered manager, the operations manager and five other members of staff. We looked at written records, which included copies of people's care records, staff personnel files and quality assurance documentation.
Is the service safe?
We saw that care plans and risk assessments were informative and up to date. Staff we spoke with were familiar with their contents, which enabled them to deliver appropriate and safe care.
People were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent it from happening. People were protected by safe and effective recruitment practices. People were cared for by staff who were properly trained and supported to develop professionally.
Is the service effective?
People were treated with respect and were encouraged to promote their independence and community involvement.
People we spoke with were satisfied with the care and support they received and were complimentary about the care staff. This was consistent with positive feedback reported in the provider's own annual quality assurance survey. People were given information and support to help them understand the care and support available to them.
Is the service caring?
We spoke with three people who used the service at their own home. One person said to us, "It's fantastic here. I really like living in this house. Staff help me cook food and my favourite is pizza." We asked another person if they liked living at their home. They replied, "Yes." We asked two people if they were looking forward to their forthcoming holiday. They both nodded enthusiastically and replied, "Oh, yes."
All interactions we witnessed between staff and people who used the service were encouraging and friendly. People were offered choices, encouraged to make decisions for themselves and staff were attentive to their needs. One staff member summed up the level of respect shown to people by commenting, "I actually feel privileged to be a part of their lives."
Is the service responsive?
People were consulted about and involved in their own care planning and the provider acted in accordance with their wishes. Care plans and risk assessments were regularly reviewed.
Five staff members told us that all of the members of the management team were approachable and they would have no difficulty speaking to them if they had any concerns about the service.
Is the service well led?
Staff said that they felt well supported by the manager, the operations manager and the management team, and they were able do their jobs safely. There was a range of quality monitoring systems in place to ensure that care and support was being delivered appropriately by staff, that the service was continuously improving and that people were satisfied with the services they were receiving.
People we spoke with told us that the staff who cared for them appeared confident and competent to provide the care people needed. One person said, "They are all so good. I can't fault the way that I am supported."
The provider completed audits of people's care plans, policies and other documents held at the office. However, we found that these audits and reviews of people's care plans were not always effective in identifying errors or omissions of information. The provider told us that they would correct the identified errors and omissions straight away. Everyone we spoke with told us that they were either happy, or very happy with the care they were provided with.
We reviewed the provider's complaints records. We saw that all complaints had been responded to and resolved to the satisfaction of the complainant. One person we spoke with said, "If ever I needed to complain I would call the office or social services." Everyone we spoke with told us that they had never had cause to complain.
We spoke to three relatives of people who use the service and one person said, 'The staff keep me updated and keep good records of what they have done.'
People told us they felt safe with the support they were being provided. One person said, "I feel safe and I can talk to staff." People told us that they liked the staff and staff were able to meet their needs. They also told us they felt they could speak to the manager or staff and they would be listened to.
We found that staff were supported to provide care that met people's needs. The provider was making appropriate checks before a new member of staff started work. We also found that the provider took steps to assess the quality of the service being provided.