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Inspection carried out on 6 November 2019

During a routine inspection

About the service

Jasmine House is a residential care home providing personal care to six people at the time of the inspection. The home is registered for up to seven people and supports people with complex needs including learning disability, physical disability and mental health. Accommodation is provided in single bedrooms.

People’s experience of using this service and what we found

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practise guidance. This ensures that people who use the service can live a full a life as possible and achieve the best possible outcomes that include control, choice and independence. People’s support focused on them having as many opportunities as possible.

The home excelled in effective monitoring of peoples’ well-being and welfare. Healthcare checks were thorough and inclusive. People were also encouraged to check their own intimate areas regularly for signs of changes. Discussion meetings were held to enable people understand and manage their mental wellbeing through talking.

We observed people’s support during our inspection and saw that staff were gentle and showed people kindness and affection, within their professional boundaries.

Audits and servicing contracts for the environment ensured that the home people lived in was safe.

Staff working in the home were recruited safely and received regular and ongoing training so they had the knowledge and skills to fulfil their role. This included medication training so that people received their prescribed medications safely and as required. There was a low turn over of staff which meant that people were supported by those who knew them well.

Care and support was provided on an individual basis. People maintained control over their lives by planning their activities and daily living schedules 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.

Families spoke of their continued involvement with their loved ones and spoke of Jasmine House as “extended family”.

There was an effective complaints procedure and any complaints were managed well.

Food, snacks and drinks were in plentiful supply in the home and the majority of people could access food independently. Staff supported people when cooking.

The management team had a good oversight of the support needs of the people in the home and an effective way in supporting staff to fulfil their responsibilities. Managers worked alongside support staff regularly to understand the support needs of those living in the home and the staff training needs.

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 June 2017). We have used the previous rating to inform our planning and decisions about the rating at this inspection.

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.

Inspection carried out on 3 May 2017

During a routine inspection

Jasmine House is a residential care home which provides support for up to seven adults who have learning disabilities. The home is situated in a residential area of Fazakerley, close to local amenities. The home has seven separate bedrooms, shower rooms and bathrooms, two lounge areas, dining area, kitchen area, conservatory, large rear garden and an activity centre. The home provides accommodation over three floors and has been adapted to support people who are physically disabled.

At the last inspection, in January 2015 the service was rated Good, with the ‘Effective’ domain rated as ‘Outstanding’.

At this inspection we found the service remained Good, with the effective domain continuing to remain outstanding.

The home operated within the principles of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). We were provided with information in relation to capacity assessments and processes which needed to be in place to make decisions in a person’s best interest. People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service supported this practice.

Medication was administered safely by staff who had received the appropriate training. Medication records were accurate, medication audits and competency assessments were conducted on a monthly basis, systems were in place to order repeat medication, dispose of medication and annual medication reviews were conducted for all people who lived at the home.

All care files contained individual care plans and risk assessments which were regularly reviewed and updated in order to minimise risk. Care plans were person centred and contained relevant information in relation to a person’s wishes, choices and preferences.

Risk assessments were in place for all seven people who lived at the home. The assessments offered key information about significant areas of risk and how such situations would need to be managed for the safety of everyone living at the home.

Staff expressed how they were fully supported in their roles; they had completed all mandatory training as well as specialist training in order to fulfil their roles effectively. Staff were receiving regular supervisions as well as annual appraisals.

A formal complaints process was visible around the home but relatives explained that any complaints or concerns could be openly discussed with the staff and managers as and when they needed to be.

The registered manager had a number of different systems in place to assess and monitor the quality of the home, ensuring that people were receiving safe, compassionate and effective care. Such systems included weekly, monthly, annual audits, staff and ‘resident meetings’ as well as resident questionnaires, stakeholder surveys and relevant health and safety and infection control checks.

Inspection carried out on To Be Confirmed

During a routine inspection

The inspection was carried out by an adult social care inspector on 14 and 15 January 2015. The inspection was announced.

There was a registered manager at the service 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.

Jasmine House is a residential care home that provides accommodation, care and support for up to seven adults who have a learning disability. The home provides accommodation over three floors and is accessible to people who are physically disabled. The service is situated in the Fazakerley area of Liverpool.

People who lived at the home were protected from avoidable harm and potential abuse because the provider had taken steps to minimise the risk of abuse. Clear procedures for preventing abuse and for responding to an allegation of abuse were in place. Staff were very confident about recognising and reporting suspected abuse and the registered manager was aware of their responsibilities to report abuse to relevant agencies.

The premises were safe and very well maintained and procedures were in place to protect people from hazards and to respond to emergencies. The home was fully accessible and aids and adaptations were in place in to meet people’s needs in line with the advice of relevant professionals.

People were protected from the risk of cross infection because staff had been trained appropriately and followed good practice guidelines for the control of infection.

There were appropriate numbers of staff on duty to meet people’s individual needs and lifestyle choices and to keep people safe. Staff recruitment checks were robust and staff were only employed to work at the home when the provider had obtained satisfactory checks on their suitability. People who lived at the home were involved in the staff selection process and in the staff induction process.

The registered manager had a good knowledge and understanding of the Mental Capacity Act (2005) and their roles and responsibilities linked to this. They were able to clearly demonstrate how they had worked alongside family members and relevant health and social care professionals to ensure decisions were made in people’s best interests when this was required.

The service was person centred. This means that people were provided with care and support that was tailored to meet their individual needs and the way in which the service was delivered was based on the individual needs of the people who used it. We saw many examples of best practice being followed and we found the service was responsive to people’s changing needs. We heard how staff provided flexible and innovative support to make sure people were achieving the things they wanted to.

People’s needs had been assessed and they had a plan of care which was detailed, personalised and provided clear guidance on how to meet their needs. Risks to people’s safety and welfare had been assessed as part of their care plan and plans to manage any identified risks were in place. We found people were well supported to take risks as part of living an independent life style.

People were well supported to access a range of healthcare professionals as appropriate to their individual needs. We heard many examples of how people who lived at the home had made significant progress with their physical and mental health needs since moving to the home. The provider worked proactively to ensure people who used the service were able to recognise and act upon their health needs. The also worked closely with healthcare professionals to ensure people had regular health checks and screening as a means to prevent detect or prevent ill health. This is in line with best practice.

Medication was very well managed and people received their medication as prescribed. The provider had tight processes in place to ensure medication was managed safely. We saw detailed guidance about how to support people with their medicines and information about what medicines were prescribed for. This meant that staff had an understanding of medicines they were administering and the effects of these. People were also supported to have a regular review of their medicines with their GP.

People were regularly supported to use the facilities in their local community and were supported to take part in work placements and social and recreational activities. The activities were based on the needs, wishes and choices of the individuals living at the home.

Staff presented as caring and we saw that they treated people with warmth and respect during the course of our visit. Relatives we spoke with told us they felt staff cared about the welfare of their family member. They told us the service exceeded their expectations of a care home.

Staff were well supported in their roles and responsibilities. Staff had been provided with relevant training and they underwent annual refresher training in a range of topics. Staff attended regular supervision meetings and team meetings. Staff had lead roles for matters such as ‘mental health’ and ‘safeguarding’. Staff had been provided with specialised training linked to the needs of the people they supported and they were knowledgeable about people’s needs. The provider had attained a gold ‘Investors in People’ award which is recognition of their commitment and investment to develop and support staff.

Staff were aware of their roles and responsibilities and the lines of accountability within the home.

Staff told us there was an open culture at the home and that they would not hesitate to raise concerns if they had any. They felt that any concerns they did raise would be dealt with appropriately. Throughout our visit staff demonstrated how they supported the aims and objectives of the service in ensuring it was person centred and inclusive.

Very clear and effective systems were in place to regularly check on the quality of the service and ensure improvements were made. These included regular audits on areas of practice and seeking people’s views about the quality of the service. The registered manager was keen to develop the service in response to people’s views and to changes in best practice guidance.

Inspection carried out on 7 June 2013

During a routine inspection

We found that people who used the service had care plans detailing their assessed needs and how they were to be met. People told us that the staff knew them well and provided them with all the care and support they needed. People were supported and encouraged to develop daily living skills and they lead active lives both at home and in the community.

Staff had a good understanding of people's dietary needs and had received training in the use of equipment people required to help with their diet. People who used the service ate meals which were healthy and well balanced and they knew the importance of a healthy diet. People told us they helped buy their food from local supermarkets, were involved in planning their menus and had helped prepare their meals.

Medication was stored and administered in the right way and people received medication at the right times. Staff had access to important information about people's medication including why it was prescribed and possible side effects.

People had information about how to complain and they told us they were confident about complaining if they needed to. We found that no complaints had been received about the service.

People's personal records which were kept at the home were stored securely, well maintained and up to date. The records included sufficient information which showed that people's health and well-being had been closely monitored.

Inspection carried out on 10 January 2013

During a routine inspection

We used a number of different methods to help us understand the experiences of people living at Jasmine House. This was because some of the people using the service had complex needs which meant they were not able to tell us their experiences. We were able to speak individually with three of the people who told us they were happy living at the home. Some comments made included, �I help around the house�. �I really like living here and everybody is friendly and kind�. �The staff know me well�.

We also spoke with relatives of people using the service, who commented:

�The staff are wonderful, I am really happy with the care and support my daughter receives at Jasmine House�.

�I have visited unannounced on a number of occasions and have always found everything to be fine�.

�The staff are really patient and caring�. "They have improved so much since moving there".

We found people had been involved in decisions made about their care and treatment and that people had been treated with dignity and respect. People received care and support appropriate to their needs and which ensured their safety.

People had been protected from the risk of abuse and staff were confident about dealing with incidents which may occur.

Staff had been properly recruited to ensure they were suitable to work at the home.

The provider regularly monitored the quality of the service provided to ensure it had been run in the best interests of people using the service.