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Archived: Jabulani Inadequate

Inspection Summary

Overall summary & rating


Updated 4 June 2020

About the service

Jabulani is a residential care home providing accommodation and personal care for people with learning disabilities, autism, physical disability, mental health conditions and sensory impairment.

The service was a large home, bigger than most domestic style properties. It was registered for the support of up to 11 people. Eight people were using the service. This is larger than current best practice guidance.

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

Practice at the service placed people at risk of harm. We found the building was cold throughout the inspection and the hot water in some people’s bathrooms did not reach suitable temperatures. Where people and relatives had raised concerns of inappropriate care or treatment, these were not always followed up or investigated. People did not always receive their medicines as prescribed. Safeguarding was not always given sufficient priority. We found examples of people telling staff or management they had been verbally or physically abused. These had not always been investigated. The provider could not demonstrate that staff had been safely recruited.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

The service rarely 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. The outcomes for people did not fully reflect the principles and values of Registering the Right Support for the following reasons, lack of choice and control, limited independence and limited inclusion.

Care and support plans did not reflect the most recent evidence-based guidelines or best practice guidance. Staff were not adequately trained, and some did not have the skills or competency required. There was not always bespoke training to teach staff how to meet people’s individual needs. For example, where people had certain health conditions or autistic spectrum disorder, staff had not received training to meet their individual needs.

Privacy and dignity were not respected, this included when people were asleep. People’s independence was not promoted. People were not supported to enhance their life skills. For example, they could not go into the kitchen unless staff unlocked the door for them. The provider did not make independent advocacy available to people. The registered manager showed a lack of understanding about independent advocacy. Staff were instructed to be task focused and companionship was not promoted.

People did not have choice and control of their own lives. People had restrictions on their freedom that were not assessed and had not been agreed as in their best interest. People were not always supported to follow their interests or to take part in activities that were relevant to them. Visiting restrictions had been put in place on relatives and people who had raised concerns had been told they were no longer allowed to enter the premises. This meant some people were unable to spend time with their families in the home. The provider’s response to complaints did not demonstrate they took people’s complaints seriously and treated them with equality.

People told us the service was not well-led. There were low levels of staff satisfaction and the provider did not demonstrate an understanding of the importance of promoting people’s human rights. This meant people’s needs were frequently overlooked. Staff told us the newly appointed registered manager offered them more support than they had experienced before but staff, relatives and some professionals raised concerns with us about the conduct and manner of other senior members of the managemen

Inspection areas



Updated 4 June 2020

The service was not safe.

Details are in our safe findings below.



Updated 4 June 2020

The service was not effective.

Details are in our effective findings below.


Requires improvement

Updated 4 June 2020

The service was not always caring.

Details are in our caring findings below.



Updated 4 June 2020

The service was not responsive.

Details are in our responsive findings below.



Updated 4 June 2020

The service was not well-led.

Details are in our well-led findings below.