This inspection took place on 26 October 2015 and was unannounced. At the last inspection in December 2014 the registered provider did not meet the requirements of the regulations of the Health and Social Care Act 2008 (Regulated Activities) 2014 and was rated as ‘Inadequate. During this inspection visit we found legal requirements had been met.
Jah-Jireh is a detached building located in central Blackpool. The home is registered to accommodate up to 36 people who require assistance with personal care. Jah-Jireh cares for people who are Jehovah’s Witnesses. All care staff are also Jehovah’s Witnesses. At the time of our visit there were 29 people lived at the home. Accommodation was arranged around the ground, first and second floor. There was parking to the front of the building and a garden area to the rear. There was a passenger lift for ease of access and the home was wheelchair accessible.
There was a registered manager in place. 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.
The registered manager was aware of and met their responsibilities and the regulations. Procedures were in place to protect people from abuse and unsafe care. Risks to people were minimised because risk assessments were in place. People told us they felt safe living at Jah-Jireh and liked living there. One person said, “I feel safe here with my brothers and sisters. We are all together.”
We looked at how medicines were managed and found appropriate arrangements for their recording and safe administration. Records we checked were complete and accurate and medicines could be accounted for because their receipt, administration and disposal were recorded accurately. However we found best practice for administering medication was not always followed. We have made a recommendation about the management of medicines.
We looked at the recruitment and selection procedures the provider had in place to ensure people were supported by suitably qualified and experienced staff. We looked at the recruitment records of five members of staff. Suitable arrangements were not in place to ensure safe recruitment practices were followed. We have made a recommendation about the effective procedures for recruitment and selection.
People said there were enough staff to support them well and give them help when they wanted this. One person said, “The staff are kind and gentle and there are always enough of them.” Another person told us, “There are enough staff to care for us properly and we are hardly ever kept waiting when needing help.” We saw since the last inspection, additional staff had been appointed to work in the morning and at mealtimes. We could see there were sufficient staff available to support people and staff were not rushed when providing care.
Records were available confirming gas appliances and electrical facilities and equipment complied with statutory requirements and were safe to use. The environment was well maintained, clean and hygienic when we visited. There were no unpleasant odours. People told us the home was always clean, tidy and fresh smelling. One person said, “It is lovely here, and nice and clean.”
Staff had been trained and had the skills and knowledge to provide support to the people they cared for. One person said, “The staff are well trained and know what they are doing. They are excellent.”
We saw the registered manager and management team had improved the care provided to people living with dementia and significantly enhanced their experiences in the home. The management team had also made the home more dementia friendly with new furnishings, special equipment and signage to assist with orientation around the home. A member of staff told us, “The management team have worked tirelessly to improve things since the last inspection. Through them we are doing more for people.”
Staff understood the requirements of the Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards (DoLS). The registered manager discussed applications she had submitted. This showed us staff were working within the law to support people who may lack capacity to make their own decisions.
People were offered a choice of healthy and nutritious meals. Staff made sure people’s dietary and fluid intake was sufficient for good nutrition. People told us the food and drinks were generous and varied and drinks were frequent along with snacks. One person said, “The food is good and I can always get a change if I don’t like the meal. We get more than enough to eat and drink and the staff all treat me well.” Another person told us, “The food is very good and, if they find that you used to like something, they soon get some in.”
People we spoke with told us staff were caring and helpful. One person said, “I am happy here now because just about everything about this home is very good.” Staff frequently interacted with people. They were supportive and attentive, responding to any requests for assistance promptly. A relative said, “The staff and management really care about the residents and show enormous patience and gentleness even when due to confusion some folks get uncooperative.”
Staff knew and understood people’s history, likes, dislikes, needs and wishes. They knew and responded to each person’s diverse cultural, gender and spiritual needs and treated people with respect and patience. We saw staff talking with people in a friendly, polite manner. Staff were aware of people’s individual needs around privacy and dignity and made sure they respected these. People told us they felt staff valued and respected them because of the way in which they supported them.
People were fully supported in their spiritual needs. It was evident people who lived and those who worked in the home had a special bond sustained by their faith where ‘brothers and sisters’ were recognised and valued. Spiritual support was a major part of life within the home and people were given every opportunity to sustain and strengthen their faith. One person told us, “I think there is real love here and those who work here obviously don’t see it as just a job. I can think of no better place for myself or for others who find themselves in a similar situation.”
Staff recognised the importance of social contact, companionship and activities. As well as the spiritual support, social and leisure activities were available. Staff were very welcoming to people’s friends and relatives. A relative said, “I am made very welcome whenever I visit, even when I am not expected.”
People knew how to raise a concern or to make a complaint if they were unhappy with something. One person told us, “I love it here and I have no need to complain about anything.” A relative commented, “The staff have been wonderful and caring and if I mention any concerns about [my family member’s] care, these are addressed quickly.”
Everyone we spoke with told us the registered manager and staff team were approachable, caring and supportive. One person said, "They are superb, so committed and listen to everyone. They are so easy to talk to.” A member of staff said, “The manager is approachable, very supportive and will help whenever needed. She will always listen and help if you have a problem.”
The registered manager was able to demonstrate the views of people who lived at the home and other stakeholders were encouraged and welcomed. We saw a number of examples of changes and developments within the service, which had been made as a result of people’s suggestions and comments.
The management team used a variety of methods to assess and monitor the quality of the service. These included satisfaction surveys, ‘residents meetings’ and care reviews. Overall satisfaction with the service was seen to be very positive.