Jubilee House

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. This is the first assessment for this service. This key question has been rated good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing, and communication needs with them. People received a face to face assessment prior to moving to the service to confirm the service was suitable for their needs and with consideration of their registration with the Care Quality Commission. The manager said, “The initial assessment forms the basis of the care and support needed. We upload the information to our electronic care planning system where it is then reviewed and updated as we further personalise the service provided.” The first assessment included consideration of people’s physical, mental health, and social well-being, as well as their nutrition and hydration requirements. People’s communication methods were outlined within their care plans to ensure they could understand and respond to the care and treatment to help make it work for them. Care plans we looked at showed any difficulties with communication, such as hearing or speech and details of equipment used such as glasses and hearing aids. Where people were unable to fully understand and agree to the care and support the provider consulted with relatives, advocates, and other health professionals to ensure the care remained in the person’s best interest with consideration of any personal wishes and preferences.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards. Suitably trained and competent staff delivered care and support in line with current evidence-based guidance, standards, and best practices. Bespoke policies included updated national guidance providing staff with clear reference on outcomes people should expect. For example, the medicine policy included adherence to national guidelines from the National Institute for Health and Care Excellence (NICE). Electronic care monitoring provided outcomes for people’s health and wellbeing. Any emerging concerns were flagged and responsive inputs provided which included support from other health professionals. This helped to improve outcomes for people.

The provider 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. Electronic care plans included transferable records which ensured up to date information about people, their background, their needs, preferences, risks, ability, and details of any medications was available to other professionals. For example, a condensed ‘hospital passport’ generated from people’s electronic care records was available during hospital visits and admissions, providing consistency of care at speed without the need for further interrogation. Following return to the service from hospital, any change in need was uploaded to their care plans and their safe return discussed at handover meetings to ensure their needs continued to be supported. Electronic care plans included links to share information between the service and local GP practices. This enabled remote investigations with quick responses and actions implemented reducing the need for face to face appointments. Staff were confident in the information they had about people. One staff told us, “The information we hold is up to date, reflective of current need and any changes are quickly actioned and supported with daily staff discussions at handover.”

The provider supported people to manage their health and wellbeing to maximise theirindependence, choice, and control. Staff supported people to live healthier lives and wherepossible, reduce their future needs for care and support.The service had effective working relationships with other health professionals including GP’s,occupational therapists, speech and language therapists, mental health teams, and socialworkers. Working together effectively enabled people to receive coordinated and person-centredcare using up to date clinical interventions. A health visitor told us, “We visit the service weekly,conduct checks on people, and respond to concerns. Staff are available for feedback and careplanning is updated where people’s needs change.”

The provider routinely checked people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves. Electronic care plans were updated digitally with information following completion of daily tasks and interventions by staff and health professionals. Daily records were linked to identified risks which included food and fluid intake, diabetes, personal cares, and activities. This information was evaluated and used to show improvement or decline. Information was flagged where emerging risks were clear and resulting records confirmed actions taken, involvement from others, and evaluation to check improvement. People were communicated with at all times to ensure they were comfortable, safe, and happy with the interventions and by the staff who supported them.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. People and their relatives told us staff discussed the service with them and electronic records confirmed people had provided their consent and understood the planned care and support. Wesaw staff routinely engaged with people during daily activities of care. A staff member said, “We would always discuss activities [of care] with people, if they refused we would come back and check in again later on. We respect choices and refusals, but we can also be persistent when it matters.” People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the Mental Capacity Act 2005 (MCA). In care services, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS). We checked whether the service was working within the principles of the MCA, whether proper legal authorisations were in place when needed to deprive a person of their liberty, and whether any conditions relating to those authorisations were being met. Where people had restrictive practices in place, for example, to not leave the home unaccompanied, all legal applications had been made following DoLS. This meant people’s rights were fully respected. The manager kept a record and tracker of DoLS applications and authorisations, full details of the requirements were recorded including any conditions in people’s care plans.