Jubilee House

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. This is the first assessment for this service. This key question has been rated good. This meant people were safe and protected from avoidable harm.

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 had an initiative-taking and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported any events of concern. Lessons were learnt to continually show and embed good practice. Staff understood and followed up to date policy and procedure to report any incidents and accidents. The manager ensured all concerns were investigated and where needed escalated. Monthly evaluations were used to show any emerging themes, implementing resulting actions as part of lessons learnt. This helped to keep everyone safe. Daily hand over meetings were completed by nurses where incidents were discussed and actions arising were reviewed. This included the updating of care plans and risk assessments when needed. Care plans reviewed included up to date information to manage people’s known risks with recorded outcomes used to provide safe care and support to people.

The provider collaborated with people and healthcare partners to set up and support safe systems of care, in which safety was managed or checked. They made sure there was continuity of care, including when people moved between different services.

Prior to admission people received a pre-assessment of their needs to decide the suitability of the service. The assessment was recorded and then updated on an individual electronic care planning system. The provider used electronic care records to safely share important information which helped people to receive consistency of care. For example, when accessing hospital or GP services.

Records showed people were referred to other healthcare professionals when needed. Care plans included access to up to date important GP records. People received help from a weekly visit from the local GP practice. An associated health professional told us the service was always supportive of their visits, responding to their feedback and amending records to ensure the information for care staff was reflective of people’s individual needs. This helped to reduce unnecessary hospital admissions and kept people safe.

Staff told us they worked well with health and social care professionals and had developed good working relationships.

The provider collaborated with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives whilst protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm, and neglect. The provider shared concerns quickly and appropriately.

People and their relatives spoke positively about their experience of living at the service. They told us they felt safe and protected from the risks of abuse. Relatives told us they felt confident their loved ones were safe and had routinely seen staff checking in on people’s wellbeing. One relative said, “There’s always plenty of staff around, they are quick to check on anyone to see they are okay and safe, especially those at risk from falling.”

Staff had received up to date training in safeguarding adults from abuse which resulted in a clear understanding of the safeguarding policy which was used to understand and raise any concerns. Staff told us if they saw poor practice by colleagues or other health professionals, they would follow the whistleblowing policy to share this information anonymously; protecting people from the risks of abuse. A staff member said, “We have a lot of opportunity to discuss any concerns we might have; the manager is also very approachable and will respond proactively to investigate anything of concern.”

It was clear from safeguarding records that management took all allegations seriously. Clear processes were used to including harm. Responses were proactive and completed in timescales commensurate with the level of risks posed.

The provider collaborated with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive, and enabled people to do the things that mattered to them. Risks associated with people’s care were identified and managed to keep people safe. People received detailed assessments to help staff manage potential risks. Examples included risk from falls, from skin sores, to manage any unmet needs resulting in behaviours that may challenge, for choking, mobilising, and accessing the community. Resulting support plans enabled staff to safely support people without being risk averse. One person told us how staff collaborated with them to understand and manage risks for mobilising in the home. They said, “Staff understand that I am at risk from falling but that I am trying to keep mobilising without equipment. I started with a ‘steady lift’ to help me get up but now with staff support I can stand on my own which is a big improvement for me and something I did not previously think would be possible.” Care plans had been regularly reviewed, including following an incident such as a fall, to ensure proper measures were in place to mitigate or prevent future risk. When risks were found, care plans provided information for staff on how to reduce the risk of harm to people. Where people had individual dietary needs, information was recorded and shared with the cook. Where people were assessed as ‘at risk from choking,’ input from the speech and language therapy (SALT) team was recorded to support textured diets; ensuring meals were prepared to make them easier and safer to swallow.

The provider identified and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. A plan of ongoing refurbishment including decoration was in progress with minimal disruption for residents and visitors. The service had robust processes in place to manage and maintain the environment, equipment, and ensure measures for health and safety were completed with regular frequency. Legally required scheduled checks, for example, on equipment and utilities were certified and dated as completed by relevant professionals. Any resulting concerns were actioned without unnecessary delay. A fire risk assessment was in place, and actions found had been completed. Ongoing fire drills, evacuations and equipment checks were completed and certified. Readily accessible individual personal emergency evacuation plans were in place along with an emergency grab bag to support safe evacuation.

The provider made sure there were enough qualified, skilled, and experienced staff, who received effective support, supervision, and development. They worked together well to provide safe care that met people’s individual needs. Checks were completed to ensure staff were safe and suitable for their roles. This included ‘right to work in UK’ information, references, and disclosure and barring service (DBS) checks. People and staff told us there was enough competent staff on duty to meet people’s individual needs. The manager completed an evaluation of people’s changing needs to decide and adjust staffing numbers. Staff we spoke with told us they enjoyed working at the home. One staff member said, “There’s good staff retention, it’s a great team with long serving staff providing people with familiarity and consistency of care.” Staff received induction, ongoing probation, with supervision and appraisals completed to support them in their roles. Checks including observations of practice were used in conjunction with training to ensure staff remained competent and followed best practice guidance. For example, to support people to take their medicines and to mobilise around the home. Training compliance rates were high with refresher training in areas considered mandatory and other areas to meet people’s individual needs were planned and completed. Nursing staff told us they were supported with their Nursing and Midwifery Council registration to uphold the code of professional standards that nurses, midwives and nursing associates must uphold in order to be registered to practise in the UK. People and their relatives told us staff appeared well trained. A relative said, “They [staff] appear to understand when [person] is in pain, they have difficulty communicating, but staff just seem to know and are quick to respond.”

The provider assessed and managed the risk of infection. Policies ensured processes were in place to detect infection and control the risk of it spreading, promptly sharing concerns with appropriate agencies. The home was clean and free from any unpleasant odours. Staff had been trained in infection prevention and control and told us there was enough personal protective equipment (PPE) available such as gloves and aprons. Staff clearly understood how and when to use PPE and how to dispose of it safely. Following our feedback the provider reviewed risk assessments for the placement of accessible PPE in communal areas of the home to prevent potential misuse and harm. Ongoing schedules for cleaning and maintenance were signed as completed with audits in place to oversee the cleanliness and safety of the environment. Deep cleaning of both communal areas and individual rooms was completed with management oversight to address any concerns. Appropriate clinical waste facilities and colour coded cleaning materials were provided. Food safety and cleanliness was supported, and an inspection rating was in place from the Food Hygiene Rating Standard (FHRS).

The provider made sure that medicines and treatments were safe and met people’s needs, abilities, and preferences. Staff involved people in planning, including when changes happened. People received their medicines safely as prescribed from suitably trained and competent staff. Medicines were administered and recorded using an electronic medicines management system which provided a clear audit trail including any refusals. People’s needs were assessed to decide if they had the ability to self-administer. Where people needed support, associated risk assessments were in place to ensure medicines were administered as prescribed. This included information to ensure any time constrained medicines and medicines after food were scheduled as prescribed. People received reviews of their medicines to ensure they remained relevant and effective. Staff administered medicines safely, following best practice such as wearing PPE. Staff approached people with drinks and discussed the medicine, recording the administration only after they observed the person had taken it. Protocols were in place to support the safe administration of medicines prescribed as needed (PRN). For example, pain relief. All medicines, including controlled drugs were stored securely and safely. The clinical lead completed audits, checks, and processes ensured any errors or omissions were investigated with resulting actions taken where needed.