Juniper Court Care Home

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 71 (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’s care and support needs were assessed before they moved to the home. This was comprehensive and involved the person, their representative and health and social care professionals. A relative confirmed they were involved and had visited the home before their relative was admitted.

Relatives confirmed they were contacted when their relative’s needs had changed, such as changes in medicines or they had experienced a fall or injury.

Feedback from professionals was positive in how the service supported people in a person-centred way which included their involvement. An example was given where a person had moved to the home from another of the provider's homes. This had been a positive experience with 2 staff from the previous home now working at Warmley House . This meant the person had staff that knew them well.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered. They did this in line with legislation and current evidence-based good practice and standards.

The provider’s systems ensured staff were up to date with national legislation, evidence-based good practice and required standards. Policies and procedures were underpinned with national guidance and legislation.

People’s nutritional needs were assessed and monitored. Referrals had been made to Speech and Language Therapists for specialist guidance which was implemented and followed. Nationally recognised tools were used to monitor skin integrity. Clear care plans supported staff to monitor and provide treatment for pressure areas. Tissue viability nurses supported staff with treatment plans.

Staff received annual refresher training to ensure they were up to date with current practice. This included wound care management, diabetes awareness and sepsis awareness.

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.

The management team and staff worked in partnership with external professionals to ensure care and support was holistic. Feedback from professionals was positive about the relationships they had with the home. They told us information they needed was readily available to enable them to provide advice and treatment.

The GP visited the service on a weekly basis to complete a ward round and see people where needed. Feedback showed staff were well prepared and maintained clear records of any care plan or medicine changes. One professional told us, “The staff always greet me warmly and from my observations frequently go above and beyond what is expected of them in the care of their residents.” Another health professional told us, “The staff are always polite and helpful.”

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

People were involved in making decisions about the support and care they needed. Care plans clearly described the support needed and what people could do for themselves. There was a programme of activities which included gentle exercise which promoted people’s wellbeing and health. People were supported to access the garden area.

People using the service told us they had access to health care professionals as required, such as GP services, tissue viability nurses, occupational therapists and physiotherapists. One person told us staff were supporting them to get a new wheelchair, which would enable them to go out in the community when they wanted. Another person, who had recently moved to the home, was being referred to a physiotherapist and occupational therapist. This was to see if they could have equipment to improve their mobility within the home.

Staff received training on various topics, enabling them to support and manage people’s health care needs such as diabetes or stroke awareness.

People were positive about the food available to them, and they were offered a choice. Menus were clearly displayed around the home. A relative told us they were bringing in a variety of soft fruits as they thought this was missing from the menus and was especially enjoyed by their relative.

The provider routinely monitored 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.

People were allocated a keyworker, who worked closely with them to foster a positive relationship and ensure their needs were met. Care plans were reviewed monthly to ensure they were current and reflected the support needs of the person.

Staff completed hourly checks at night and half hourly checks during the day. The observations were recorded in respect of what the person was doing at the time and where they were within the home.

People’s general wellbeing was monitored and presentation charts completed. This enabled health and social care professionals to make clinical judgements about treatment and give advice based on these observations, that were completed throughout the day.

Staff had daily handover meetings to discuss important changes and to ensure continuity of care for people. Staff read handover documents which enabled them to understand people’s current needs. Staff confirmed they could access people’s care records and used the information to provide care that was person centred and based on their wishes.

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment.

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The Act requires that, as far as possible, people make their own decisions and are helped to do so when needed. When a person lacks mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible.

Assessments had been completed when people lacked capacity, and best interest meetings used to agree decisions. Professionals and relatives were included to support this process. One person’s care plan was confusing as it stated the person had mental capacity. However, there were conflicting statements in respect of thinking and orientation where the plan stated ‘deemed to lack insight’ into their care. This was fed back to the provider to address.

Staff asked for consent from people when providing care and support. People were encouraged wherever possible to make their own decisions. One person told us, “Staff always ask but I do not feel I can say no.” This was discussed with the management team who said this person preferred a later morning wash and often declined. We observed staff knocking on doors and seeking consent before they entered their bedrooms.

Relatives confirmed their involvement in the care of their loved ones. Staff understood the importance of seeking consent and involving people in day-to-day decisions.

Staff had completed MCA training. Staff were knowledgeable about people’s capacity and ability to consent.