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Inspection carried out on 27 November 2018

During a routine inspection

This was an unannounced inspection that took place on 27 November 2018. The service was last inspected in April 2016 where there were no breaches in regulation seen and the home was rated as Good. We found at this inspection that the evidence continued to support the rating of good and there was no evidence or information from our inspection and on-going monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Jah Jireh is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The care home can accommodate up to twenty people. There were nineteen people in residence when we visited. People living in the service are mainly older adults. The home does not provide nursing care.

The home had a suitably qualified and experienced registered manager who had a background in social care and in management. 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 staff team understood how to protect vulnerable adults from harm and abuse. Staff had received suitable training and spoke to us about how they would identify any issues and report them appropriately. Risk assessments and risk management plans supported people well. Good arrangements were in place to ensure that new members of staff had been suitably vetted and that they were the right kind of people to work with vulnerable adults. Accident and incident management was of a good standard.

The registered manager kept staffing rosters under review as people's needs changed. We judged that the service employed enough staff by day and night to meet people's needs and to deliver services like cleaning and cooking.

Staff were appropriately inducted, trained and developed to give the best support possible. We met team members who understood people's needs very well and who had suitable training and experience in their roles.

Medicines were suitably managed in the service with people having reviews of their medicines on a regular basis.

People in the home saw their GP and health specialists whenever necessary. The staff team had good working relationships with local GP surgeries and with community nursing services.

Good assessments of need were in place, and the staff team reviewed the delivery of care for effectiveness. They worked with health and social care professionals to ensure that assessment and review of support needed was suitable and up to date.

People told us they were very happy with the food provided and people enjoyed a well prepared light lunch during our inspection. Good nutritional planning was in place and special diets catered for appropriately.

Jah Jireh is situated in the village of Ellenborough. The provider had updated and added to the original building to a good standard. It had suitable adaptations and equipment in place. The house was warm, clean and comfortable on the day we visited.

This home mainly, but not exclusively, cares for adults who are members of the religious group known as Jehovah's Witnesses. People attended the Kingdom Hall as the home was next door to this meeting place of the congregation. People continued to lead meetings and participate in community activities that are fundamental to Jehovah's Witness's beliefs and practices. There was no compulsion to follow the religious beliefs of Jehovah's Witnesses and eople were supported to continue to be involved with the religion of their choice if they were not Jehovah's Witnesses.

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Inspection carried out on 14 April 2016

During a routine inspection

This inspection took place over two days - 14 and 15 April 2016. This was an announced inspection conducted by an adult social care inspector.

Jah Jireh provides care for up to 20 people. This service is privately owned and is not part of the wider Jah Jireh group of homes. The home mainly caters for older adults but can also take younger adults with care needs. This is often done because people who live in this home are Jehovah's witnesses who want to live within this community. On the day of our visit there were 15 people in residence.

The home had a registered manager. 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.

People were protected from harm and abuse because staff had suitable training and understood how to protect people. Staff understood how to report concerns.

The staff undertook risk assessments and management plans so that any assessed risks would be reduced.

The home was suitably staffed to meet people's needs. New staff were only given access to people in the home once all the relevant checks were made. Staff received suitable levels of training and supervision and their competence checked.

The home was clean and orderly with good infection control measures in place. The home had been adapted and extended to give people a comfortable and safe environment.

The provider was aware of responsibilities under the Mental Capacity Act 2005. Arrangements were in place to apply for Deprivation of Liberty authorities. People were asked for their consent before any intervention. Restraint was not used in this service.

People told us they were happy with the choice of food provided. Arrangements were in place to monitor people who had problems maintaining their weight. Health eating was encouraged.

We observed kind and caring staff who supported people in a respectful and dignified way. People were encouraged to be as independent as possible.

End of life care was managed with support from health providers. The home had good support from local community nurses and GPs. Medicines were appropriately managed.

Assessment of need and ability was on-going. Care plans were simple narratives that set out people's strengths and needs. Staff followed the guidance contained in these plans.

People in the home were all Jehovah's witnesses and told us they were happy with the way their spiritual needs were met. Hobbies and activities of a more secular nature were being developed.

Concerns and complaints were managed appropriately.

The home had a suitably qualified and experienced provider manager. The vision and values of the service were in line with the teachings of the church and were also reflective of good care practice.

The home had a simple quality monitoring system and people told us that their opinions were valued and appropriate changes made.

Inspection carried out on 5 June 2014

During a routine inspection

We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask;

• Is the service caring?

• Is the service responsive?

• Is the service safe?

• Is the service effective?

• Is the service well led?

This is a summary of what we found-

Is the service safe?

People who lived in the home told us that they felt safe and well cared for:

"I never feel frightened here. The staff are always around and the doors are locked...I ring the bell if I need help."

"There is nothing wrong here...we are not a 'worldly' community...we all care for each other...whether we are residents or staff. There is no abuse here."

Staff had a good understanding of how to protect vulnerable adults and they had received appropriate training on safeguarding.

The house was well maintained and secure. Risk assessments and risk management plans were in place. Food and fire safety took high priorities in the monitoring of quality matters.

Is the service effective?

We had evidence to show that care planning, the deployment of staff and the checks on quality matters meant that care and support was given to people in an effective way. We saw that people were helped to be as independent as possible and were also given the right levels of care during periods of ill health or at the end of their lives.

People who lived in the home and paid for their own care and services were given suitable contracts about terms and conditions. We asked the provider to make sure that a copy of the contract was kept on file in the home for inspection purposes.

Is the service caring?

People told us that the family who owned the home, the registered manager and the staff team were all:

"Very caring brothers and sisters...we are all of one belief here and our younger brothers and sisters care for us very well..."

We observed dignified, caring and respectful interactions from staff. We met people who told us they felt that the team at Jah-Jireh cared for all aspects of their well-being. We learned that, for example, people were taken out by staff or by the management team to ensure they were still part of the wider community. We learned that the registered manager would sit with a person who was at the end of their life.

Is the service responsive?

We had evidence to show that, from time to time, the manager sent questionnaires to people in the home and to other interested parties. We also learned that people were asked in a group and individually about their preferences. We had examples where people had asked for changes to their daily routines and to their care plans.

Is the service well-led?

This service had an established manager who was suitably trained and qualified. People spoke highly of her and we had evidence to show that she was fully aware of all aspects of the running of the home. The staff team told us that they were given good levels of support. We also had evidence to show that the family who owned the home all had different management roles in the home and they gave the manager support in all aspects of her management role.

Inspection carried out on 14 May 2013

During a routine inspection

People who lived in Jah Jireh told us that they were very happy with the way staff supported them in their care and welfare. They said that they were given good levels of personal and health care and that the spiritual support they receive from being part of the community was very important to them.

"We are nourished in body and spirit in this service."

We had evidence to show that people were cared for properly and that they were happy with the food provided.

"The food is beautiful and I look forward to all my meals."

We checked that medicines were being managed properly and we found that drugs were ordered, administered and disposed of correctly. Medicines were regularly reviewed and people were only given what was necessary.

We checked on the rosters for the service and we found that by both day and night there were enough staff to deliver high-quality services to people. People in the service said that there were enough staff to care for them properly.

The manager and her team made sure that good quality care and services were delivered because there was an effective quality management system in place. One person who lived in the home told us:

"Everything about this home is of the highest quality."

There had been no matters of complaint or concern raised to us but there were suitable systems in place to ensure that any concerns would be managed appropriately.

"We have no complaints...we are like a family and we get the best kind of support."

During a check to make sure that the improvements required had been made

We conducted this review to check that the provider had taken actions to address the concerns we highlighted within our inspection report of May 2012. Within this desk top review the provider has provided information to demonstrate they are now compliant with the standard.

The provider has sent us information which showed us that designated supervisors of staff had been put into place. They also provided us with a copy of the supervision sign off sheet for 2012. This sign off sheet demonstrated to us that all staff had received supervision on a monthly basis between May and September 2012.

The provider has now demonstrated to us, by providing evidence of audits, that audits of care plans and medication were now in place. These audit reports recorded what had been audited, any errors in completion of records and actions taken to address concerns. In August 2012 the providers supplied us with a copy of the residents evaluation summary from July 2012 which demonstrated that the majority of people who used services were happy with the care they received.

Inspection carried out on 9 May 2012

During a routine inspection

The people we spoke with confirmed they had been involved in the ongoing assessment of their care which had identified their religious and cultural, care, nutritional and relationship needs and they had agreed with the level of support to be provided. They told us their views about how they wished their support to be delivered had been listened to and respected.

We spoke with two relative who all said they were satisfied with the care their relative received. They confirmed they had been involved in the planning of care for their relative and were kept informed if there were any changes to that care.

People told us they were well cared for and treated with respect in the home and one person said, “I feel very well cared for, you get the attention when you need it.” Another said, “Staff are brilliant, I am definitely well looked after.”

One person told us: “You get well treated here, I have no complaints.”

Whilst another said: "The staff are very good, they will do anything for you."

One other person said that: "The staff are brilliant. They are always so kind."

Whilst another commented that: "The staff are very attentive, they always come very quickly when I need assistance."

A relative told us: “People wander around nice and happy. I have never heard about anything bad happening in the home. She always looks well, they provide super care. I am happy and do not have any problems with the care provided.”

Reports under our old system of regulation (including those from before CQC was created)