We carried out a review of the data available to us about Juga Homes Ltd on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Juga Homes Ltd, you can give feedback on this service.
Juga Homes Ltd is a small care home providing care and support for up to three people living with mental health needs and people with learning disabilities and/or autistic people. At the time of our inspection three people were living at the service. Not everyone at the service was receiving support with personal care.
People’s experience of using this service and what we found
At the previous inspection we found that care plans were not always clear on what measures were in place to mitigate the risks. The provider had made improvements to how risks were documented and mitigated. People were protected from the risk of acquiring infections and the service was clean and hygienic. People’s medicines were managed safely by staff who had received relevant training. The provider had improved the way accidents and incidents were recorded and analysed.
The provider had made improvements to the quality assurance processes since the last inspection. There were a range of audits and checks to ensure quality and safety was maintained. People and their representatives were involved in decisions about their care and support needs. The provider engaged with people receiving care and staff to help drive improvements to the service. The provider worked in partnership with other professionals to plan, deliver and review care and support.
Rating at last inspection
The last rating for this service was inspected but not rated (published 10 August 2020).
Why we inspected
This inspection was carried out to follow up on action we told the provider to take at the last inspection.
You can read the report from our last inspection, by selecting the ‘all reports’ link for Juga Homes Ltd on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Juga Homes Ltd is a small care home providing personal care for up to three people living with mental health needs. At the time of our inspection three people were living at the service.
People’s experience of using this service and what we found
People's care plans and risk assessments were not always clear about the level of risk or what actions were required to mitigate risks to their safety. When people’s needs changed the care plans and risk assessments did not fully reflect the changes to ensure staff worked in a safe and consistent way. Staff did not always make appropriate records of serious incidents that happened in the service.
Staff felt supported with the provision of a thorough induction and ongoing supervision. However, training did not include how to support people with behaviours that challenge. We have made a recommendation about providing staff training in this area. People were supported to manage their physical and mental health. Staff worked in partnership with health and social care professionals to achieve positive outcomes for people.
People told us they felt supported to work towards achieving their goals and aspirations. There were monitoring processes in place to ensure care plans and risk assessments were reviewed, but these were not always effective and did not identify the issues we found during this inspection.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was good (report published 17 August 2018).
Why we inspected
The inspection was prompted in part by notification of a specific incident. The information CQC received about the incident indicated concerns about the management of the risks associated with people’s mental health needs. This inspection examined those risks.
CQC have introduced targeted inspections to follow up on a Warning Notice or other specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.
Enforcement
We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in relation to safe care and treatment and good governance.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Juga Homes Ltd is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission regulates both the premises and the care provided, and both were looked at during this inspection. This service was inspected for the first time on 31 July 2017, following its registration in January 2016. We did not rate Juga Homes Ltd because at the time of the inspection people had been living at the care home for a short time, therefore we had not been able to gather sufficient information to determine how the provider would meet people’s needs over a longer period.
There was a registered manager in post, who was present during the inspection visit. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they 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 is the proprietor of Juga Homes Ltd and is therefore also the ‘registered individual’ for the service.
At the previous inspection we had found that the registered manager had not always ensured that references had been obtained from the most recent employer and had been verified to ensure authenticity. At this inspection the personnel records we looked at demonstrated that the registered manager had implemented a thorough approach to the recruitment process, which ensured that people who used the service were appropriately supported by staff with suitable skills and experience.
Staff had received training to safely administer people’s prescribed medicines and at the time of the inspection were supporting one person with their medicine needs. Although medicines were safely stored and the registered manager routinely checked to ensure that stock balances reconciled with the medicine administration record (MAR) charts, we found that the system for signing MAR charts was not sufficiently detailed for accountability and auditing purposes.
We have made one recommendation within the main report in relation to the provider's system for staff to sign medicine administration charts.
Staff understood how to identify and report any safeguarding concerns, and were aware of how to whistleblow about any issues of concern related to the running of the service. Risk assessments were conducted to ensure people were kept as safe as possible from potential harm.
People were supported by sufficient staff, who had received training and supervision to carry out their roles and responsibilities. The registered manager and staff member we spoke with were familiar with people’s individual needs and knew how to support people to meet their wishes and goals. This included support to access leisure facilities, local amenities and health care services.
People’s dignity and privacy was promoted, and staff supported people to make their own choices. The registered manager and the staff team sought people’s consent before they provided care and support in line with the Mental Capacity Act (MCA) 2005. The registered manager and staff member at the inspection demonstrated that they understood the legal requirements of the MCA.
The person we spoke with was happy with the quality of the food. People were supported to make choices about the menu and participate in the preparation of meals and snacks.
People’s needs had been assessed by the provider before they moved in. Individual care and support plans were developed in consultation with people who used the service, health and social care professionals, and their relatives if applicable. Care plans were periodically reviewed and were always updated when there were changes in people’s needs and aspirations.
People demonstrated that they liked the registered manager and staff team and felt comfortable about the prospect of voicing any concerns or complaints.
The registered manager updated her knowledge so that she could improve how staff increased their understanding about how to effectively support people who used the service. There was evidence in place that the registered manager carried out specific monitoring, for example daily visual checks were undertaken to ensure people were provided with a safe environment. The registered manager made unannounced visits to the service and we discussed the need to always document her findings.
Juga Homes Ltd is registered with the Care Quality Commission to provide care and accommodation for up to two people with mental health needs, and the service was at full occupancy at the time of the inspection. The service comprises an ordinary two storey domestic property and a single storey small building located in the rear garden. One of the bedrooms is in the main house and has ensuite facilities, whilst the second bedroom is in the single storey small building and also has a bathroom. The main house contains a lounge with a dining area, a downstairs bathroom, a kitchen and an office. The office was used for administrative purposes but could also be availed of by people who use the service for private meetings with visiting health and social care professionals.
There was a registered manager in post, who was present during the inspection visit. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they 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 is the proprietor of Juga Homes Ltd and is therefore also the ‘registered individual’ for the service.
There were systems in place to recruit staff with suitable knowledge and experience to work at the service and meet people’s needs. However, we found that the registered manager had not always ensured that references were obtained from the most recent employer and were verified to ensure authenticity.
Staff understood how to identify and report any safeguarding concerns, and were aware of how to whistleblow about any issues of concern related to the running of the service. Risk assessments were conducted to ensure people were kept as safe as possible from potential harm. Medicines were stored and administered appropriately to ensure people’s safety.
People were supported by sufficient staff, who had received training and supervision to carry out their roles and responsibilities. The registered manager was working towards the introduction of an appraisal system although at the time of the inspection staff had been working at the service for approximately two months. The registered manager and staff member we spoke with were familiar with people’s individual needs and knew how to support people to meet their wishes and goals. This included support to access leisure facilities, local amenities and health care services.
People’s dignity and privacy was promoted, and staff supported people to make their own choices. The registered manager and the staff team sought people’s consent before they provided care and support. The Care Quality Commission (CQC) is required by law to monitor the operation of the Mental Capacity Act (MCA) 2005, Deprivation of Liberty Safeguards (DoLS) and to report upon our findings. DoLS are in place to protect people where they do not have the capacity to make decisions and where it is regarded as necessary to restrict their freedom in some way, to protect themselves or others. The registered manager and staff member at the inspection demonstrated that they understood the legal requirements of MCA.
The quality of the food was described as “good”. People were supported to make choices about the menu and participate in the preparation of meals and snacks.
People’s needs had been assessed by the provider before they moved in. Individual care and support plans were developed in consultation with people who used the service, health and social care professionals, and their relatives if applicable. At the time of the inspection we were not able to gather evidence about how the provider reviewed and updated care and support plans as this had not yet been necessary.
People told us they liked the registered manager and staff team and felt comfortable about voicing any concerns or complaints.
The registered manager demonstrated their understanding of the quality assurance practices they proposed to implement in order to gain people’s views about their care and support. There was evidence in place that the registered manager carried out specific monitoring, for example daily visual checks were undertaken to ensure people were provided with a safe environment. The registered manager planned to carry out a range of monitoring checks once the service had been operative for a longer period.
We have made one recommendation within the main report in relation to the provider's system for scrutinising references.