Juniper House Residential Care Home

Juniper House Residential Care Home is a residential care home providing personal care for up to 60 older people who may have physical disabilities and/or be living with dementia. The home’s purpose-built environment is divided into four units: Willow, Maple, Chestnut and Beech. At the time of our inspection, there were 52 people living at the home.

People’s experience of using this service and what we found

We were not assured the provider effectively deployed sufficient numbers of staff to ensure people’s safety and consistently meet their needs. Staff understood how to identify and alert others to potential abuse involving the people who lived at the home. The risks to people had been assessed and reviewed, and plans were in place designed to manage these. People received their medicines safely from trained staff. Staff were provided with, and made use of, personal protective equipment to reduce the risk of cross-infection. Accidents and incidents involving people were monitored by the management team to learn from these and reduce risks.

People’s needs were assessed before they moved into the home and kept under review. Staff received an initial induction, following by ongoing training and support, to enable them to work effectively. People had support and encouragement to eat and drink enough, and any associated risks were assessed and managed. Staff and management worked with a range of community health and social care professionals to achieve positive outcomes for people. The home’s purpose-built environment reflected people’s needs and requirements. People’s health needs were monitored and they had regular access to their GP. Staff respected and supported people’s right to make their own decisions.

Staff knew the people they supported well, and provided care and support in a kind and compassionate manner. People had support to express their views about the care they received. Staff promoted people’s rights to privacy and dignity, as part of which they took steps to protect their personal information.

People’s care plans were individualised and read by the staff who supported them. People’s communication needs were assessed in order to meet these. People had support to participate in a range of in-house and community-based activities. Any complaints received about the service were investigated and responded to. The provider had procedures in place to identify people’s wishes and choices regarding end-of-life care. However, the outcomes of these discussions were not always recorded.

Staff found the home’s management team approachable and appreciative of their work. The management team recognised their responsibility to inform people and relevant others if something went wrong with the care provided. The management team took steps to keep themselves up to date with current legislation and best practice guidelines. They also sought to engage effectively with people, their relatives and staff through, for example, regular meetings with them. The provider had quality assurance systems and processes in place to enable them to monitor and improve the quality of people's care. Links within the local community were maintained and strengthened to benefit people living at the home.

Rating at last inspection

The last rating for this service was Good (report published 31 March 2017).

Why we inspected

This was a planned inspection based on the previous rating.

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.

The home is registered to provide accommodation and personal care for adults and who may have a dementia related illness. A maximum of 60 people can live at the home. There were 58 people living at home on the day of the inspection.

There was a registered manager in post. 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 told us that they felt safe and secure living in the home and that staff supported them to maintain their safety. Staff told us about how they minimised the risk to people’s safety and that they would report any suspected risk of abuse to the management team. People told us that staff helped them by supporting them and offering guidance or care that reduced their risks. Staff were available to meet people’s requests and care needs in a timely way. People told us they had not waited long if they requested assistance or used the call system when in their rooms. People told us they received their medicines from senior care staff who managed the administration for them, when they needed them. People also felt that if they needed extra pain relief or other medicines as needed, these were provided.

People told us staff knew the care and support they needed and relatives told us staff were trained and supported to provide the care needed for their family members. Staff we spoke with told us they knew the care people needed from their training courses and guidance from senior care staff and managers. Staff knowledge reflected the needs of people who lived at the home. People told us staff acted on their wishes and their agreement had been sought before staff carried out a task.

People told us they enjoyed their meals, had a choice of the foods they enjoyed and we saw where needed people were supported to eat and drink enough to keep them healthy. People had access to other healthcare professionals that provided treatment, advice and guidance to support their health needs.

People told us they enjoyed spending time with staff and spent time chatting and relaxing with them. Relatives we spoke with told us staff were considerate, kind and friendly and took time to get to know and develop positive relationship with their family members. We saw people maintained their privacy and dignity and staff supported them to do this where needed. People’s day to day preferences were listened to by staff and those choices and decisions were respected. Staff told us it was important to promote a person’s independence and ensure people had as much involvement as possible in their care and support.

People were involved in planning their care and if requested their relatives were involved. Care plans reflected people’s life histories, preferences and their opinions. People told us staff offered encouragement to remain active and try activities on offer. People also told us they enjoyed their hobbies and interests and spent time reading, attend places of worship or going on day trips.

People and relatives we spoke with told us they were aware of who they would make a complaint to if needed. People told us they were happy to talk though things with staff or the registered manager if they were not happy with their care. The provider had reviewed and responded to all concerns raised.

The registered manager provided good leadership and management for the staff team. The staff demonstrated their commitment to care for people following best practice. They linked with care provider forums and ensured people had access to the local community. The service had a good reputation within the local community and also with health and social care professionals.

The provider had a robust programme of audits in place to monitor the quality and safety of people’s care and support. Action plans were developed where shortfalls or people’s feedback had identified any improvements that could be made. The provider continually strived to make things work better so that people benefitted from a home that met their needs. The provider’s planned improvements were followed up to ensure they were implemented.