Archived: Jubilee House

Jubilee House is a residential care home providing personal care to seven people with learning disabilities or autistic spectrum disorders. The service can support up to eight people. Jubilee House accommodates people in one adapted building.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

The service was a large home, bigger than most domestic style properties. It was registered for the support of up to eight people. This is larger than current best practice guidance. However, the size of the service having a negative impact on people was mitigated by the building design fitting into the residential area and the other large domestic homes of a similar size. There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.

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

We have made a recommendation about medicines management. Risks to people were assessed and addressed. Staffing levels were sufficient to keep people safe.

Staff were supported with regular training, supervision and appraisal. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence. The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

Staff provided caring and kind support. People were happy at the service and treated with dignity and respect. Staff supported people to live as independent a life as possible.

People received personalised support. Staff supported people to access activities they enjoyed. The provider had an effective complaints process.

The provider had effective quality assurance processes in place. Feedback was sought and acted on. The service had a number of positive community links.

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 requires improvement (published 13 July 2018) and there were two breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulation.

At the last inspection we found the provider had failed to notify us of significant events by submitting required notifications. This was a breach of regulation and we issued a fixed penalty notice. The provider accepted a fixed penalty and paid this in full.

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.

Jubilee House 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. Jubilee House was registered for up to seven people. There were seven adults living and receiving care and support from staff at Jubilee House at the time of our inspection. People had a variety of care and support needs related to maintaining their mental well-being, learning disabilities or autistic spectrum disorders as well as dementia.

A registered manager was in post at the time of the inspection visit. They were registered with the Care Quality Commission in January 2017 with the current provider. However, they had been registered with the previous provider Positive Approach Services Led since 2011. 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.

This was the services first inspection under the current provider.

We found concerns with the safe administration of medicines. The provider was following unsafe practice, which was not within best practice guidelines.

Plans were not in place to minimise all risks to people who used the service. For example, where a person was a diabetic.

We found concerns with the fire risk assessments for parts of the building and learning from fire drills was not acted upon.

The audits that were taking place were not robust enough to highlight the concerns we raised.

The premises had not been adapted to support people who were now living with dementia.

We have made a recommendation about the premises.

Although staff had received training, they did not fully understand all the subjects such as Deprivation of Liberty Safeguards (DoLS). Records showed that training in certain subjects was out of date. Staff were supported from supervisions and a yearly appraisal . Staff had received training in Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards (DoLS) however could not demonstrate a basic understanding of the requirements of the Act. The registered manager did not understand their responsibilities in relation to the DoLS.

We have made a recommendation about further MCA and DoLS training.

A number of recruitment checks were carried out before staff were employed to ensure they were suitable.

We found there were enough staff employed to support people with their assessed needs. However, certain times throughout the day they could be short. We were told that extra staff were put on the rota to cover appointments or if people wanted a day out.

People enjoyed the food provided and were offered choice.

People said staff were kind and caring and we saw independence was promoted.

Staff could easily demonstrate a person centred approach to care, they knew people and their life history’s well. However, we found that care plans needed more structure and some care plans were not in place.

There were no regular arrangements to engage people in meaningful activities.

We have made a recommendation about activities.

The service had a complaints policy that was applied if and when issues arose. People and their relatives knew how to raise any issues they had. The service had received no complaints.

We identified two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the registered provider to take at the back of the full version of the report.