7 February 2018
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This comprehensive inspection took place on 24 and 30 November 2017 and was unannounced. This inspection was undertaken by one inspector.
We reviewed information we held about the provider including, for example, statutory notifications that they had sent us. A statutory notification is information about important events which the provider is required to send us by law.
We contacted the health and social care commissioners who help place and monitor the care of people living in the home as well as 'Healthwatch' in Northamptonshire which is an independent consumer champion for people who use health and social care services.
Before the inspection visit, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what it does well and improvements they plan to make. We took this information into account when we inspected.
We undertook general observations throughout the home, including observing interactions between care staff and people in the communal areas. By observing the care received, we could determine whether or not they were comfortable with the support they were provided with.
We spoke with six people using the service and three visitors. We also spoke with five care staff, the registered manager, the deputy manager, and a senior nurse. We looked at the communal facilities throughout the home as well as three bedrooms when we spoke with people in their own rooms. We also looked at where medicines and foodstuff were stored as well as equipment and precautions in place to protect people against the risk of fire.
We looked at four people's care records and records in relation to staff training and recruitment. We also looked at other records related to the running of the home and the quality of the service provided. This included the provider quality assurance audits, maintenance schedules, training information for staff, and arrangements for managing complaints.
7 February 2018
Juniper House 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 (CQC) regulates both the premises and the care provided and both were looked at during this inspection.
Juniper House provides accommodation and care for up to 60 older people, including people that need support because of their physical frailty and those who need professional nursing care because of their medical condition. Additionally the ‘Memory Lane’ section of the home specialises in supporting people living with dementia. Respite care and short breaks are part of the service provided at Juniper House. The home is purpose built and adapted throughout to meet the diverse care needs of the people in residence. There were 59 people in residence when we inspected the service on 24 and 30 November 2017.
At the last inspection on 21 August 2015 the service was rated ‘Good’. At this unannounced inspection we found the service remained ‘Good’.
A registered manager was in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 safe. People were protected by robust recruitment procedures that made sure people did not receive unsafe care from staff that were unsuited to the job. They were safeguarded from avoidable harm and poor practice by staff that knew what action they needed to take if they suspected this was happening.
People were cared for by sufficient numbers of professional nurses and care staff. People's needs had been assessed prior to admission and they each had an agreed care plan that was regularly reviewed to ensure they continued to receive the care and support they needed. They received care from staff that had received training and support to carry out their roles.
The premises and equipment used to provide people with the care they needed were appropriately maintained throughout to ensure their safety. Systems were in place to ensure the premises was kept clean and hygienic so that people were protected by the prevention and control of infection. There were arrangements in place for the service to make sure that action was taken and lessons learned when things went wrong, to improve safety across the service.
People’s capacity to make informed choices had been assessed and the provider and staff were aware of the Mental Capacity Act 2005 and the importance of seeking people’s consent when receiving care and support.
People received care and support from staff that knew what was expected of them and they carried out their duties effectively and with compassion. They were treated equally and their individuality was respected by staff.
Risks to people’s safety were reviewed as their needs and dependencies changed. Care plans were personalised and reflected each person’s individual needs and provided staff with the information and guidance they needed to manage risk and keep people safe.
People had access to community healthcare professionals and received timely medical attention when this was needed. There were appropriate arrangements in place for people to have regular healthcare check-ups. Medicines were appropriately and safely managed. Medicines were securely stored and there were suitable arrangements in place for their timely administration by the nurse in charge.
People enjoyed their meals and said they always had enough to eat and drink. Individuals who needed encouragement and support with eating a healthy diet received the help they required.
The provider and registered manager led staff by example and enabled the staff team to deliver individualised care that consistently achieved good outcomes for all people using the service. Staff had insight into people’s capabilities and aspirations. People were encouraged and enabled to do things for themselves by friendly staff that were responsive and attentive. Their individual preferences for the way they liked to receive their care and support were respected.
The rating from our previous inspection was prominently displayed in the foyer of the home. The provider also ensured that this rating was appropriately displayed on their website.