Jubilee Court Nursing Home

Jubilee Court Nursing Home is a care home which provides residential and nursing care for up to 100 people. Care is primarily provided for older people, some of whom are living with dementia. At the time of this inspection 68 people were using the service.

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

Robust systems were not currently in place to ensure that when an accident or incident occurred, the registered manager had enough oversight to review whether actions taken by staff were effective. This was a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Staff training was not fully up to date. The registered manager’s understanding of duty of candour legislation was limited.

We have made a recommendation to the provider to improve their understanding of the management of people’s medicines within a care home setting.

People received care and treatment that kept them safe. The risks to their health and safety were appropriately assessed and acted on. Detailed and robust processes were in place to reduce the risk of people developing pressure sores. People were protected from the risk of abuse and neglect. Staff were recruited safely and there were enough staff in place to keep them safe. Where an incident occurred, staff acted quickly to make people safe. Robust procedures were in place to reduce the risk of the spread of infection.

People felt able to discuss any concerns they had with staff and the management. Staff understood the requirements of their role and they felt supported by the management. Effective working relationships had been formed with other health and social care agencies. They worked together to provide safe care and treatment that met their individual needs.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was Good (published 3 July 2019)

Why we inspected

The inspection was prompted in part by notification of a specific incident. Following which a person using the service died. We inspected this service at the request of the Nottinghamshire Coroner to ensure that there was no on-going risk of harm to others. The information CQC received about the incident indicated concerns about the management of pressure care and accidents and incidents. This inspection examined those risks.

We have found evidence that the provider needs to make improvements. Please see the Well-Led section of this full report.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.

You can see what action we have asked the provider to take at the end of this full 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 work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Jubilee Court Care Home is a care home which provides residential and nursing care for up to 100 people. Care is primarily provided for older people, some of whom are living with a dementia. At the time of this inspection 96 people were using the service.

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

Staff knew how to report any safeguarding concerns they had and the provider had systems in place to address any allegations of abuse made.

Risks to people were identified and actions were taken by staff to reduce these. Staff were recruited using systems to reduce the risk of unsuitable candidates being employed. Medicines were managed effectively.

Staff had the skills and knowledge to deliver care and support in an effective, person-centred way. They received the received appropriate training, supervision and support.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People were cared for in a kind and respectful manner. Good relationships between people and staff had been formed. People could access a wide range of activities. People’s health needs were met. The service worked with a range of professionals to achieve good outcomes for people.

Staff said they felt supported by the management team. People’s concerns and complaints were listened and responded to. Governance systems and processes were in place to monitor and improve the quality of the service however the scheduling of these needed to be more robust.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk.

Rating at last inspection

The last rating for this service was Good (report published 12 December 2016).

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 Court Nursing Home is run and managed by Westfield Care Ltd. The home is purpose-built in a residential area on the outskirts of Worksop and provides a combination of residential, nursing and respite packages for up to 60 people at the present time. On the day of our inspection 41 people were using the service.

The service 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 who used the service and staff at Jubilee Court knew who to report any concerns to if they felt anything untoward had occurred. People’s care records showed that any risk to their safety had been identified and measures were put in place to reduce these risks. There were enough staff with the right skills and experience to meet people’s immediate needs. Medicines were stored, administered and handled safely.

People were supported by staff who had received the training they needed to support people effectively. People had consented to the care that they received. People’s rights were protected because staff acted in accordance with the Mental Capacity Act 2005. The principles of the Deprivation of Liberty Safeguards were understood and applied correctly.

People spoke positively about the food they received. They were able to have choice in what they ate at each meal and received support to eat if required. People had regular access to their GP and also other health care professionals when required.

People were supported by staff who were caring and treated them with kindness, respect and dignity. Staff encouraged people to remain independent wherever possible and where people showed signs of distress or discomfort, staff responded to them quickly. There were no restrictions on friends and relatives visiting their family members.

People received the care they needed in a way that met their needs. We saw staff provide planned care well. While a range of group activities were provided, people who could not or did not wish to join in with these activities complained of boredom. Care plans were written with the involvement of each person and their family. They were reviewed regularly to ensure staff responded appropriately to any change in need a person may have. A complaints procedure was in place and people felt comfortable in making a complaint if needed.

The atmosphere within the home was warm and friendly. People living in the home were asked for their opinions with regard to the service that they received, which meant that their views informed decisions to improve the service. Staff understood the values and aims of the service and spoke highly of the registered manager. The registered manager had clear processes in place to check on the quality of the service and to ensure that any improvements identified were made and sustained

We carried out this inspection to answer five key questions; is the service safe, effective, caring, responsive and well-led. Below is a summary of what we found. The summary describes what we observed, the records we looked at and what people using the service, their relatives and the staff told us. If you want to see the evidence that supports our summary please read the full report.

Is the service safe?

We found people's care and support was planned and delivered in a way that ensured their safety and welfare. A person who returned from hospital said, 'I am glad to be back here.'

Systems were in place to ensure people received their medication safely and medicines were safely administered. A relative said their relation was, 'Kept free from pain.' A person who used the service said, 'I have a lot of tablets, I can't judge them. They look after it well for me.'

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. While no applications have needed to be submitted, proper policies and procedures were in place. Relevant staff have been trained to understand when an application should be made, and how to submit one.

Is the service effective?

We found the provider had effective systems to involve people in planning their care, and obtaining people's consent for this to be provided. We found staff were effective at meeting the care and welfare needs of all the people who used the service. A relative said their relation was, 'Cared for extremely well and kept as comfortable as they could be.' Staff told us they involved other professionals where needed to meet people's needs. We saw this included various healthcare professionals.

Is the service caring?

We observed staff speaking with and supporting people in a sensitive and caring manner. A person who used the service said one staff member, 'Does my tea just how I like it.' We saw a number of people who used the service enjoying breakfast in the dining room on the residential floor where staff were present in the room,

We saw a nurse ask people if they wanted any pain relief and responded to their wishes. A relative said their relation was, 'Kept free from pain.'

Is the service responsive?

We found care workers responded appropriately when people had the capacity to make decisions about their care and welfare. A person who used the service said, 'My choices are respected.'

We found staff responded appropriately to the care and welfare needs of people who used the service. One person said, 'I have put on some weight, which I needed to.'

We found there were not always enough staff on duty on the nursing floor to respond to people's needs in a timely manner. A staff member said, 'If we are with a person in a room and someone is buzzing [using the call bell] we tell people they have to wait.' A person who was cared for in bed said, 'If I ring they try to come straight away, but sometimes they might be attending to someone else.'

Is the service well-led?

There is a registered manager in post to oversee the management of the home and they are supported in this by a management team. We found the provider was effective at assessing and monitoring the quality of the services provided. There were staff meetings held and staff were provided with supervision and training.

We received a number of positive comments about the service. A relative said, 'I find it very positive here, I have no complaints.' However some relatives and people who used the service also told us they did not feel comfortable to raise issues.

People felt their respect and dignity was maintained. One person told us, 'They (care staff) are very good, they look after me. I try to be as independent as possible but when I do need help they are very respectful.' Another person said, 'I cannot grumble about any of the staff, they listen and respect me.'

We found that systems were in place which ensured people received input and treatment from other health care professionals when required.

People told us they felt safe in the home and the staff had the right qualifications, skills and knowledge to perform their duties in a safe manner. Comments included, 'It's nice and safe here. I have no concerns at all. They (care staff) always pop in to see me and ask if I am feeling okay. It's nice to have people around who care.'

People were provided with the opportunity to comment on the quality of service provision at residents meetings and were also able to discuss any issues which were important to them with the management team.

We found that the communal areas were maintained to a very good standard. This observation was confirmed by people who used the service as they told us that the service had improved significantly over the past few months and said the general d'cor had improved together with the standard of hygiene maintained throughout the home.

You can see our judgements on the front page of this report.