Jubilee Court

Jubilee Court is a residential care home providing personal to up to 91 people. The service provides support to older people, some of whom are living with dementia, in one purpose-built building. At the time of our inspection there were 88 people using the service.

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

People were supported safely in most cases. However, there were areas where this needed further development. This was in relation to correct positioning when people were eating and consistent approach to falls risks and monitoring. Medicines were managed safely. We found that records and quantities tallied and recording systems, were used consistently. Infection control practices were in place and staff knew what they needed to do. However, we identified occasions when staff were not wearing their masks correctly.

People had their care needs met. People told us in most cases this was done in a person-centred way. However, we raised awareness of areas to review to ensure this was always delivered in a way that promoted people’s choices. For example, appropriate bedding and spending time with people after a fall.

People and staff said there was generally enough staff to meet people’s needs. Agency staff were supporting the home, many having worked at the home often. Staffing levels at peak times had been increased to help ensure people’s safety and welfare was promoted.

The registered manager had managed another of the provider’s locations and moved to Jubilee Court in April 2022. They had recently been joined by the deputy manager from their previous location. There were management systems in place and registered and deputy managers were further developing these to drive improvements in the home. People, relatives and staff were positive about the management and leadership in the home. Lessons learned were recorded and actions implemented. The registered manager was extremely knowledgeable about people living in the home and areas needing further development.

Following our feedback, action was taken to address all points raised. These actions, and supporting records provided, gave us reassurance that any risks were mitigated.

We found the registered manager to be open and responsive to feedback. Visiting healthcare professionals told us that the management team and staff worked well with them.

People told us that their needs were met, and staff were nice. They told us they felt safe. Relatives were confident about the standard of care and told us staff were friendly. Relatives felt the management team and staff were approachable and knew people well.

People had access to food, drink and call bells throughout our inspection. We saw that staff were friendly in their approach with people.

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.

Rating at last inspection

At the last inspection, the service was not rated. (Published 16 February 2022). At the last rated inspection, the service was rated good (Published 23 May 2019).

Why we inspected

The inspection was prompted in part due to information of concern received about safe care and risk management. A decision was made for us to inspect and examine those risks. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained good based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Jubilee Court on our website at www.cqc.org.uk.

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

Follow up

We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

We found the following examples of good practice.

There were safe visiting processes which were overseen by staff when visitors entered the home. People nominated visitors which included essential care givers to visit them and we saw this happening when we inspected the home. There were other options available to relatives if they were unable to enter the home to see their loved ones.

Professionals visiting people at the home had to show their COVID-19 vaccination passes or show proof of their exemption. The registered manager checked that all staff working in the home had received their COVID-19 vaccinations.

Staff were checking people’s temperatures daily to see if people had COVID-19 symptoms. The registered manager made sure people who consented to, received COVID-19 tests as directed by government guidelines. Staff promoted social distancing when possible and amongst themselves. Staff wore personal protective equipment (PPE) correctly. The registered manager had ensured this was made available throughout the home.

People who needed to, were supported to shield from others when they had returned for an emergency hospital admission.

We found the following examples of good practice.

¿ The service used video calls for people to keep in touch with their families and friends. Visits had been going ahead with robust control measures in place, however these were due to cease the following day due to the national lockdown.

¿ The individual units were being managed as social bubbles so people living on those units could spend time, join in with activities and eat together. Staff generally worked on the same units to reduce the risk of cross infection and no agency staff were used.

¿ The provider had developed policies, procedures and risks assessments for managing the service in relation to COVID 19. There were PPE checks on staff and this was recorded.

¿ When people moved into the home or returned from hospital, they were required to isolate in their rooms when possible, for a set period of time, even if they had a negative test. Staff were clear on what it meant to isolate and what symptoms of COVID 19 to look out for.

¿ Staff received training on donning and doffing PPE, infection control and COVID 19. They told us they felt supported and had the right knowledge for their roles.

¿ A person who usually sells poppies each year to raise money was unable to sit outside or communal areas this year. The home set the person up a just giving page for his fundraising and this lifted their spirits while reducing risk to them.

Further information is in the detailed findings below.

Jubilee Court provides accommodation and personal care to older people. The care home accommodates up to 91 people in one purpose built building. At the time of the inspection 89 people were living there.

People’s experience of using this service:

People were happy at the service and were supported by staff who knew them well. People felt privacy and dignity was promoted. People were able to choose how to spend their time and encouraged to make decisions about their care. People’s care plan included information that gave staff information on how to support people.

People told us they enjoyed the activities available. People had the opportunity to go out. There were communal areas throughout the home which were all used regularly. The friend’s café was the hub of the home where people from every unit of the home joined for social events, activities and general get togethers.

The recruitment process and training systems meant people were supported by staff who were suitable to work in a care setting and equipped for their role. People’s view on staffing was that in most cases there was enough staff to meet their needs. Staff told us that in most cases there was enough staff, at times people may need to wait a little longer than preferred. On the day of inspection people had their needs met in a timely fashion. There were systems in place to help ensure staff were trained and received regular supervision. Staff felt supported.

People had their individual risks assessed and staff were aware of these. People were supported safely. People received their medicines when needed. People’s personal care needs were met.

The provider had systems in place to help them identify and resolve any issues in the home. The registered manager was known throughout the home and people and staff were positive about them. All staff were clear about what was expected of them and any lessons learned from events or incidents.

The service met the characteristics for a rating of "Good" in all key questions.

More information about our inspection findings is in the full report.

Rating at last inspection:

At the last inspection on the 27 September 2016 the service was rated as Good in four key questions and Requires Improvement in one key question. The rating for Responsive has improved at this inspection.

Why we inspected:

This inspection was part of our scheduled plan of visiting services to check the safety and quality of care people received.

Follow up: We will continue to monitor the service to ensure it provides safe and effective care. We will plan further inspections in the future.

Jubilee Court provides accommodation and personal care for up to 91 older people, some of whom live with dementia. They also provide an enablement and intermediate service for people who are recuperating following a stay in hospital. At this inspection 81 people were being living at the service.

The service had a manager who was registered with the Care Quality Commission (CQC). A registered manager is a person who has registered with the 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 and associated Regulations about how the service is run.

People received care that met their needs. Some care plans were person centred but some needed further information added to ensure all information was available. However, staff knew people well and were able to support them safely and appropriately.

People were supported by sufficient numbers of trained staff who felt supported. Staff were able to identify risks and knew how to report any concerns of abuse. Medicines were managed safely and risk assessments were reviewed regularly. The registered manager and the provider also monitored accidents and incidents.

People had their capacity assessed and where needed best interest decisions were put into place. People were asked for their consent and their choices were respected. Privacy and dignity was promoted. Confidentiality was maintained.

People had access to a variety of food and drink. They were supported where needed and health care professionals were involved on a regular basis. People had access to the community and a range of activities that suited their hobbies and interests. People knew how to make complaints and these were responded to appropriately.

There were systems in place to monitor the quality of the service. The registered manager was working with the management team and the provider to further develop these systems to drive improvement and more oversight in the home.

We undertook this focused inspection to check that they had followed their plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Jubilee Court on our website at www.cqc.org.uk

This inspection was carried out on 24 May 2016 and was unannounced. At their last inspection on 30 September 2015 they were found not to be meeting all the standards we inspected. We found that people did not always receive safe care and treatment. This related to addressing health care needs and the management of medicines. At this inspection, although we found that some action had been taken to address the shortfalls, some issues still remained.

Jubilee Court provides accommodation and personal care for up to 91 people. They also provide an enablement and intermediate care service which means people stay at the home for short periods of time while they recuperate from ill health.

The service had a registered manager 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 and associated Regulations about how the service is run.

There were shortfalls in relation to the record keeping at the service. This was in relation to the accurate recording of medicines and ensuring all information in relation to people’s health was recorded clearly and consistently. We also found that systems implemented to address the previous breach of regulation needed further work to ensure they were effective. In addition, systems already in place, such as audits, were not always identifying issues.

Systems had been implemented to help ensure the safe handling of medicines. However, this required additional time to become consistently effective.

People’s health care needs were responded to appropriately and managers were checking to ensure all actions were carried out.

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people who used the service, their relatives, the staff supporting them and from looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

People had up to date risk assessments in place to enable them to be as independent as possible.

One person we spoke with told us, 'I have never felt vulnerable; there are always enough staff for me to sit and talk to.'

Where required, Mental Capacity Assessments had been carried out, following these, either Best Interest meetings had been held or an application for Deprivation of Liberty safeguards (DoLS) had been submitted.

People's medication was managed by trained staff and stored safely.

Is the service effective?

People's care needs were assessed and care plans written to reflect individual needs.

Staff had received appropriate training to enable them to carry out their role effectively.

Is the service caring?

We observed that staff were responsive to people's needs, and treated them with respect and dignity.

We observed the atmosphere to be relaxed and homely.

One person told us, 'I have got a lovely bedroom, and the staff look after me.'

Is the service responsive?

Care plans were reviewed and updated on a regular basis to reflect the changing needs of people.

The service employed activity staff to provide stimulation for people. A variety of internal activities and external entertainers provided entertainment for people, who told us they enjoyed this.

Is the service well led?

The service had a registered manager in post, who was supernumerary to the staff rota. They were supported by a management team.

The quality assurance system was robust and included monthly visits from the area manager.

Staff and people who used the service were asked for their opinions and feedback was acted on.

One person told us, 'The staff are really lovely. They are always bright and happy.'

We saw that care and support was planned according to people's individual needs. One person said, 'They ask me questions about what I need. They get everything I need for me.' People were protected from the risks of unsafe care because risk assessments were accurate and regularly reviewed.

One member of the care staff we spoke with told us that they felt the information in people's care plans was very important because 'it helps us to get to know [people] individually and that means we can do a better job.'

People who use the service were protected from the risk of abuse because the provider had taken reasonable steps to identify the possibility of abuse and prevent it from happening.

There were sufficient staff to meet people's needs at all times. One person said, 'At night time, if I need help then I ring the bell and they always come promptly.'

We saw that people living at the home, their representatives and staff were asked for their views about their care and treatment and they were acted on.