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Inspection carried out on 17 May 2019

During a routine inspection

About the service:

Joyleen is a care home for up to three people who require care, support and accommodation for mental health issues and or learning disabilities. At the time of our inspection three people were using the service.

People’s experience of using this service:

People continued to benefit from kind and committed staff. People complimented the support received and told us they formed meaningful, caring relationships with the staff. Staff knew what was important to people and ensured people had care that met their needs and choices. People's dignity, confidentiality and privacy was respected, and their independence was promoted.

People received support that met their needs and was in line with care plans and good practice. People's rights to make own decisions were respected. People were encouraged to maintain good diet and access health services when required.

The registered manager ensured people received safe care and treatment. Relatives complimented the continuity of care provided by skilled and competent staff. People received their medicines safely and as prescribed. Risks to people's well-being were assessed, recorded and updated when people's circumstances changed. The staff ensured any lessons learnt were reflected to improve the service delivery.

The service was well run by the registered manager who was supported by a team of committed staff. The provider's quality assurance processes were effective and there was a focus on continuous improvement. Where an area for improvement had been identified there was a prompt action taken to address it. People, staff and relatives were involved and felt listened to. The team at Joyleen worked well in partnership with other agencies, social and health professionals and external organisations.

The service met the characteristics of good in all areas. More information is in the detailed findings below.

Rating at last inspection:

Good, report published 9 December 2016

Why we inspected:

This was a planned inspection based on the rating at the last inspection.

Follow up:

We will monitor all intelligence received about the service to inform the assessment of the risk profile of the service and to ensure the next planned inspection is scheduled accordingly.

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

Inspection carried out on 13 October 2016

During a routine inspection

The inspection took place on 13 October 2016. This was an unannounced inspection. The service was last inspected in July 2014. There were no breaches of regulations at that time.

Joyleen is one of five homes owned by Cardell Care Limited in Gloucestershire. It provides accommodation for three people with mental health needs and/or a learning disability. There were three people living at Joyleen at the time of the inspection.

There was a registered manager at the service at the time of our inspection. 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.’

The service was safe. Risk assessments were implemented and reflected the current level of risk to people. There were sufficient staffing levels to ensure safe care and treatment to support people. Staff had a good awareness of safeguarding policies and procedures and felt confident to raise any issues of concerns with the management team. The registered manager had carried out the relevant checks to ensure they were employing suitable people at Joyleen.

People were receiving effective care and support. Staff received appropriate training which was relevant to their role. Staff received regular supervisions and appraisals. Where required, the service was adhering to the principles of the Mental Capacity Act 2005 (MCA) or Deprivation of Liberty Safeguards (DoLS). The environment had been adapted to meet the needs of people living at Joyleen. People were supported to personalise their living spaces.

The service was caring. People and their relatives spoke positively about the staff at the home. Staff demonstrated a good understanding of respect and dignity and were observed providing care which maintained peoples dignity.

The service was responsive. Care plans were detailed; person centred and provided sufficient detail to provide safe, high quality care to people. Care plans were reviewed regularly and people were involved in the planning of their care. Staff had supported people to take part in the activities that they wanted to. Staff were knowledgeable and supportive in assisting people to communicate with them. People were confident in the presence of staff and staff were able to communicate well with people. Staff evidently knew people well and had built positive relationships. There was a robust complaints procedure in place and where complaints had been made, there was evidence these had been dealt with appropriately.

The service was well-led. Quality assurance checks and audits were taking place regularly and identified actions required to improve the service. Staff, people and their relatives spoke positively about management. The registered manager attended various events to maintain up to date knowledge of practice.

Inspection carried out on 30 July 2014

During a routine inspection

One adult social care inspector carried out this inspection. The focus of the inspection was to answer the 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 people using the service, their relatives and staff told us, what we observed and what records we looked at.

If you want to see the evidence that supports our summary, please read the full report.

Is the service safe?

Risk assessments were seen to be thorough and individualised for each person living at Joyleen. There was a thorough analysis of the risks and guidance was provide for staff regarding risk management plans.

The service was safe, clean and hygienic because the environment was observed to be clean and well maintained with good infection control monitoring procedures in place.

Staff and management understood the requirements of the Mental Capacity Act (2005) and the Deprivation of Liberties Safeguards. There was comprehensive documentation to support this. People�s capacity had been assessed and only where there was a lack of capacity were decisions made on their behalf in best interests meetings.

Is the service effective?

People�s health and social care needs were assessed before they came to live at Joyleen. Subsequently they were seen to be involved in the developing of their care plans. People said �I decide what I do each day� and �We choose what is on the menu each week and we go shopping to buy the food we need�.

People told us that they were very happy with the care provided and that they liked the independence they were encouraged to maintain.

Is the service caring?

People were treated with dignity and respect. People told us that they liked living at Joyleen. Staff were observed interacting with people in a humane and caring way, listening to their views and responding to them appropriately.

People�s preferences, interests, wishes, aspirations and diverse needs were recorded in their care plans. This meant that care and support was provided in accordance with their wishes.

Staff said that the care plan documentation was straightforward to understand. This meant that care and support was delivered in way that met the individual's needs.

Is the service responsive?

People who used the service were seen to express their views to staff about how they wished to spend their day. There were also notes of meetings between staff and people who use the service which demonstrated that ideas were put forward by people and these views were taken into account when plans for activities were made.

Is the service well-led?

The provider had a quality assurance system which evaluated each of the key outcomes monitored by the Care Quality Commission. This system included an action plan to meet any plans for improvement of the service.

The service worked well with other agencies such as the Community Mental Health Team and the Community Learning Disability Team.

The staff rota was organised to ensure that there were sufficient staff with the right knowledge, skills and experience so that people were safe and received good quality care.

Inspection carried out on 22 May 2013

During a routine inspection

At the time of our inspection Cardell Care Limited had applied to us to increase the numbers of people living at the home to three. We spoke with the two people living at the home and spent time observing interactions between them and staff. We spoke with three members of staff.

People told us they were involved in developing the service provided to them. They were supported to be as independent as possible. They liked to use local facilities including shops, pubs and garden centres. We observed them being treated respectfully and sensitively.

People said they talked with staff about their care needs. They said, "staff talk to me about care, they mostly understand me now". We found that care records were person centred and kept up to date. They were available in formats using pictures and photographs.

People were being safeguarded from harm or abuse. Staff had access to training in the safeguarding of adults and the prevention and management of challenging behaviour. One person told us, "they treat me very well indeed. I have no issues".

Staff had access to an induction programme to equip them with the knowledge and skills to support people. Training and refresher training were provided when needed.

The quality assurance process was being developed to take into account people's views of the service provided. People had individual meetings with staff to discuss the support they received and any concerns they might have.