Jackson House

We found the following examples of good practice.

The provider had developed detailed policies, procedures and risk assessments to manage risks relating to the COVID-19 pandemic. These were clearly written and regularly updated.

Systems were in place to screen visitors for symptoms of COVID-19. People were supported to keep in touch with their loved ones though face to face visits, telephone and video calls.

Staff wore appropriate personal protective equipment (PPE) and had access to adequate supplies. People receiving care also confirmed staff wore PPE when supporting them.

Signage and information was prominently displayed. Posters displayed were in an easy to read format using a mixture of words and pictures. These were effective in helping people living at Jackson House understand the risks associated with COVID-19.

Staff undertook regular COVID-19 tests and daily temperature checks. People living at the service were also monitored for symptoms of COVID-19 so that signs of ill-health were picked up quickly and appropriate action taken.

Jackson House is a small care home. It provides accommodation with nursing care for up to four adults with a learning disability and mental health needs. The care home is a semi-detached cottage with a small car park. It has gardens to the front and rear of the property. Bedrooms are single occupancy and there are shared lounges and a shared dining area. At the time of our visit, two people lived at the home.

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.

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

People received safe and effective care from staff that were kind and caring. People’s needs had been fully assessed prior to them being supported by the service. Care plans were person centred and held sufficient detail for staff to follow to ensure people’s likes, and preferences were supported. Risk assessments were put in place to ensure people's individual needs could be met and risks reduced or mitigated.

People’s privacy and dignity was respected, and their independence promoted. Relatives spoke positively about the staff team. Staff had developed positive relationships with people and their family members. They had a good understanding of how to meet each person's individual needs. People’s dietary needs were assessed and met.

Safe recruitment procedures were in place and people were supported by regular staff that knew them well. People were protected from the risk of harm and abuse by staff that had received training and felt confident to raise any concerns they had.

Medicines were managed safely by trained and competent staff. Staff had access to medicines policies and procedures as well as best practice guidelines. Medication administration records (Mars) were fully completed and were regularly audited to identify any areas for development and improvement. Staff had received infection control training and understood how to minimise the risk of infection being spread.

People participated in activities of their choice and were supported and encouraged to maintain contact with family members. Staff communicated with people in ways that were meaningful to them.

The provider management team completed audits across areas of the service. Actions identified were used to continually develop and improve the service. Feedback from people and their family members was regularly sought.

People were supported to have 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.

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 11 July 2017).

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.

At the time of our inspection there was a manager in post. They had been in post approximately five months at the time of our visit and were in the process of applying to become the 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.’

At our last inspection in June 2015 we had concerns with regards to Regulation 19 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 relating to the safe recruitment of staff. At this inspection we saw that improvements had been made and the service was now compliant with this regulation. Staff were recruited safely with appropriate checks on their suitability completed before they started to work at the home.

People who used the service said they were happy with the support they received and liked living at the home. Staff we spoke with were knowledgeable about people’s needs and risks and what was important to each person. We saw that staff supported and encouraged people to pursue their social interests and aspirations. People were provided with person centred care in accordance with their care plans.

People’s care records provided detailed information about their needs and risks and how best to support them in accordance with their wishes and preferences. Records showed that risks were well managed and people’s needs were supported by multi-disciplinary teams in the community. For example, doctors, dentists, mental health services, specialist medical teams and podiatry and opticians. Arrangements were in place to regularly review people’s care to ensure the support provided continued to keep them safe and well.

Records showed evidence of good practice in relation to the implementation of the Mental Capacity Act 2005. Capacity assessments were in place when a person’s capacity to consent to a particular decision was in question and we saw that any decisions made were taken in the person’s best interests. Some people were subject to a deprivation of liberty safeguards to keep them safe. During our visit, we observed a restriction being temporarily imposed. The reasons for the restriction were clearly explained to the person with alternative arrangements made to ensure their wishes were met later on in the day. This was good practice and showed that staff at the home worked hard to ensure any restriction placed on people’s liberty was as least restrictive as possible.

From our discussions with staff it was clear that they knew people well and genuinely cared for the people they looked after. Interactions between staff and the people who lived in the home were natural, relaxed and good humoured. It was obvious that people felt comfortable and close to the staff that supported them.

People’s independence was promoted and staff supported them to pursue their social and recreational interest in addition to organising volunteering opportunities for people to participate in. This gave people a sense of purpose. The people and staff we spoke with, told us about a recent holiday to Wales and about the various activities that they liked to enjoy together such as snooker, the cinema, golf and football. This indicated that people’s social and emotional well-being was an important aspect of people’s care.

Medication was stored and managed safely. Medication was administered by nursing staff and from people’s medication records we could see that people had received the medication they needed.

Staffing levels in the home were suited to people’s needs and ensured people received the support they needed. Staff were supervised appropriately but had not received up to date training to do their job role. This meant there was a risk that their skills and knowledge were out of date. We spoke with the manager about this. They showed us the action plan that was in place to address this.

We found the service to be well-led. There were suitable checks and systems in place to monitor the quality and safety of the service. These checks enabled the manager to identify issues and make improvements as and when required. People’s feedback on the service had not been surveyed since 2015 but we saw that there were plans in place to do so. A new questionnaire had been developed and was due to be sent out to people who lived at the home, their families and the health and social care professionals involved in people’s care. A weekly resident meeting also took place where people discussed menu planning and any other issues that were important to them.