Jubilee House

Updated 23 September 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check 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 inspection visit took place on 10 August 2017 and was unannounced. The inspection was undertaken by one adult social care inspector.

Before our inspection visit we reviewed the information we held on Jubilee House. This included notifications we had received from the provider, about incidents that affect the health, safety and welfare of people who lived at the service. We also reviewed the Provider Information Record (PIR) we received prior to our inspection. This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. This provided us with information and numerical data about the operation of the service

We spoke with a range of people about the service; this included six people who lived at Jubilee House, three relatives, six staff members and the manager. We also spoke with one health professional visiting the service. We spoke with other people but due to their communication needs they were unable to provide us with detailed information about their care. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We looked at the care records of three people who lived at the service, training and recruitment records of three staff members. We also looked at records relating to the management of the service. In addition we checked the building to ensure it was clean, hygienic and a safe place for people to live.

Updated 23 September 2017

The inspection visit took place on 10 August 2017 and was unannounced. The previous comprehensive inspection was carried out on 17 March 2015. At that time the service was meeting the requirements of regulations.

At the previous inspection we found the registered manager and staff were not trained in the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. They did not understand its potential impact on their practice. This had been recognised by the registered manager who was seeking the necessary training. Since that inspection action had been taken to ensure all staff had undertaken training and understood what restrictive practice meant and what action to take. The current manager understood the requirements of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). This meant they were working within the law to support people who may lack capacity to make their own decisions. 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.

Jubilee House provides residential care for up to 28 older people some of whom were living with dementia. The service is also registered to provide nursing care, however nursing care was not being provided and the manager said it was not the intention of the service to admit people who required nursing care. The manager told us the provider is continuing to review whether a nursing category is to be retained for this service. At the time of the inspection there were 26 people living at the service.

The service is situated within a residential area of Torquay, close to the town centre and transport network. Car parking is available at the front of the service on a private forecourt. There are two floors serviced by a passenger lift. There were a range of aids and adaptations suitable to support the needs of people using the service. There was an external garden area suitable for people to use.

The service is required to have 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. The manager had submitted an application to register with the Care Quality Commission (CQC) at the time of the inspection.

People and relatives all spoke positively about the service. Relatives told us that people were safe living at the service and that staff were kind, friendly and treated people well. They told us that the manager was always available and approachable. Comments included, “Can’t praise the staff enough,” “They (staff) are very good at sorting things out for me when I get a little muddled” and “The support and care from the team is excellent.”

Safeguarding procedures were in place and staff had a good understanding of how to identify and act on any allegations of abuse. Accidents and Incidents were logged, investigated and action taken to keep people safe. Risk assessments were in place which were individualised for the person. This was to minimise potential risk of harm to people during the delivery of their care and support. Risk assessments were regularly updated and changes made as necessary so staff were responding to current risk levels.

The service had clear pictorial signage to meet the needs of people living with dementia. This helped people to recognise their rooms and orientate themselves around the building. The service was well maintained and clean. There were no incontinence odours at the service. People’s bedrooms were well decorated and personalised to give them a familiar feel. One person told us they loved the fact they had personal items around them including specific items of furniture and ornaments.

The way medicines were managed was safe. Staff responsible for the administration of medicines had received training to ensure they had the competency and skills required. Medicines were safely kept with safe arrangements for storage.

Staff were supported by a system of induction training, supervision and appraisals. Staff felt well supported by the manager who saw all staff regularly for a one to one meeting. Staff received training relevant for their role and there were good opportunities for on-going training and support and development. The training needs of all staff were well monitored by the manager and updates were provided in a timely manner.

The service had identified the minimum numbers of staff required to meet people’s needs and these were being met. Recruitment procedures were safe to help ensure staff were of suitable character to work with vulnerable people.

People and relatives spoke positively about the meals provided by the service. There was sufficient choice and people received appropriate support where required. We observed regular snacks and drinks throughout the day were provided between meals to make sure people received adequate nutrition and hydration. Comments from people who lived at the service were all positive about the quality of meals provided. One person said, “I have a good appetite and I like the range and quality of the meals here. Very good.”

People had good access to healthcare professionals and their healthcare needs were being met. A medical emergency was responded to effectively during the inspection and demonstrated staff knew what action to take.

Care plans were well organised and contained accurate and up to date information. People appeared to be well cared for. Care planning was reviewed regularly and people’s changing needs recorded.

People had access to a programme of varied activities. A new activity co-ordinator was reviewing current activities and making arrangements for events for people. These included singing, crafts and visits to the local area. Not all people wanted to take part in activities. Three people told us they liked to sit and have a chat, or read. Staff respected people’s choices.

People who used the service and their relatives knew how to raise a concern or to make a complaint. The complaints procedure was available and people said they were encouraged to raise concerns or make comments.

There was an effective quality assurance process in place to drive improvement in Jubilee House. These included regular audits of the service, annual surveys, resident meetings and staff meetings to seek the views of people about the quality of care at the service.