Background to this inspection
Updated
14 May 2021
Why we inspected
This was a targeted inspection to check whether the provider had met the requirements of the warning notice in relation to Regulation 12 ( Safe care and treatment) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and Regulation 17 (Governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
Inspection team
This inspection was completed by one inspector.
Service and service type
Jubilee Villa Care Home Ltd is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection
The service had a manager registered with the Care Quality Commission. The registered manager is also the provider and owner of the home. This means that they, as the provider and registered manager, are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
The inspection was unannounced. However, we gave the service 5 minutes notice of the inspection. This was because we had to gather information on the home's current COVID 19 status and the providers procedures for visiting professionals.
What we did before the inspection
The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
We reviewed information we had received about the service since the last inspection. We sought feedback from Shropshire Fire and Rescue Service.
During the inspection
We spoke with three staff members including the deputy manager, the provider and the domestic support. We looked at documents relating to checks completed by the provider.
After the inspection
We continued to seek clarification from the provider to validate evidence found.
Updated
14 May 2021
About the service
Jubilee Villa Care Home Ltd is a residential care home providing personal care to 17 people at the time of the inspection. The service can support up to 17 people over the age of 18 years who may have mental health needs or dementia.
The home has bedrooms over the ground and first floor. There is no passenger lift at the home. People have access to communal areas and the garden.
People’s experience of using this service and what we found
People were not always safe as the infection prevention and control procedures were not effectively implemented.
The provider did not have effective systems in place to identify environmental issues which could put people at the risk of harm.
The provider did not have effective systems in place to identify and drive good and safe care provision.
People received their medicines as prescribed. Staff understood how to protect people from the risk of abuse and knew what to do if they suspected something was wrong.
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.
People and staff found the management team to be approachable and their opinions were valued and respected.
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 5 February 2020).
At this inspection we found improvements were needed to keep people safe and to effectively monitor the quality of service provided.
Why we inspected
The inspection was prompted in part due to concerns received about the environment and the providers infection prevention and control procedures. A decision was made for us to inspect and examine those risks.
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
You can see what action we have asked the provider to take at the end of this full report.
Following our inspection site visit the provider took action to mitigate the risks to people.
Enforcement
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 discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.
We have identified breaches in relation to keeping people safe and the providers monitoring of the provision of care at this inspection.
Please see the action we have told the provider to take at the end of this report.
Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
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.