Archived: Jubilee Court

Updated 15 August 2018

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 took place on 4 and 5 June 2018 and was unannounced. The inspection was undertaken by two inspectors, and a specialist nurse advisor with experience of this type of service.

The provider had completed a Provider Information Return (PIR) at our previous inspection in 2017. 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. We took this information into account when we planned our inspection. Providers are required by law to notify us about events and incidents that occur; we refer to these as 'notifications'. We looked at the notifications the provider had sent to us. We also contacted the local authority who monitor and commission services for information they held about the service. We took this information into account when planning our inspection.

We spoke with ten people, three relatives, a nurse, occupational therapist, six care staff, the cook, activities coordinator, registered manager and area manager. Some of the people living at the home had complex care needs and were unable to tell us about the service they received. We used a tool called the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us. We sampled ten people’s care and medicine records, viewed training records for staff, staff rotas, three recruitment records, accident and incident records and the providers quality monitoring to include complaints and compliments. We looked at external professional’s reports such as the homes pharmacist, the clinical commissioning group and the local authority.

Updated 15 August 2018

This inspection took place on the 4 & 5 June 2018 and was unannounced. Jubilee Court is a purpose-built rehabilitation centre. It provides accommodation with personal care and nursing for up to 30 adults who have acquired brain injury. At the time of our inspection 29 people were using the service.

The service has a registered manager. 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 2008 and associated Regulations about how the service is run.

At the last inspection of the service in June 2017, the provider was rated as Requires Improvement in all five key questions. They were also in breach of regulations because they did not have effective systems of governance to assess, manage and monitor risks to people living at the service. Following the last inspection, we served a Warning Notice to require the provider to take immediate action in relation to their governance. We asked the provider to complete an action plan to show what they would do and by when to improve the key questions Safe, Effective, Caring, Responsive and Well-led to at least good.

At this inspection, we found that regulations had been met, and there had been improvements across all five key questions.

People were supported by trained staff who understood how to recognise, and report abuse or harm. A clinical lead nurse had been recruited which had improved the oversight and management of risks to people’s safety in relation to their medical conditions. Risks assessments were up to date and showed what support people needed to keep them safe. People were supported by sufficient numbers of staff and safe recruitment practices were followed. People received their medicines as prescribed. Shortfalls in nurses keeping accurate medicine records were being addressed with improved checks in place to enable the provider to identify and act on errors.

People received effective care from staff that had the skills and additional training specific to the needs of people. Staff had an induction and regular supervision and described positive support from the management team. Staff had additional support to enable them to understand the Mental Capacity Act and we saw they supported people in line with its principals. 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. People’s dietary needs were met; they enjoyed the meals provided and had assistance to eat and drink sufficient amounts. People were supported to maintain their health and had access to a range of healthcare professionals. This included on-site therapists who supported people to manage their medical conditions.

Staff were caring towards people and demonstrated a compassionate response to people’s personal circumstances and needs. People were supported with their privacy and dignity.

People had been enabled to identify their personal goals in relation to developing their skills and level of independence. They were involved in the development and review of their care plan. The resources needed to support people were identified and we saw people had benefitted from the combined efforts of the therapist team and care staff to develop their strengths and quality of life. People enjoyed a range of activities and social opportunities which focused on their personal interests and included opportunities for voluntary work and maintaining educational interests. People knew how to raise concerns and were happy these would be responded to.

The provider’s quality assurance systems and processes had improved. We saw audits were carried out regularly and had been effective in identifying areas for improvement. The systems in place had enabled the provider to assess, monitor and manage risks to people’s safety. We found the introduction of a clinical lead nurse had improved the clinical oversight of people’s needs. Records had been improved to show the clinical support people needed and provided. Feedback from external professionals recognised improvements had been made. The provider had addressed shortfalls identified at the previous inspection in relation to staff knowledge regarding people whose liberty was restricted. They had also sourced additional training to support staff in meeting people’s complex medical conditions. There had been an improvement in maintaining up to date care records. The checks in place helped the provider to ensure people who used the service were not at risk of unsafe care. As the provider was previously rated requires improvement on three consecutive inspections the improvements now need to be sustained.