The inspection was carried out by an adult social care inspector on 14 and 15 January 2015. The inspection was announced.
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.
Jasmine House is a residential care home that provides accommodation, care and support for up to seven adults who have a learning disability. The home provides accommodation over three floors and is accessible to people who are physically disabled. The service is situated in the Fazakerley area of Liverpool.
People who lived at the home were protected from avoidable harm and potential abuse because the provider had taken steps to minimise the risk of abuse. Clear procedures for preventing abuse and for responding to an allegation of abuse were in place. Staff were very confident about recognising and reporting suspected abuse and the registered manager was aware of their responsibilities to report abuse to relevant agencies.
The premises were safe and very well maintained and procedures were in place to protect people from hazards and to respond to emergencies. The home was fully accessible and aids and adaptations were in place in to meet people’s needs in line with the advice of relevant professionals.
People were protected from the risk of cross infection because staff had been trained appropriately and followed good practice guidelines for the control of infection.
There were appropriate numbers of staff on duty to meet people’s individual needs and lifestyle choices and to keep people safe. Staff recruitment checks were robust and staff were only employed to work at the home when the provider had obtained satisfactory checks on their suitability. People who lived at the home were involved in the staff selection process and in the staff induction process.
The registered manager had a good knowledge and understanding of the Mental Capacity Act (2005) and their roles and responsibilities linked to this. They were able to clearly demonstrate how they had worked alongside family members and relevant health and social care professionals to ensure decisions were made in people’s best interests when this was required.
The service was person centred. This means that people were provided with care and support that was tailored to meet their individual needs and the way in which the service was delivered was based on the individual needs of the people who used it. We saw many examples of best practice being followed and we found the service was responsive to people’s changing needs. We heard how staff provided flexible and innovative support to make sure people were achieving the things they wanted to.
People’s needs had been assessed and they had a plan of care which was detailed, personalised and provided clear guidance on how to meet their needs. Risks to people’s safety and welfare had been assessed as part of their care plan and plans to manage any identified risks were in place. We found people were well supported to take risks as part of living an independent life style.
People were well supported to access a range of healthcare professionals as appropriate to their individual needs. We heard many examples of how people who lived at the home had made significant progress with their physical and mental health needs since moving to the home. The provider worked proactively to ensure people who used the service were able to recognise and act upon their health needs. The also worked closely with healthcare professionals to ensure people had regular health checks and screening as a means to prevent detect or prevent ill health. This is in line with best practice.
Medication was very well managed and people received their medication as prescribed. The provider had tight processes in place to ensure medication was managed safely. We saw detailed guidance about how to support people with their medicines and information about what medicines were prescribed for. This meant that staff had an understanding of medicines they were administering and the effects of these. People were also supported to have a regular review of their medicines with their GP.
People were regularly supported to use the facilities in their local community and were supported to take part in work placements and social and recreational activities. The activities were based on the needs, wishes and choices of the individuals living at the home.
Staff presented as caring and we saw that they treated people with warmth and respect during the course of our visit. Relatives we spoke with told us they felt staff cared about the welfare of their family member. They told us the service exceeded their expectations of a care home.
Staff were well supported in their roles and responsibilities. Staff had been provided with relevant training and they underwent annual refresher training in a range of topics. Staff attended regular supervision meetings and team meetings. Staff had lead roles for matters such as ‘mental health’ and ‘safeguarding’. Staff had been provided with specialised training linked to the needs of the people they supported and they were knowledgeable about people’s needs. The provider had attained a gold ‘Investors in People’ award which is recognition of their commitment and investment to develop and support staff.
Staff were aware of their roles and responsibilities and the lines of accountability within the home.
Staff told us there was an open culture at the home and that they would not hesitate to raise concerns if they had any. They felt that any concerns they did raise would be dealt with appropriately. Throughout our visit staff demonstrated how they supported the aims and objectives of the service in ensuring it was person centred and inclusive.
Very clear and effective systems were in place to regularly check on the quality of the service and ensure improvements were made. These included regular audits on areas of practice and seeking people’s views about the quality of the service. The registered manager was keen to develop the service in response to people’s views and to changes in best practice guidance.