- Care home
Jubilee House
Report from 5 April 2024 assessment
Contents
On this page
- Overview
- Shared direction and culture
- Capable, compassionate and inclusive leaders
- Freedom to speak up
- Workforce equality, diversity and inclusion
- Governance, management and sustainability
- Partnerships and communities
- Learning, improvement and innovation
Well-led
The management team had created a culture in which providing exceptional care whilst enabling people’s wishes and lifestyle was the core ethos of the service. The registered manager led by example, and staff shared the goal of ensuring people received exceptional care. This was achieved through various initiatives, training and feedback opportunities, and had been recognised in recent national award ceremonies. Robust governance systems were in place to identify areas for improvement, which was always followed by action to achieve this. Staff worked closely with external stakeholders to maximise people’s health and wellbeing and make a positive impact on their life. The registered manager had worked scrupulously to ensure staff were able to speak up and where they had, appropriate action was taken to thoroughly investigate and respond to any concerns.
This service scored 93 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.
Staff spoke with enthusiasm about their roles and the culture of the service and supporting people with care and compassion. One staff member told us, “This is my first job as a carer - I love it. We are all family here - the staff, the residents, even our management team. It feels like a home." Another staff member said, “It’s a brilliant team to work in. With the residents it’s a family and we get to know them. It’s a happy and friendly place to be.” Staff satisfaction survey results had a high response rate of 76%, Of these 95% of staff stated they were proud of the job they did, felt valued by their manager, supported by the team as a whole and enjoyed their roles. Staff reported they understood their job and felt colleagues were committed to doing a good job.
There was a strong and positive culture within the service which centred around people being supported in the way they wished. The registered manager was passionate about people receiving holistic care. They understood the need to develop a strong identity and values base within the home and promoted this throughout the staff team. Processes in place to monitor the care people received demonstrated a commitment to maintaining people’s autonomy and respecting their choices. Dementia champions had been trained to complete observations of the care people received, provide feedback to staff and to support the development of care plans. This had been instrumental in reducing people’s anxiety and periods of distress. The staff team worked closely with residents and relatives to ensure they were able to contribute and enjoy their home. Both the residents and relative’s questionnaires showed a satisfaction rate of over 95%. With relatives stating they felt the running of the home was based on good values and principles.
Capable, compassionate and inclusive leaders
There was a positive and relaxed atmosphere between the management team and staff. Staff told us they felt supported in their roles. One staff member said, “They are very supportive they treat us like a friend.” Another staff member told us, “I am supported very well. Everyone is supported to work together and help each other. [Registered manager] and the nurses are always there for us.”
There was a strong leadership team within the home. The registered manager was visible around the home and had a detailed knowledge of both people, staff and their skills. They ensured that staff felt rewarded and proud of the home. Staff were regularly thanked for how they support they provided and instances of staff going above and beyond were recognised and openly shared. The provider also ensured staff and leaders contribution to people’s care was recognised. One nurse at Jubilee House had been awarded Nurse of the Year out of over 150 other homes. The head chef had won a divisional award and been further nominated for a regional award. This was based on their knowledge of nutritional support for people living with dementia and their highly personalised approach. The registered manager ensured they prioritised keeping up to date with current best practice and learning. They had recently completed training as a Frailty Champion and took part in on-going training and initiatives offered by the local Integrated Care Board. The registered manager saw themselves as a role model to staff which meant they needed to ensure they were continually updating their practice.
Freedom to speak up
The registered manager told us they worked to foster an environment where staff felt able to speak up and share ideas. They told us, “My door is always open to any staff if they have personal or professional issues. I’m not an office-based person. I want colleagues to know I’m approachable.” Staff members confirmed they felt able to share concerns and avenues available to them were shared within team meetings and individual discussions. One staff member told us, “We share our problems, what we need to do to make a difference. We can share our opinions. And [registered manager] is brilliant and approachable. She has helped me personally.” Another staff member said, “If you share with the [registered] manager they will make things good for the team.”
Due to a number of anonymous concerns received, that were investigated and unsubstantiated, the provider had looked for ways to improve the systems and encourage staff to speak out should they identify concerns. This approach showed a commitment to ensuring staff felt able to speak to them but also doing absolutely everything they could to alleviate staff worries in relation to the accusations. The provider and registered manager had continued to enhance the ways in which staff could raise concerns. These included staff meetings daily handover meetings clinical review meetings, a 24 hour on call system and staff supervisions. The provider had also developed a mobile phone application which allowed staff to report concerns should they feel they could not speak within the service. In addition, the regional senior management team visited the home to speak with staff on a regular basis. Records showed where concerns were reported these were taken extremely seriously and thoroughly investigated. This open and transparent approach demonstrated to staff that any issues would be dealt with in a fair and proportionate way. The local authority had spent time at the service reviewing the provider’s systems to support staff in speaking up and had found these to be comprehensive and robust. They told us staff they spoke with felt they would be able to speak to senior staff members and were all confident any concerns would be taken seriously.
Workforce equality, diversity and inclusion
We did not look at Workforce equality, diversity and inclusion during this assessment. The score for this quality statement is based on the previous rating for Well-led.
Governance, management and sustainability
The registered manager felt the systems for auditing and governance were relevant, effective and useful in enabling them to monitor the quality of the care and support people received. They told us, “The systems we have support the running of the home. Everything is tracked I have support from regional and quality. The local authority have also been very supportive and are happy with everything.”
The provider had robust governance systems in place. A central quality assurance team visited the service regularly in addition to regional support. Audits completed were thorough and reflected the experiences of both people and staff. Action plans showed the management team responded promptly to any suggestions for improvements. Action plans were developed and closely monitored to ensure any changes were fully embedded into practice. Satisfaction surveys were completed regularly and responded to comprehensively.
Partnerships and communities
People and their relatives told us staff worked with a range of organisations and used community facilities to enhance people’s quality of life and be part of the community. People and their relatives told us of events and opportunities planned with other organisations which had a positive impact on people’s lives. One person told us, “I enjoy the church events and they have different entertainers and young folk coming along.” A resident said, “They take residents out. [Person] used to like going out, so I know they do take her out for a coffee.” Another relative told us, “Due to [person] being a life-long catholic, I asked a member of the church to go in and see her and the home is up for that. They have facilitated it and it’s a regular event. She now has this happening. [Person] is also taken to the church for singing. She has the opportunity to go to the cinema. There is loads of opportunities, and sometimes the activities people will take [person] out in the wheelchair in the sunshine.
Staff understood and were committed to promoting community engagement and partnership working. The registered manager told us, “It is so important to keep connections and develop them. We work with everyone who approaches us to make things good for the residents and to develop understanding. And we have good relationships with professionals. We communicate and can call on them when we need any advice.” Community connections were a strong part of the culture of the home with staff referring to different visitors and trips during conversation. Photographs showed the difference these connections made to people and the positive impact these had on their lives. One staff member told us, “We have a lot of visitors here, doctors, nurses, specialist. We have the schools come in and different group, entertainers. All the staff work really hard to coordinate it all.” Another staff member said, “Every week we take a group to the Baptist church. There is a community singing group run at the church. There is a lot of companionship, and the singing brings back lots of memories. In the summer we go down to the river and have a picnic. We try and go to the library every other week. We go to garden centres, we go to the lake and have an ice cream. I have organised live music once a month."
Feedback from partners was positive. They felt the staff were responsive to people's needs and the management team were approachable
Partnership working with professionals and the local community was at the heart of the care and support people received. The service worked with a range of professionals to ensure people received the care and support they needed to live well and to minimise risks to their safety and wellbeing. This included the GP surgery, speech and language therapist, tissue viability nurse, palliative nurse, learning disability nurse, physiotherapist, and dentists. In addition, nurses had received training from the local hospice to ensure people and their families living with an advanced or terminal illnesses such as cancers, heart, lung or neurological disease are supported in end of life management when their health deteriorates. The service ensured they sought feedback from health care professionals they worked with to determine if there were any improvements or learning they could take from the partnerships. Feedback received was positive and outlined good communication systems were in place which helped to ensure people received positive outcomes and good quality, compassionate care. People benefitted from a wide range of community initiatives which both enabled people to go out and to form relationships at home. Examples of this included developing links with a local primary school who visit every Tuesday afternoon and joined in activities, and student volunteers from a local College who were looking to go into the medical profession. The leadership team continued to work within the community as a member of the Godalming Dementia Friendly Town project to raise awareness of those living with dementia and how they can be supported within the local area. In addition to regularly accessing local shops and cafes they also supported a ’relaxed’ cinema held monthly in a community hall and a regular dementia friendly church service held in the local church. Relatives were also invited to these events so families could continue to share experiences together.
Learning, improvement and innovation
Staff confirmed an ongoing culture of learning and improvement in the service. The registered manager told us, “For me it’s about training, It’s the basis of everything so staff understand why we do things. That’s what makes staff follow the guidance, if they know why. We often talk to staff about what motivates them to work in care. We all want to keep improving.” Staff confirmed they were able to raise any concerns and were informed of any changes or developments in the service.
The home was committed to ensuring continuous improvement to achieve better outcomes for people in all areas of their lives. This commitment and sharing of good practice had been instrumental in Jubilee House achieving Care Home of the Year at the Surrey Care Awards. Particular acknowledgement was given to the changes made leading to a reduction in the number of falls people experienced by 60% and the reduction in use of antipsychotic drugs to support people with their anxiety. The registered manager had enrolled in the My Home Life training program accredited by Skills for Care. This training provides essential skills and personal resilience necessary to effectively lead teams and deliver a high quality of life for residents. There are practical sessions to equip managers with different skills, how to recognise challenges in different generations and how to retain staff. By putting the training into practice the service has been successful in both recruitment and retention. This has meant no agency staff have been required for over a year, bringing a higher degree of consistency to people’s care. The registered manager had enrolled in the Train the Trainer Frailty Champions training conducted by the Frailty Academy. This comprehensive training covered various areas, including: The concept of frailty, falls prevention, Nutrition and swallowing, Anxiety and depression management, Polypharmacy awareness, and Dementia and delirium care. By becoming champions in frailty, the registered manager and their team would be equipped to lead knowledgeable groups of nurses and deliver care that lead to positive outcomes for people. Action plans were used to develop the service people received and were monitored close both by the registered manager and the regional team. In addition to setting target dates, interim objectives were in place to measure what had been achieved to date and review effectiveness.