Jah Jireh Maryport

We found the following examples of good practice.

The home had comprehensive policies and procedures to manage any risks associated with the COVID-19 pandemic. This included the management of people with a COVID-19 positive diagnosis.

People living in the home and their relatives were supported to maintain contact. When visitors were unable to access the home, for example if they tested positive for COVID-19 technology such as on line visiting was utilised.

A programme of regular COVID-19 testing for both people in the home, staff, and visitors to the home had been implemented. All visitors, including professionals were subject to a range of screening procedures, including showing evidence of vaccination and a negative lateral flow test before entry into the home was allowed.

There was an ample supply of PPE for staff and any visitors to use. Hand sanitiser was readily available throughout the service. Staff had received updated training on the use of PPE and we observed staff wearing it correctly during out inspection. Clear signage and information was in place throughout the home to remind staff of their responsibilities.

Daily cleaning schedules were implemented by housekeepers and all staff were involved in undertaking touch point cleaning.

Jah Jireh is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The care home can accommodate up to twenty people. There were nineteen people in residence when we visited. People living in the service are mainly older adults. The home does not provide nursing care.

The home had a suitably qualified and experienced registered manager who had a background in social care and in management. 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 staff team understood how to protect vulnerable adults from harm and abuse. Staff had received suitable training and spoke to us about how they would identify any issues and report them appropriately. Risk assessments and risk management plans supported people well. Good arrangements were in place to ensure that new members of staff had been suitably vetted and that they were the right kind of people to work with vulnerable adults. Accident and incident management was of a good standard.

The registered manager kept staffing rosters under review as people's needs changed. We judged that the service employed enough staff by day and night to meet people's needs and to deliver services like cleaning and cooking.

Staff were appropriately inducted, trained and developed to give the best support possible. We met team members who understood people's needs very well and who had suitable training and experience in their roles.

Medicines were suitably managed in the service with people having reviews of their medicines on a regular basis.

People in the home saw their GP and health specialists whenever necessary. The staff team had good working relationships with local GP surgeries and with community nursing services.

Good assessments of need were in place, and the staff team reviewed the delivery of care for effectiveness. They worked with health and social care professionals to ensure that assessment and review of support needed was suitable and up to date.

People told us they were very happy with the food provided and people enjoyed a well prepared light lunch during our inspection. Good nutritional planning was in place and special diets catered for appropriately.

Jah Jireh is situated in the village of Ellenborough. The provider had updated and added to the original building to a good standard. It had suitable adaptations and equipment in place. The house was warm, clean and comfortable on the day we visited.

This home mainly, but not exclusively, cares for adults who are members of the religious group known as Jehovah's Witnesses. People attended the Kingdom Hall as the home was next door to this meeting place of the congregation. People continued to lead meetings and participate in community activities that are fundamental to Jehovah's Witness's beliefs and practices. There was no compulsion to follow the religious beliefs of Jehovah's Witnesses and eople were supported to continue to be involved with the religion of their choice if they were not Jehovah's Witnesses.

The staff team were aware of their responsibilities under the Mental Capacity Act 2005. We checked whether the service was working within the principles of the MCA, whether any restrictions on people’s liberty had been authorised and whether any conditions on such authorisations were being met. 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. No one was currently under an authorisation of the MCA.

People who lived in the home told us that the staff were caring. We also observed kind and patient support being provided. Staff supported people in a respectful way. They made sure that confidentiality, privacy and dignity were maintained.

Risk assessments and care plans provided detailed guidance for staff in the home. People in the service were aware of their care plans and had influenced the content. The management team had ensured the plans reflected the person centred care that was being delivered. We noted that good attention was paid to spiritual needs as well as personal and psychological care and practical support.

Staff had supported a person who used British Sign language and could access training and support for other forms of specialised communication.

We saw evidence of regular activities and entertainments in the home. People led bible study groups and other forms of learning. The Kingdom Hall is next to the home and people attended or joined in through CCTV.

The service had a quality monitoring system in place that the registered manager and her deputy had developed. People were asked their views in a number of different ways. Quality assurance was used to support future planning.

We had evidence to show that the registered manager and the deputy manager were able to deal with concerns or complaints appropriately .

Records were well organised, easy to access and stored securely.

Jah Jireh provides care for up to 20 people. This service is privately owned and is not part of the wider Jah Jireh group of homes. The home mainly caters for older adults but can also take younger adults with care needs. This is often done because people who live in this home are Jehovah's witnesses who want to live within this community. On the day of our visit there were 15 people in residence.

The home had 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.

People were protected from harm and abuse because staff had suitable training and understood how to protect people. Staff understood how to report concerns.

The staff undertook risk assessments and management plans so that any assessed risks would be reduced.

The home was suitably staffed to meet people's needs. New staff were only given access to people in the home once all the relevant checks were made. Staff received suitable levels of training and supervision and their competence checked.

The home was clean and orderly with good infection control measures in place. The home had been adapted and extended to give people a comfortable and safe environment.

The provider was aware of responsibilities under the Mental Capacity Act 2005. Arrangements were in place to apply for Deprivation of Liberty authorities. People were asked for their consent before any intervention. Restraint was not used in this service.

People told us they were happy with the choice of food provided. Arrangements were in place to monitor people who had problems maintaining their weight. Health eating was encouraged.

We observed kind and caring staff who supported people in a respectful and dignified way. People were encouraged to be as independent as possible.

End of life care was managed with support from health providers. The home had good support from local community nurses and GPs. Medicines were appropriately managed.

Assessment of need and ability was on-going. Care plans were simple narratives that set out people's strengths and needs. Staff followed the guidance contained in these plans.

People in the home were all Jehovah's witnesses and told us they were happy with the way their spiritual needs were met. Hobbies and activities of a more secular nature were being developed.

Concerns and complaints were managed appropriately.

The home had a suitably qualified and experienced provider manager. The vision and values of the service were in line with the teachings of the church and were also reflective of good care practice.

The home had a simple quality monitoring system and people told us that their opinions were valued and appropriate changes made.

• Is the service caring?

• Is the service responsive?

• Is the service safe?

• Is the service effective?

• Is the service well led?

This is a summary of what we found-

Is the service safe?

People who lived in the home told us that they felt safe and well cared for:

"I never feel frightened here. The staff are always around and the doors are locked...I ring the bell if I need help."

"There is nothing wrong here...we are not a 'worldly' community...we all care for each other...whether we are residents or staff. There is no abuse here."

Staff had a good understanding of how to protect vulnerable adults and they had received appropriate training on safeguarding.

The house was well maintained and secure. Risk assessments and risk management plans were in place. Food and fire safety took high priorities in the monitoring of quality matters.

Is the service effective?

We had evidence to show that care planning, the deployment of staff and the checks on quality matters meant that care and support was given to people in an effective way. We saw that people were helped to be as independent as possible and were also given the right levels of care during periods of ill health or at the end of their lives.

People who lived in the home and paid for their own care and services were given suitable contracts about terms and conditions. We asked the provider to make sure that a copy of the contract was kept on file in the home for inspection purposes.

Is the service caring?

People told us that the family who owned the home, the registered manager and the staff team were all:

"Very caring brothers and sisters...we are all of one belief here and our younger brothers and sisters care for us very well..."

We observed dignified, caring and respectful interactions from staff. We met people who told us they felt that the team at Jah-Jireh cared for all aspects of their well-being. We learned that, for example, people were taken out by staff or by the management team to ensure they were still part of the wider community. We learned that the registered manager would sit with a person who was at the end of their life.

Is the service responsive?

We had evidence to show that, from time to time, the manager sent questionnaires to people in the home and to other interested parties. We also learned that people were asked in a group and individually about their preferences. We had examples where people had asked for changes to their daily routines and to their care plans.

Is the service well-led?

This service had an established manager who was suitably trained and qualified. People spoke highly of her and we had evidence to show that she was fully aware of all aspects of the running of the home. The staff team told us that they were given good levels of support. We also had evidence to show that the family who owned the home all had different management roles in the home and they gave the manager support in all aspects of her management role.

"We are nourished in body and spirit in this service."

We had evidence to show that people were cared for properly and that they were happy with the food provided.

"The food is beautiful and I look forward to all my meals."

We checked that medicines were being managed properly and we found that drugs were ordered, administered and disposed of correctly. Medicines were regularly reviewed and people were only given what was necessary.

We checked on the rosters for the service and we found that by both day and night there were enough staff to deliver high-quality services to people. People in the service said that there were enough staff to care for them properly.

The manager and her team made sure that good quality care and services were delivered because there was an effective quality management system in place. One person who lived in the home told us:

"Everything about this home is of the highest quality."

There had been no matters of complaint or concern raised to us but there were suitable systems in place to ensure that any concerns would be managed appropriately.

"We have no complaints...we are like a family and we get the best kind of support."

The provider has sent us information which showed us that designated supervisors of staff had been put into place. They also provided us with a copy of the supervision sign off sheet for 2012. This sign off sheet demonstrated to us that all staff had received supervision on a monthly basis between May and September 2012.

The provider has now demonstrated to us, by providing evidence of audits, that audits of care plans and medication were now in place. These audit reports recorded what had been audited, any errors in completion of records and actions taken to address concerns. In August 2012 the providers supplied us with a copy of the residents evaluation summary from July 2012 which demonstrated that the majority of people who used services were happy with the care they received.