Background to this inspection
Updated
10 October 2019
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
The inspection was carried out by one inspector, an Expert by Experience and a specialist advisor who is nurse specialist. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
Juniper House Residential Care Home 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 service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This was an unannounced inspection.
What we did before the inspection
Before the inspection visit, we reviewed information we had received about the service since the last inspection. This included information about incidents the provider must notify us of, such as any allegations of abuse. We sought feedback on the service from the local authority and local Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.
During the inspection
We spoke with 11 people who used the service, five relatives and a community healthcare professional about their experience of the care provided. We also spoke with the regional manager, registered manager, deputy manager, head chef, activities assistant and minibus driver. In addition, we spoke with three senior care staff, five care staff and two domestic staff.
We reviewed a range of records. these included nine people’s care records, medicines records, staff rotas, staff training records, and three staff recruitment records. We also reviewed incident and accident records, complaints, selected policies and records relating to the safety of the premises and management of the service.
After the inspection
We reviewed additional information provided to us by the regional manager. We also spoke with a community healthcare professional.
Updated
10 October 2019
About the service
Juniper House Residential Care Home is a residential care home providing personal care for up to 60 older people who may have physical disabilities and/or be living with dementia. The home’s purpose-built environment is divided into four units: Willow, Maple, Chestnut and Beech. At the time of our inspection, there were 52 people living at the home.
People’s experience of using this service and what we found
We were not assured the provider effectively deployed sufficient numbers of staff to ensure people’s safety and consistently meet their needs. Staff understood how to identify and alert others to potential abuse involving the people who lived at the home. The risks to people had been assessed and reviewed, and plans were in place designed to manage these. People received their medicines safely from trained staff. Staff were provided with, and made use of, personal protective equipment to reduce the risk of cross-infection. Accidents and incidents involving people were monitored by the management team to learn from these and reduce risks.
People’s needs were assessed before they moved into the home and kept under review. Staff received an initial induction, following by ongoing training and support, to enable them to work effectively. People had support and encouragement to eat and drink enough, and any associated risks were assessed and managed. Staff and management worked with a range of community health and social care professionals to achieve positive outcomes for people. The home’s purpose-built environment reflected people’s needs and requirements. People’s health needs were monitored and they had regular access to their GP. Staff respected and supported people’s right to make their own decisions.
Staff knew the people they supported well, and provided care and support in a kind and compassionate manner. People had support to express their views about the care they received. Staff promoted people’s rights to privacy and dignity, as part of which they took steps to protect their personal information.
People’s care plans were individualised and read by the staff who supported them. People’s communication needs were assessed in order to meet these. People had support to participate in a range of in-house and community-based activities. Any complaints received about the service were investigated and responded to. The provider had procedures in place to identify people’s wishes and choices regarding end-of-life care. However, the outcomes of these discussions were not always recorded.
Staff found the home’s management team approachable and appreciative of their work. The management team recognised their responsibility to inform people and relevant others if something went wrong with the care provided. The management team took steps to keep themselves up to date with current legislation and best practice guidelines. They also sought to engage effectively with people, their relatives and staff through, for example, regular meetings with them. The provider had quality assurance systems and processes in place to enable them to monitor and improve the quality of people's care. Links within the local community were maintained and strengthened to benefit people living at the home.
Rating at last inspection
The last rating for this service was Good (report published 31 March 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.