Jude House

Jude House is a residential care home providing the regulated activity of accommodation and personal to up to 4 people with a mental health condition. Jude House accommodates people in one adapted building. At the time of our inspection there were 4 people using the service.

People’s experience of using this service and what we found

People and their relatives were happy with the care and support provided. Comments included, “I am happy here. We get on well with each other” and “[Staff] are friendly and always around to help.” People were protected from the risk of avoidable harm. Comments included, “[Staff] are good. I feel safe around them” and “I have now worries at all. [Staff] treat me so well.”

Staff were aware of their responsibility to protect people from harm. They knew how to identify and report abuse, and when to whistle blow concerns. The registered manager undertook risk assessments and put guidance in place which enabled staff to support people safely. The provider ensured there were enough staff to deliver care. Recruitment processes were safe and ensured only suitable staff were employed to support people. Staff underwent induction before they started providing care. People received their medicines when required. Staff knew how to minimise the risk of infection and followed good hygienic practices.

Staff provided effective care as they were supported to undertake their roles. The provider ensured staff received regular training and supervision to do their work. People were supported to maintain good health and their well-being.

A regular team of staff delivered care to people. This enabled them to develop positive and meaningful caring relationships. People’s dignity and privacy were respected. Staff sought consent from people before they provided care to them. People were supported to maintain their independence and to make choices about their day to day living.

People’s needs were assessed and met. The registered managed reviewed and updated care plans to reflect changes to each person’s needs and support they required. People were supported to access health services when required. People and their relatives knew how to make a complaint if they were unhappy with any aspect of their care.

People, their relatives and staff were happy with the way the service was managed. They felt the provider listened to them and their views were valued and considered. They described the registered manager as open, honest and approachable. Quality assurance audits were carried out on the care provided. Improvements were made when needed. The provider ensured staff learnt lessons when things went wrong. The provider took action to prevent incidents from happening again. The registered manager worked in partnership with health and social care professionals and other agencies to ensure people received care appropriate to their needs.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (14 April 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and on-going monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At this inspection we found the service remained Good.

There was a registered manager in post. 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 told us that staff treated them well. Staff had an informed and considerate approach to their work and understood the importance of treating people with dignity and respecting their privacy.

People received personalised care and support. People's care plans reflected people’s individual preferences and needs. They contained the information staff required to provide people with the care and support they needed in the way that they wanted. People’s care plans were reviewed regularly and were updated when people's needs changed. Staff understood and respected people’s diversity.

Staff were appropriately recruited, trained and supported to provide people with individualised care and support. Staff were positive about the support and training they received.

Arrangements were in place to keep people safe. Staff understood how to safeguard the people they supported. People's individual needs and risks were identified and managed as part of their plan of care and support. Staff had a good understanding about their responsibilities to manage risks and report any concerns relating to people's safety or poor practise.

Systems were in place to manage people’s medicines safely.

The home was working within the principles of The Mental Capacity Act 2005 (MCA). The Care Quality Commission (CQC) is required by law to monitor the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. DoLS ensure that an individual being deprived of their liberty is monitored and the reasons why they are being restricted is regularly reviewed to make sure it is still in the person's best interests. At the time of this inspection people had capacity to consent to their care and support and went out freely without the need for supervision from staff.

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 were listened to and supported to be fully involved in decisions about their care and other aspects of their lives.

Arrangements were in place to ensure that complaints were responded to and addressed appropriately. People had the opportunity to feedback about the service.

There were systems in place to regularly assess, monitor and improve the quality of the services provided for people. These arrangements were in the process of being reviewed and developed by the service.

Further information is in the detailed findings below.

The previous inspection of the service took place on 13 June 2014 when it was found to meet all the required standards.

Jude House provides personal care and support to up to four people with mental health needs. The service is used as a step down facility from more secure mental health settings. There were four people living at the service on the day of our inspection. 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.

People who used the service told us they were very satisfied with the care they received. People said that they felt safe at the home and that they were involved in the development of their care plan and making decisions about how and when their support was delivered.

People said staff listened to their views and treated them with respect. Each person received support that met their specific needs. For example, people were supported to access local colleges to gain further education or were supported to find voluntary employment. People told us that this had helped them to integrate better in the community and provided them with additional skills to become more independent.

People cooked their own meals; however, we saw that the ingredients were purchased by the provider. People told us that they were happy with this arrangement and that food was always available.

People told us the manager of the service knew them and regularly met with them. They said they were asked how things were going in relation to their support and whether any changes needed to be made. People said staff were trustworthy and they received care which kept them safe.

People said they received a reliable service which met their needs and staff were friendly and treated them with dignity and respect.

People said they got the support they needed with their medicines and had easy access to health care professionals such as community psychiatric nurses (CPN), psychiatrists, GPs and psychologists if required.

People told us staff were well trained and had a good understanding of mental illness and how to positively support people.

The service had learnt from incidents and made changes to improve the service. People’s views were sought during resident meetings and suggested changes were listened to.

The provider had systems in place to assess and monitor the quality of care, which included formal quality assurance checks, surveys and questionnaires and regular staff and residents meetings.

During the inspection we spoke with all of the four people who used the service. We spent time observing and we spoke with a care worker, the administrator, the general manager, two other managers and the registered manager. Following the inspection we spoke with two social workers and a healthcare professional.

Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at.

If you want to see evidence that supports our summary please read the full report.

This is a summary of what we found:

Is the service safe?

People who used the service told us that they felt safe and staff were friendly. We saw staff interact with people who used the service in a respectful manner. The two social workers and a healthcare professional told us that they were confident people were safe.

Staff understood their role in safeguarding the people whom they supported and they understood the whistleblowing policy.

The home had systems in place to identify assess and manage risks relating to the health, welfare and safety of people who used the service.

Staff were clear about their roles and responsibilities and felt well supported by management staff. The management team had systems in place to keep staffing levels under review and to provide extra staff promptly when needed. Staffing numbers and skill mix met people's needs. Healthcare and social care professionals we spoke with told us that they felt that staff were competent and they understood people's varied and complex needs.

The Care Quality Commission monitors the operation of the Deprivation of Liberty Safeguards (DoLS), which applies to care homes. Management staff knew when an application for deprivation of liberty would need to be submitted for authorisation.

Arrangements were in place for managing medicines safely.

Checks of the premises and other health and safety checks were carried out.

Is the service effective?

People told us that they were happy living in the home and received the care and support that they wanted and needed. Comments from people about the staff included 'They are helpful,' 'Staff are ok, they listen' and 'If I feel like talking I talk to them.'

Staff told us that they were well supported by management staff and there was good communication amongst staff about the service and people's needs, so that they could carry out their roles effectively in providing the care and support people needed. Staff were knowledgeable regarding how to care for people with mental healthcare needs.

People's care needs had been assessed and care and treatment were planned and delivered in a way that promoted people's safety and welfare. Risk assessments had been carried out where necessary. Care plans had been regularly reviewed with participation from the people who used the service.

Is the service caring?

We saw that people were supported by kind, attentive staff who approached people in a friendly manner. People who used the service told us they were happy with the staff and confirmed that they were approachable and listened to them. We saw people approach staff without hesitation and spoke with them freely. Staff provided support to people when they requested it and involved them in decisions about their care.

Staff were knowledgeable regarding the specific care needs of people and respected the choices that people made. People's privacy and dignity were respected. Healthcare and social care professionals we spoke with told us that people were well cared for and received the support that they needed.

Staff had an understanding of people's cultural and religious needs and where appropriate, arrangements had been made to meet these needs. People took part in activities of their choice.

Is the service responsive?

People were supported to express their views and be actively involved in making decisions about their care and support. People told us that they were listened to. Staff responded promptly to issues to do with people's behaviour and care needs. They frequently met with people to discuss their individual care and support needs. People's care and health were monitored closely.

People's health, safety and welfare were protected as they received the advice and treatment that they needed from a range of health and social care professionals. Healthcare and social care professionals we spoke with told us that they were kept informed of people's progress.

People who used the service told us that if they had any concerns or complaints they would feel comfortable raising them with staff. There was an effective complaints system in use at the service, which helped ensure that people had their comments and complaints listened to and acted on.

Is the service well-led?

The home had an experienced registered manager who was supported by other management staff including a general manager who visited the home at least daily and who carried out monitoring checks of the quality of the service. These included checks of the care provided to people and the quality of environment. Improvements were made when needed.

Staff meetings took place regularly so staff views about the service were taken into account.

Incidents were recorded and relevant agencies including the Care Quality Commission, local authority and police were notified when required. Action was taken so that staff learnt from incidents and complaints.

Each person who used the service had a plan of care that had been regularly reviewed, and included information about the individual support and care that people who used the service needed. People were involved in decisions about their lives and provided their consent about matters to do with their care and treatment.

Staff received appropriate support, appraisal and training. They knew about their roles and responsibilities in meeting the needs of the people whom they supported. Staff interacted with people who used the service in a positive manner. People approached staff without hesitation and accessed their bedrooms, communal areas of the home and the community freely.

People's health, safety and welfare were protected as they received the advice and treatment that they needed from a range of healthcare and social care professionals.

The home was clean. Staff and people who used the service were aware of the importance of ensuring that appropriate standards of cleanliness and hygiene were maintained.

People were asked for their views about the service and there were systems in place to make improvements to the service when needed.

People told us they made decisions about their lives. These included decisions about what they wanted to eat, when they wanted to get up and what they wanted to do. People's independence and their skills were promoted and supported by staff.

People told us that they felt safe and knew who to talk to if they had any worries or concerns. Safeguarding policies and the training received by staff protected people from abuse.

Staff numbers and skills mix met people's varied needs. Staff had a good understanding of each person's needs, and knew about their roles and responsibilities in providing the care and support that people required.

Records were comprehensive, accurate and up to date.