All inspections: Jubilee Gardens - Care Quality Commission

This inspection took place on 20 May 2016. The inspection was unannounced which meant the staff and provider did not know we would be inspecting the service.

The service was last inspected in May 2015. At that inspection we found the service was in breach of regulations in that some checks had not been undertaken in order to ensure that people were being supported in a safe, suitable environment. For example, the window restrictors that were in place were not effective and did not meet published guidance; this was because the mechanism could be overridden. You can read the report from our last inspections, by selecting the 'all reports' link for ‘Jubilee.Gardens’ on our website at www.cqc.org.uk

Jubilee Gardens provides supported accommodation and personal care for up to 16 people with enduring mental health needs aged 18 years and over. People access the service for a maximum of two years; within this period of time they receive support to develop their skills in order to live independently. Staff are based on site 24 hours a day and provide practical and emotional support to people. At the time of this inspection 6 people were using the service.

The home had a registered manager. However, they were on leave at the time of the inspection and we were supported in the inspection by the project lead. 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.

At this inspection we found improvements had been made since our last inspection in May 2015 and no further breaches were identified. The window restrictors had been replaced, audit system checks for the window restrictors introduced, and staff awareness of the associated risks had been raised.

People received their medicines safety and appropriately and were supported to manage their own medicines in a planned way. Changes had been made, and the room used to store medicines helped to ensure they were always stored at the required temperature.

We found that some areas of the building were in need of refurbishment to help maintain good standards of cleanliness. For instance, in the kitchen used by the people for making breakfast, snacks and drinks the kitchen units were tired and the work surface was worn.

People told us they felt safe at Jubilee Gardens. Staff knew how to recognise and report signs of abuse. They understood the individual risks associated with people’s care and protected them from harm. An effective recruitment procedure was in place to minimise the risk of abuse.

Staff were knowledgeable about the Mental Capacity Act 2005.

There were enough staff with the right skills and competencies on duty to meet people’s needs.

Staff received regular supervision and an annual appraisal of their work performance. They spoke positively about the training they received.

Healthy eating was promoted and people were encouraged to make healthy food choices, as well as to develop their cooking skills.

The service promoted and encouraged people to develop their independence skills in readiness for moving on from the project.

People’s needs were assessed before they entered the service. People told us they were fully involved in their support plans and were provided with opportunities to express their views about the support they received.

The staff team worked closely and effectively with health and social care professionals to make sure that people’s needs were met. Staff supported people to attend and access health and medical appointments when needed.

The support plans were centred on people’s individual needs and included information about their preferences, backgrounds and interests. People spoke positively about the social, therapeutic and educational activities and opportunities within and outside of Jubilee Gardens.

The staff had a clear understanding of the diverse needs of people using the service and we saw them responded to people in a caring, sensitive, patient and understanding manner.

A range of checks were undertaken by the registered manager, the project lead and staff to monitor the quality of the service. The results of these checks were then fed into a monthly monitoring visit undertaken by the provider’s quality assurance lead.

Our inspection visit was unannounced and took place on 26 May 2015.

Jubilee Gardens provides supported accommodation and personal care for up to 16 people with enduring mental health needs aged 18 years and over. People access the service for a maximum of two years; within this period of time they receive support to develop their skills in order to live independently. Staff are based on site 24 hours a day and provide practical and emotional support to people.

Jubilee Gardens was last inspected by the Care Quality Commission (CQC) in January 2014 and was found to be meeting regulations relating to care and welfare of people who use services, management of medicines, safety, availability and suitability of equipment and requirements relating to workers.

A registered manager was in place and was responsible for the management of Jubilee Gardens and some of the provider’s other services. The registered manager was on leave on the day 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.

Our inspection identified a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in that we found that some checks had not been undertaken in order to ensure that people were being supported in a safe, suitable environment. For example, we noted that the window restrictors in place were ineffective and did not meet published guidance; this was because the mechanism which limited the windows could be overridden by pressing a button situated next to it. Our conversations with staff and our review of records also demonstrated that there was a lack of knowledge, assessment and checks of the possible risks posed by the ineffective window restrictors. You can see what action we told the provider to take at the back of the full version of this report

People told us that they received their medicines on time. Our observation of one person being supported to take their medicines together with our review of records provided evidence that medicines were safely administered. However, we identified that medicines were not always stored at the required temperature, this meant that some medicines may not be safe to use. Medication audits had identified this as an issue. However, it had not been addressed in a timely way. This was an area which required improvement.

People told us they felt safe at Jubilee Gardens. Staff knew how to recognise and report signs of abuse. They understood the individual risks associated with people’s care and protected them from harm. An effective recruitment procedure was in place to minimise the risk of abuse.

Staff were knowledgeable about the Mental Capacity Act 2005 and provided examples of when they had identified that people’s mental health needs had impacted upon, or caused their capacity to make decisions to fluctuate.

There were enough staff with the right skills and competencies on duty to meet people’s needs.

An induction in place for new staff. Existing staff received regular supervision and an annual appraisal. Staff were positive about the training courses they received.

Healthy eating was promoted and people were encouraged to make healthy food choices as well as develop their cooking skills. In addition to supported cooking sessions, we found that the service promoted and encouraged people to develop their independence skills in readiness for moving on from the project.

People’s needs were assessed before they entered the service. People told us and our review of records confirmed that they were fully involved in their support plans and were provided with opportunities to express their views about the support they received at Jubilee Gardens. People’s support plans were regularly reviewed and updated when needed in order to ensure that they accurately reflected people’s needs.

Jubilee Gardens worked closely and effectively with health and social care professionals to ensure that people’s needs were met. Staff supported people to attend and access health and medical appointments when needed. Visits to and from visiting health and social care professionals were recorded within people’s support plans.

The support plans were centred on people’s individual needs and contained information about their preferences, backgrounds and interests. People were positive about the differing social, therapeutic and educational activities and opportunities provided within and outside of Jubilee Gardens. One person told us, “There’s not enough time to do everything you can do here.”

Our observations, together with our conversations with people provided evidence that the service was caring. The staff had a clear understanding of the differing needs of people staying at Jubilee Gardens and we saw then responded to people in a caring, sensitive, patient and understanding professional manner.

A range of checks were undertaken by the project lead and staff to monitor the quality of the service. The results of these checks were then fed into a monthly monitoring visit undertaken by the provider’s quality assurance lead. This visit also focussed upon a particular area of practice each month. We noted that some of the shortfalls identified during our inspection had not been incorporated into or identified within the provider’s quality assurance systems and processes.

People told us that they were happy living at Jubilee Gardens and satisfied with the care and support they received. Their comments included, " It's alright here, the staff are fine,' 'The staff are brilliant, really helpful, lovely,' 'Staff are really nice, they are really helping me to become independent' and 'My keyworker is great, they help me, we have a meeting at least once a week to look at my progress and talk about any worries. I've learned so much since being here. The skills I have learned are budgeting my money, cleaning, cooking, it's all good.'

During the inspection we were able to observe people's experiences of living in the home. The interactions between people living at the home and staff were positive. We found that support was offered appropriately to people.

We found that people's needs were identified in support plans. Records showed that people had been involved in the care/support planning process.

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.

We found there were processes in place to ensure the safety, availability and suitability of equipment.

The provider had an effective recruitment and selection procedure in place to ensure that staff were appropriately employed.

We found people were protected from the risks of unsafe or inappropriate care and treatment because accurate and appropriate records had been maintained.

We spoke with four people about how the service respected and involved them. From these discussions it was evident that people's involvement and choices were central to the running of Jubilee Gardens. For example, we heard about a weekend of decorating earlier in the year. One person had initiated the idea and other people had joined in. This had resulted in a number of people re-decorating their rooms as well as communal areas of the building. People told us that they had chosen the colour schemes and that the manager of the home had supported them to purchase paint and to develop their decorating skills. One person told us, 'it was really good.' Another person stated, 'we worked really well together.'

People also told us that their views, experiences and choices were actively sought, and listened to through regular 'tenant participation' meetings. These meetings previously took place every two weeks but were now monthly at the request of people living at Jubilee Gardens. People told us that they put forward ideas about activities both inside and outside of the project within these meetings. One person said, 'if we ask for something it happens,' another person stated, 'I feel listened to in the meetings.' Activities included regular, 'foods of the world' nights, art nights and trips out to the seaside, local museums and shopping centres.

We also heard positive examples from one person about how the project had respected their cultural needs. They told us that the project ensured that the menu included culturally appropriate foods. The same person had a keen interest in cooking and also told us that the project had invited them to join the cook in order to prepare a meal reflecting their cultural heritage for one of the projects regular, 'food of the world' nights.

We spoke also spoke with people about the care, treatment and support they received at Jubilee Gardens. One person described living at Jubilee Gardens as, 'nice and pleasant, it's a home from home.' Another person told us about their weekly meeting with their key worker to review their outcome plan. This person said that it had reduced their anxieties about a particular area of their life and stated, 'the meeting helps me a lot.'

Each person we spoke with told us that they felt safe living at the project. One person told us that the fact that staff were always on site and available helped them to feel safe and stated, 'I know I can always go to staff and know that they'd listen to me.'

None of the people we spoke with had any complaints about the service. People told us that they liked living at Jubilee Gardens and were confident that staff and the manager of the home would listen and take any complaints they may have seriously.

Archived: Jubilee Gardens

All Inspections

20 May 2016

During a routine inspection

26 May 2015

During a routine inspection

20 January 2014

During a routine inspection

28 September 2012

During a routine inspection