This inspection took place on 17 and 19 October 2016 and the inspection was unannounced, which meant the registered provider did not know we would be visiting the service.Mary & Joseph House provides high quality accommodation and personal care to adult males with enduring mental health needs. Mary and Joseph House is part of the Joseph Cox Charity founded in 1963, and has been in its present purpose built house since 1993.
At the time of our inspection there were 41 people living at the home. The home specialises in the care of people living with Korsakoff syndrome. Korsakoff syndrome is a chronic memory disorder caused by severe deficiency of thiamine (vitamin B-1). Korsakoff syndrome is most commonly caused by alcohol misuse, but certain other conditions also can cause the syndrome.
The property provides 11 self-contained flats and 30 single bedrooms. The home has been built to an exceptionally good modern standard, specifically adapted for people living with dementia. The home provides accommodation over two floors arranged in five suites. There is a lift, a games room, dining room, chapel, art studio, project room and two lounges on the ground floor. There was a sensory garden for people and their relatives to enjoy that stimulated the senses of smell and hearing.
There was a registered manager in post. 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.
There was a truly open atmosphere on entering the premises. People could access the internet if they wanted to and could use a tablet computer provided by the service if they wished to send emails or skype family. All areas within the home had been designed for the needs of the people. There was plenty of communal space, lounges, and dining areas were available to people, as were quiet areas where people could sit in peace. We observed that this was a very safe home with a well-designed system enabling staff and visitors to move freely within the home. A relative said, “I know my dad is extremely safe at Mary & Joseph House, the environment doesn’t restrict his movement.”
The registered manager was inspiring and dedicated to providing care which met the highest of standards. They strived for excellence through consultation, they were passionate and dedicated to providing an outstanding service to people. They led with a dynamic approach and continually reflected on how to improve the service further. They demonstrated a strong and supportive leadership style, seeking feedback in order to further improve what was offered. The provider's vision and values were understood and shared across the staff team, and they were fully supportive of development plans.
People's care plans were tailored for them as individuals with the involvement of their families at all stages. People were cared for by staff that knew them really well and understood how to support them to maximise their potential and attain their goals. People's progress was monitored and celebrated. Staff were constantly looking for opportunities to offer to people that would help them grow, gain confidence and live a fulfilled life. People were supported and encouraged with their goals of moving back into the community. People were able to participate in the quality assurance processes of their home and could undertake a variety of different training offered by the provider.
The culture of the service was open, transparent and progressive. All the staff were committed to continuous improvement of the service, individual care and looking at the provider as a whole.
People using the service, their representatives and the staff felt valued and important representatives of the organisation. The staff felt ownership of and followed the aims and objectives of the organisation. People using the service and their representatives gave very positive feedback about their experiences. The staff regularly consulted relatives and external professionals to ask for their opinions. Relatives and professionals told us how they felt the service was outstanding.
The service provided outstanding care to people which were continually reviewed to ensure the best possible outcomes. People, staff, relatives and professionals were extremely complimentary about the service and what it provided.
People living at the home felt happy and were able to follow their own personal interests. Activities were individualised and meaningful to people and designed around people's own interests and hobbies. Staff ensured people received a nutritious, balanced diet and people who required it were supported to eat their meals. People were very happy with the quality of their meals and said they were given enough to eat and drink.
Staffing levels were high to meet people’s needs. If people were upset or unwell and more staff were required, this was provided straight away to support people. Relatives of people who had been unwell said they were kept fully informed and said staff were allocated to their relatives to provide comfort and care. This was greatly appreciated by the relatives we spoke with.
People lived in a safe environment that had been designed and adapted to meet the specific needs of people who used the service. Staff made sure risk assessments were carried out and took steps to minimise risks without taking away people’s right to make decisions. There was a system of audits, checks and analysis to identify shortfalls and to rectify them so the quality of care could continually be improved and developed.
Staff demonstrated an in-depth awareness of the principles of the Mental Capacity Act 2005 and associated Deprivation of Liberty Safeguards (DOLS).
People were always at the heart of the service. New staff were recruited with the involvement of people who used the service, in a safe way; all checks were in place before they started work and they received an induction.
A comprehensive induction and mentorship programme was in place for new staff and there was continuing training and development for established staff. There were four 'Champion' roles within the service where the provider had ensured staff had an enhanced level of knowledge in areas such as, infection control, dementia, dignity and hydration.
People were happy and felt safe. People's confidence and ability to be as independent as possible had grown since living at Mary & Joseph House. Their risks were managed effectively and they felt confident meeting new challenges with the support of the staff. They had their medicines administered safely and there were enough staff so that they could undertake the activities they wished and be supported in meeting their individual needs.
The provider had a quality assurance system in place, which was based on seeking the views of people, their relatives and other health and social care professionals. There was a systematic cycle of planning, action and review, reflecting aims and outcomes for people who used the service.
Complaints received were responded to thoroughly, and solutions put in place when possible. People were encouraged to share their opinions informally through comment cards in reception. Results of surveys were shared and actions they had taken in response to questionnaires and comment cards. People, their relatives and other health professionals were encouraged to share their opinions to ensure their views drove improvement. Planned improvements were focused specifically on improving people's quality of life.