- Care home
Admiral Jellicoe House Also known as The Royal Naval Benevolent Trust
Report from 3 January 2024 assessment
Contents
On this page
- Overview
- Kindness, compassion and dignity
- Treating people as individuals
- Independence, choice and control
- Responding to people’s immediate needs
- Workforce wellbeing and enablement
Caring
We assessed all quality statements within the caring key question. People were treated with kindness, empathy and compassion. We received some very positive feedback about people’s experience in the home and the kindness and quality of care from staff. Staff respected people’s privacy and dignity and treated them as individuals. Staff responded quickly to meet people’s needs. We observed people were engaged and able to pursue their own interests and choices. Staff promoted people’s independence and involved them in choices relating to their care and support. People were able to receive visitors freely. However, staff morale had been impacted by an unsettled period of leadership change since October 2023 and a lack of regular support and supervision. Since our visit, a new leadership team has been appointed and staff reported feeling listened to in staff meetings.
This service scored 70 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.
Kindness, compassion and dignity
People and relatives spoke positively about the kindness and compassion shown by staff at the service. They told us they felt respected and were treated with dignity. People’s comments included, “They always knock on the door before coming in”, “You feel you can ask anything, and you will be helped”, “They are compassionate, kind, empathetic and are quite prepared to give you the time”, “The staff know me well and remember all the things I like, and how I like it” and, “I can do what I want, I feel respected, and I am very well looked after.” The service had received a written compliment from a relative which read, ‘I wanted to offer my heartfelt thanks to every member of the AJH family for how they have helped [person] settle in…From your respect for the fact [person] had lived on their own for the past 10 years and so would need time and space to get used to be with other people in close proximity again to [person’s] need for gentle nudge to join others at the table for meals. I think [person] is now ageing backwards.” Another relative shared, “I came here for Christmas lunch with Dad and the staff were all amazing and they put themselves out for everyone.”
The registered manager told us they led by example and said, “That’s the biggest thing I do is to ensure people are treated in a person-centred way. They are my priority if they ask for help I will go and help them. I hope this rubs off onto the carers. I also walk around the home to check on everything.” The registered manager described how she would sit with people and share a cup of coffee. She told this helped show the staff team it was OK to do that. She also told us how she supported people and staff, for example by assisting people who had become agitated by finding a means of engagement which they responded to. Staff gave examples of how they provided dignified, kind and compassionate care. One staff member said, “Always care and compassion, talking softly. Their level, not shouting, holding hand reassurance. Be gentle when providing support.” Another told us, “Knock on door, talk to them using their preferred name, ask if they are ready to do [activity/task] and not just doing it, giving choices.”
A recent audit by the local authority found people were complimentary about the quality of care they received. A Healthwatch visit carried out in April 2023 stated, “Throughout the visit it was observed that people were supported by kind and caring staff and people were treated with dignity and respect.”
During each site visit we observed people were treated with kindness, compassion and dignity by staff. For example, we observed staff knocking before entering people’s rooms and calling out the person’s name. We saw people who were distressed being comforted by staff and staff engaging in conversation and activities with people. Personal care was provided behind closed doors and staff supported people discretely in communal areas.
Treating people as individuals
People and relatives spoke positively about how individual preferences and needs were met. People’s comments included, “They get to know your idiosyncrasies and are very patient”, “I have control over what I want to do” and, “The staff know me well and remember all the things I like, and how I like it.” One person told us, “Father John comes on a Friday in the Garden room, and you can have communion if you want.”
Staff shared examples of how people’s diverse needs were met. These included adaptations to meet people’s needs such as large print, talking lifts, use of voice activated technology and referral to the sensory deprivation team. People’s spiritual and religious needs were supported by visiting clergy or access to online services. A programme of activities was in place and photos showed a wide variety of activities were enjoyed by people. A wellbeing team was available 7 days a week to meet people’s social and activity needs. Staff shared examples of responding to individual requests or interests, for example attending an external gym or setting up an adaptive golf session. Another example was celebrating a person’s 100th birthday with a Marine band, which they were said to really enjoy. One staff member said, "We really care about our residents, and all will do anything for them. We are taking [person] out to a music concert in the Summer because they really love the band."
Everyone living at the service had a connection to the Navy, with most people being Navy veterans. The home has been designed to reflect Navy culture with memorabilia and amenities such as a such as a NAFFI shop, and a dementia friendly boat. We observed the environment offered a stimulating connection to the shared experience/history of people living in the service. We observed people engaged in a range of activities to meet their interests. We also observed people being able to choose how they spent time. People’s rooms were personalised with their own possessions.
Initial assessments gathered person-centred information including communication needs, expressing sexuality, spiritual, religious, and cultural needs, working and socialising. This information was used to plan each person’s care. People were asked for their preference on the gender of care staff supporting them with personal care. Care plans included a biography which gives staff information on the person’s history, interests, and achievements. The registered manager knew the protected characteristics under the Equality Act. People’s care plans identified when they had needs related to any protected characteristic, except for sexual orientation. We have recommended the service ask about this to help identify and consider a full range of people’s needs.
Independence, choice and control
People and relatives spoke positively about staff supporting their independence, choice, and control. One person told us, “I am fully in charge off my own space and if I wanted something it would happen.” Another said, “It’s great because if I want to, I can make myself drinks and that gives me independence.” A relative told us, “[Name] goes to some activities, but they can say no.” People and relatives confirmed they could have visits or visit whenever they chose to. Relatives also commented on social events at the home and a training event in Dementia care arranged by the provider, which they had valued.
The registered manager told us about how people were supported to maintain relationships with people who are important to them. This included supporting people to have privacy and maintain relationships where they had a partner also living at the service. When people formed relationships which resulted in sexual safety concerns, for example when people did not have the mental capacity to consent, actions had been taken to protect people. Staff were aware of these risks and their responsibilities to report any concerns.
We observed people engaged in a range of activities to meet their interests. We also observed people being able to choose how they spent time. When we visited on a Sunday we saw people had visitors and some were going out with them. Other people were engaged in activities such as a reminiscence session which was really well attended. We noted specialist adaptive equipment was available, for example a large tablet to enable people to use the internet or communicate with loved ones.
The service had a visitor policy and procedure which outlined people’s rights to have visitors when they chose with no restriction except in exceptional circumstances. Care plans included information on what people could do independently and their preferences. Care plans included the person’s ‘circle of care’; these are the people who are important to the person and includes any representative such as a Lasting Power of Attorney. People’s interests and social needs were known and supported. Resident meeting minutes from October 2023 showed people on each floor had been consulted to seek their views. Whilst feedback from people was documented, it was unclear what action had been taken in response.
Responding to people’s immediate needs
People and relatives told us staff responded to their needs promptly. A person said, “I did have a fall onto my knees last year, but I was seen to straight away.” Another person said, “When a call button goes, you don’t have to wait too long to see someone.” Other people commented on how staff knew what they liked, and a person gave an example of staff responding to a person in distress by cheering them up.
Staff feedback indicated inconsistencies in responding to people to prevent distress. One staff member said, "I find that if we distract [person] by asking them to help with little things like drying up or putting things away, it helps them have purpose, then it often stops them becoming agitated." In relation to our questions about a person who refused personal care at times another staff member said “The core team [Ganges floor] share this stuff with other staff – staff not from this floor won’t necessarily attempt this – we spend so much time on this floor we know these residents and we have a good understanding. I think it may be that other staff don’t know how to go about it and maybe [person] has not had a good experience with other carers.” Some staff told us they would value more training and guidance to support their confidence and competence in supporting people when they become distressed or agitated. The registered manager confirmed training was planned for staff following this feedback. Information was available to guide staff when people may not be able to express their immediate needs, such as pain. Staff did not report difficulties in attending to people’s immediate needs when fully staffed. When a staff member reported being stretched at times they confirmed, “People that need assistance always receive the assistance.”
We observed staff being attentive and patient with people and responding promptly to their needs. During our site visits we did not note any concerns about call bell wait times.
Workforce wellbeing and enablement
Staff supervision had not been regularly delivered as per the provider’s policy. This had contributed to some staff feeling undervalued and unsupported and some staff expressing insecurity due to a lack of feedback about performance. The registered manager was acting to address this as they said changes in leadership and a lack of supervisory staff had impacted on delivering regular staff supervision. Following the inspection, staff meetings were held and addressed the lack of supervision. Managers gave a commitment to prioritise and address this. One staff member reported, “We had a carer meeting last Wednesday I felt we were listened to. They admitted they were behind on supervisions and are addressing this. They really did listen.” Staff gave mixed feedback about well-being and enablement. A staff member said, “It would be good to get feedback on performance. Supervision isn’t frequent enough. Whether it is an email or a face-to-face chat. Ideas are listened to, but action may not be taken.”
Staff supervision had not been delivered in line with the provider’s policy. The last staff satisfaction survey was completed in June 2023. Most feedback was positive however, some themes including communication, training and being valued were fed back for improvements. There was no evidence of an action plan resulting from this survey. The registered manager told us they planned to do a staff survey following the inspection, the results of which would be shared with staff. They were aware of low morale in the staff team which had been exacerbated by changes in management and other staff roles in the service. An employee benefit scheme was in place offering staff practical, emotional, and financial support options. The provider had an employee of the month scheme, with a financial reward. Staff could buy subsidised meals and were invited for ‘tea and toast’ during handover.