Jubilee Lodge

We found the following examples of good practice.

• Staff supervised all essential visitors to ensure social distancing and infection control guidelines were followed. All visitors were asked a set of screening questions to ascertain any risks posed and for track and trace.

• People could choose to use applications such as video calls to maintain contact with their families.

• The provider was fully aware of all current best practice guidance including the safe admission of people from hospital. This had been communicated to people, their families and staff as and when updates occurred.

• Personal Protective Equipment was safely stored in designated stations throughout the service. This reduced staff time putting on and taking off PPE and reduced the risk of transmission.

• The environment and furniture had been risk assessed to ensure it was arranged in such a way to reduce the risk of transmitting the virus. In particular staff had a process to follow to ensure they did not pass on a narrow staircase so they could maintain social distancing.

• Cleaning schedules were thorough. The schedules through the day were continued at night to ensure all areas were regularly cleaned to reduce the risk of transmission.

• Staff were able to seek quick healthcare support when people needed this. Work to support staff to further understand when a person’s health was deteriorating was being implemented.

• The provider and registered manager had recognised the challenges staff had overcome during the pandemic and had introduced specific support sessions staff could use to de-brief and offload their feelings. This supported staff resilience.

We were assured that this service met good infection prevention and control guidelines as a designated care setting.

Further information is in the detailed findings below.

Jubilee Lodge is a purpose built respite unit and is registered to provide personal care and support for up to five people at a time. The service specialises in providing support for people who have learning disabilities. At the time of this inspection the service was providing respite care for a total of 17 people. This could range from a few hours per day to twenty four hours a day to several weeks during a year. There were two people staying for respite care on the day we visited.

At our last inspection we rated the service Good overall. 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.

There were systems and processes in place to protect people from the risk of harm. Staff were able to tell us about different types of abuse and were aware of action they should take if abuse was suspected. Appropriate checks of the building and maintenance systems were undertaken to ensure health and safety.

Safe recruitment and selection procedures were in place and appropriate checks had been undertaken which ensured staff were suitable to work with vulnerable people.

Staffing levels were sufficient and staff received supervision and training to give them the necessary skills and knowledge to meet people's assessed needs.

Risks to people's safety had been assessed by staff and regularly reviewed to ensure they contained up to date information. Care plans included information about how people preferred to be supported.

People were provided with a choice of healthy food and drinks which helped to ensure their nutritional needs were met. People were supported to maintain good health and had access to health care professionals and services.

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. Staff knew people well, they offered choices and care was person centred.

People were supported by kind and caring staff who treated them with dignity and respect. We observed positive interactions between people and staff. People's independence was encouraged and there was a range of activities and outings they could participate in.

The provider had a system in place for responding to people's concerns and complaints. People were regularly asked for their views and there were effective systems in place to monitor and improve the quality of the service provided.

Further information is in the detailed findings below.

Jubilee Lodge is a purpose built respite unit and is registered to provide personal care and support for up to five people. It does not provide nursing care. The service specialises in providing support for people who have learning disabilities. At the time of this inspection the service was providing respite care for seventeen people. This could range from a few hours per day or twenty four hours a day for several weeks. There were two people staying for respite care on the day we visited the respite unit. The service employs nine care staff and also a registered manager.

There was a registered manager at this service. 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 we spoke with on the day told us they felt safe when staying at the respite centre. Relatives we spoke with told us they felt their relatives were safe at Jubilee Lodge. Staff knew the correct procedures to follow if they considered someone was at risk of harm or abuse. They received appropriate safeguarding training and there were policies and procedures to support them in their role.

The service recruited staff in a safe way making sure all necessary background checks had been carried out. There were sufficient staff to meet people’s needs. People who used the service, their relatives and staff members confirmed this.

Staff had a good understanding of safeguarding procedures and how to protect people from harm. There were risk assessments in place to identify risks due to people’s health or mobility and to make sure these were minimised without intruding on people’s privacy and independence. There were records that showed staff received the training they needed to keep people safe.

Medicines of people who stayed at the service were managed safely. Staff had received the appropriate training.

Staff were supported and trained to help them deliver effective care. They had access to basic training, and staff told us they were supported to attend other courses which would be of benefit to their personal development and people who used the service.

People told us the food was good. We saw people had access to regular drinks, snacks and a varied and nutritious diet. If people were at risk of losing weight we saw plans were in place to manage this. People had good access to health care services and the service was committed to working in partnership with both healthcare and social care professionals.

The principles of the Mental Capacity Act (MCA 2005) were consistently followed by staff. Consent to care and treatment was sought. When people were unable to make informed decisions we saw a record of best interest decisions. There was a record of the person’s views and other relevant people in their life. The registered manager had a clear understanding of the Deprivation of Liberty Safeguards (DoLs).

People who used the service and their relatives were positive in their comments about staff and the service they received from Jubilee Lodge. Everyone we spoke with told us that Jubilee Lodge offered a ‘good service.’

The service was well-led. Everyone we spoke with was full of praise for the registered manager. Staff morale was high and there was a strong sense of staff being committed to providing person centred care.

There were good auditing and monitoring systems in place to identify where improvements were required and the service had an action plan to address these.

' Is the service caring?

' Is the service responsive?

' Is the service safe?

' Is the service effective?

' Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people's relatives and the staff supporting them and from looking at records.

There were two people staying on short time care when we visited the service. We spoke with one of the people who was staying at the respite unit about their experience. We were unable to speak to the other person as they were out for the day. We spoke with one member of staff during our visit. We also spoke with relatives and other members of staff by telephone.

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

Is the service safe?

We found that people were supported to make choices about their care and support, and people experienced care and support that met their needs.

Relatives we spoke with told us that they thought Jubilee Lodge was a good service. One relative told us 'I genuinely have no doubts about my relative's safety when they are at Jubilee Lodge, they are always happy to go. If I had any concerns I would not leave them there.'

Systems were in place to make sure that the manager and staff learned from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This reduced the risks to people and helped the service to continually improve.

We saw that recruitment procedures were rigorous and thorough. No staff had been subject to disciplinary action. Policies and procedures were in place to make sure that unsafe practices could be identified and therefore people were protected.

The service had proper policies and procedures in relation to the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. We also found relevant staff had been trained to understand when an application should be made, and how to submit one. This meant people were safeguarded as required.

Is the service effective?

Staff we spoke with were knowledgeable about the people they supported and knew people very well. People's health and care needs were assessed with them, and they were involved in developing their plans of care. People told us they were included in decisions about how their care and support was provided. From speaking with staff they were able to demonstrate a good understanding of people's care and support needs.

Staff had received training to meet the needs of people they supported. Comments included, 'We have a variety of training available to us, not just the mandatory training.'

Is the service caring?

We observed a relaxed and friendly atmosphere at the service throughout our visit. Good professional relationships appeared to exist between people using the service and staff. People's preferences, interests, aspirations and diverse needs were recorded and care and support was provided in accordance with people's wishes.

Relatives were also asked for their opinion and they too were welcomed and kept well informed. One relative said, 'They (staff) communicate with me properly. They contact me immediately if they are concerned' another said 'Overall, X is very happy going there.'

When speaking with staff it was clear that they genuinely cared for the people they supported. One member of staff said 'It is brilliant working here.'

Is the service responsive?

There were sufficient staff available to meet people's needs; staffing was arranged flexibly in order that people could be supported in activities of their choice. Staff completed specialist training to enhance their skills and knowledge and met individual's needs.

The service carried out an annual satisfaction survey. Results were collated and analysed and action plans in response were agreed and actioned.

People we spoke with knew how to make a complaint if they were unhappy. People told us they were confident that any issues they raised would be looked into and action taken.

Is the service well-led?

Effective management systems were in place to promote and safeguard people's safety and welfare.

Relatives we spoke with told us they thought that overall the service ran well. One relative we spoke with made it very clear that if they were unhappy with anything they would not leave their relative at the service.

The quality assurance system included audits and checks carried out by staff at the service and by other people from within the organisation. Records showed that issues were identified and responded to in a timely way. As a result the quality of the service was continuously improving.

We looked at the care records and found that assessments and care plans were in place. We saw that they were regularly reviewed to make sure that people's needs were met.

We looked at the care people received and found that they were well cared for and consistently supported with their needs. We observed that people were well supported to make their own choices and participated in varied and interesting activities.

We also looked at staffing levels at the service and saw that staffing was based on the individual needs of people staying at the service. However when we looked at the night staffing arrangements we had some concerns that the staffing levels may not always safely meet people's needs. The provider told us that they would review the staffing levels with immediate effect to make sure people were safe at all times.

We confirmed that there was consistent leadership and effective systems in place to regularly monitor the care, treatment and support people received.