The inspection visit took place on 07 February 2018 and was unannounced.

At our last inspection we rated the service overall Good. The safe domain required improvement in relation to recruitment and medicines. At this inspection we found recruitment had improved and good recruitment practices were in place. Medicines were managed safely. The service improved to good in safe domain and remained good in the other four domains. We found the evidence continued to support the rating of overall 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.

Jah-Jireh Charity Homes Blackpool is a care home where Jehovah's Witnesses care for other Jehovah's Witnesses. The staff team and environment caters for people’s spiritual needs as well as for their health and social needs, Jah-Jireh provides accommodation for up to 36 people who require personal care, some of whom are living with dementia. There are 30 single rooms and three double rooms. The building has two floors with lift access to the first floor. Car parking is available at the front of the home on a small private forecourt. There are gardens at the rear for the use of residents.

At the time of our inspection visit 32 people lived at Jah-Jireh.

There was a registered manager in place. 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 told us they felt safe and well cared for at Jah-Jireh. People told us they were happy and supported by staff who cared for them and treated them well. One person told us, “No problem with the staff they are so hardworking and kind.”

There were procedures in place to minimise the risk of unsafe care or abuse and staff understood their responsibilities to report unsafe care or abusive practices. They knew how to do this if they saw or suspected abuse. Staff had received training on safeguarding vulnerable people.

Care plans were personalised, involved people and where appropriate, their relatives and were informative about the care people received. Risk assessments had been developed to minimise the potential risk of harm to people during the delivery of their care. These had been kept under review and were relevant to the care provided.

Medicines were managed safely. They had been ordered appropriately, checked on receipt into the home, given as prescribed and stored and disposed of correctly. People received their medicines when needed and appropriate records had been completed.

Staff had been recruited safely, appropriately trained and supported. They had skills, knowledge and experience required to support people with their care and social needs. There were sufficient staffing levels in place to provide the support people required. Although there had been some staffing difficulties prior to the inspection, staff had pulled together to make sure there were enough staff on each shift. We saw staff showed concern for people’s wellbeing and responded quickly when people called for assistance.

We looked around the building and found it had been maintained, was clean and hygienic and a safe place for people to live. The design of the building and facilities provided were appropriate for the care and support provided and we found equipment had been serviced and maintained as required. There were safe infection control procedures and practices and staff had received infection control training. Staff wore protective clothing such as gloves and aprons when needed. This reduced the risk of cross infection.

Most people told us t

This inspection took place on 26 October 2015 and was unannounced. At the last inspection in December 2014 the registered provider did not meet the requirements of the regulations of the Health and Social Care Act 2008 (Regulated Activities) 2014 and was rated as ‘Inadequate. During this inspection visit we found legal requirements had been met.

Jah-Jireh is a detached building located in central Blackpool. The home is registered to accommodate up to 36 people who require assistance with personal care. Jah-Jireh cares for people who are Jehovah’s Witnesses. All care staff are also Jehovah’s Witnesses. At the time of our visit there were 29 people lived at the home. Accommodation was arranged around the ground, first and second floor. There was parking to the front of the building and a garden area to the rear. There was a passenger lift for ease of access and the home was wheelchair accessible.

There was a registered manager in place. 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.

The registered manager was aware of and met their responsibilities and the regulations. Procedures were in place to protect people from abuse and unsafe care. Risks to people were minimised because risk assessments were in place. People told us they felt safe living at Jah-Jireh and liked living there. One person said, “I feel safe here with my brothers and sisters. We are all together.”

We looked at how medicines were managed and found appropriate arrangements for their recording and safe administration. Records we checked were complete and accurate and medicines could be accounted for because their receipt, administration and disposal were recorded accurately. However we found best practice for administering medication was not always followed. We have made a recommendation about the management of medicines.

We looked at the recruitment and selection procedures the provider had in place to ensure people were supported by suitably qualified and experienced staff. We looked at the recruitment records of five members of staff. Suitable arrangements were not in place to ensure safe recruitment practices were followed. We have made a recommendation about the effective procedures for recruitment and selection.

People said there were enough staff to support them well and give them help when they wanted this. One person said, “The staff are kind and gentle and there are always enough of them.” Another person told us, “There are enough staff to care for us properly and we are hardly ever kept waiting when needing help.” We saw since the last inspection, additional staff had been appointed to work in the morning and at mealtimes. We could see there were sufficient staff available to support people and staff were not rushed when providing care.

Records were available confirming gas appliances and electrical facilities and equipment complied with statutory requirements and were safe to use. The environment was well maintained, clean and hygienic when we visited. There were no unpleasant odours. People told us the home was always clean, tidy and fresh smelling. One person said, “It is lovely here, and nice and clean.”

Staff had been trained and had the skills and knowledge to provide support to the people they cared for. One person said, “The staff are well trained and know what they are doing. They are excellent.”

We saw the registered manager and management team had improved the care provided to people living with dementia and significantly enhanced their experiences in the home. The management team had also made the home more dementia friendly with new furnishings, special equipment and signage to assist with orientation around the home. A member of staff told us, “The management team have worked tirelessly to improve things since the last inspection. Through them we are doing more for people.”

Staff understood the requirements of the Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards (DoLS). The registered manager discussed applications she had submitted. This showed us staff were working within the law to support people who may lack capacity to make their own decisions.

People were offered a choice of healthy and nutritious meals. Staff made sure people’s dietary and fluid intake was sufficient for good nutrition. People told us the food and drinks were generous and varied and drinks were frequent along with snacks. One person said, “The food is good and I can always get a change if I don’t like the meal. We get more than enough to eat and drink and the staff all treat me well.” Another person told us, “The food is very good and, if they find that you used to like something, they soon get some in.”

People we spoke with told us staff were caring and helpful. One person said, “I am happy here now because just about everything about this home is very good.” Staff frequently interacted with people. They were supportive and attentive, responding to any requests for assistance promptly. A relative said, “The staff and management really care about the residents and show enormous patience and gentleness even when due to confusion some folks get uncooperative.”

Staff knew and understood people’s history, likes, dislikes, needs and wishes. They knew and responded to each person’s diverse cultural, gender and spiritual needs and treated people with respect and patience. We saw staff talking with people in a friendly, polite manner. Staff were aware of people’s individual needs around privacy and dignity and made sure they respected these. People told us they felt staff valued and respected them because of the way in which they supported them.

People were fully supported in their spiritual needs. It was evident people who lived and those who worked in the home had a special bond sustained by their faith where ‘brothers and sisters’ were recognised and valued. Spiritual support was a major part of life within the home and people were given every opportunity to sustain and strengthen their faith. One person told us, “I think there is real love here and those who work here obviously don’t see it as just a job. I can think of no better place for myself or for others who find themselves in a similar situation.”

Staff recognised the importance of social contact, companionship and activities. As well as the spiritual support, social and leisure activities were available. Staff were very welcoming to people’s friends and relatives. A relative said, “I am made very welcome whenever I visit, even when I am not expected.”

People knew how to raise a concern or to make a complaint if they were unhappy with something. One person told us, “I love it here and I have no need to complain about anything.” A relative commented, “The staff have been wonderful and caring and if I mention any concerns about [my family member’s] care, these are addressed quickly.”

Everyone we spoke with told us the registered manager and staff team were approachable, caring and supportive. One person said, "They are superb, so committed and listen to everyone. They are so easy to talk to.” A member of staff said, “The manager is approachable, very supportive and will help whenever needed. She will always listen and help if you have a problem.”

The registered manager was able to demonstrate the views of people who lived at the home and other stakeholders were encouraged and welcomed. We saw a number of examples of changes and developments within the service, which had been made as a result of people’s suggestions and comments.

The management team used a variety of methods to assess and monitor the quality of the service. These included satisfaction surveys, ‘residents meetings’ and care reviews. Overall satisfaction with the service was seen to be very positive.

This inspection took place on 17 December 2014 and was unannounced. This meant the staff and provider did not know we would be visiting. The service was last inspected in October 2013. They met the requirements of the regulations during that inspection.

Jah-Jireh is a detached building located in central Blackpool. The home is registered to accommodate up to 36 older people, people with sensory impairment or with physical disability and people living with dementia, who require assistance with personal care. Jah-Jireh cares for people who are Jehovah’s Witnesses. All care staff are Jehovah’s Witnesses. At the time of our visit there were 28 people who lived at the home. Accommodation was arranged around the ground and first floor. There was parking to the front of the building and a garden area to the rear. There was a passenger lift for ease of access and the home was wheelchair accessible.

There was a registered manager in place. 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.

There was a mix of views regarding staffing levels but some acknowledgement that there were not always enough members of staff available for more dependent people. One person said, “There’s always somebody if you want help.” However another person stated, “We could do with more staff.” We saw that there were not always enough members of staff on shift to support people. Staff were not deployed in an effective way.

At mealtimes more dependent people were not assisted with their meals as they needed. It was also evident from our observations people who had high care needs, were left sitting unattended, with little stimulation or attention for long periods of time. You can see what action we told the provider to take at the back of the full version of the report.

We looked at how medicines were prepared and administered. We saw medicines were not always given as prescribed or stored safely. Failing to give people their medicines properly places the health and welfare of people at unnecessary risk. You can see what action we told the provider to take at the back of the full version of the report.

People we spoke with told us they felt safe and well cared for. However this did not always reflect the practice we saw. The home was not designed or adapted to effectively support people living with dementia. We have made a recommendation about staff researching best practice in dementia care.

The right care and support was not always provided to people living with dementia. Staff had only basic awareness of dementia care. You can see what action we told the provider to take at the back of the full version of the report.

Staff did not always receive the training they needed to provide effective care to people, particularly where people were living with dementia. You can see what action we told the provider to take at the back of the full version of the report.

People told us that staff were very caring and kind. One person told us, “They’ve been very good, nothing is a bother.” Another person said, “Absolutely wonderful, they’re kind and they’re always there.” However this did not reflect our findings. Although staff were pleasant, they did not focus on the well-being of more dependent people or those who challenged the service. There were no management strategies in place to guide staff in supporting people with behaviour that challenged.

There were significant periods of time where people living with dementia, who were supported in an open plan lounge, were left unsupervised and unsupported. At other times although staff were present they did not interact with people living with dementia and they were left unstimulated and inactive. You can see what action we told the provider to take at the back of the full version of the report.

Although the home had policies in place in relation to the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS), the registered manager and management team did not have a working knowledge of them. The MCA was not implemented in any formal way in this home. You can see what action we told the provider to take at the back of the full version of the report.

Care planning was not person centred. Choices of when to receive personal care and support were limited by the staff routines. These were task centred rather than in response to people’s individual needs and preferences. Social and leisure activities were limited, particularly for people living with dementia. We have made a recommendation that the service develops a person centred way of working, and provides suitable activities.

People told us that their views were sought on a regular basis. They and staff found the registered manager supportive and approachable. One person told us, “The manager is wonderful, very kind and listens to us.” However we found the registered manager was not fully aware of their responsibilities as the registered person.

There were procedures in place to monitor the quality of the service. Audits were being completed by senior managers from the organisation and by the management team in the home. Yet the audit systems were not picking up the areas of concern identified during this inspection process. You can see what action we have told the provider to take at the back of the full version of the report.

Resident and relative surveys had recently highlighted some issues including around improving activities and dementia care. Action was planned but had not yet been taken when we inspected.

All the people and their relatives we spoke with confirmed that staff were kind and compassionate. It was evident that people who lived and those who worked in the home had a special bond sustained by their faith where “brothers and sisters” were recognised and valued. People were praising of the spiritual support they received from staff and the faith they shared. Communal prayers were said before meals and there were frequent bible study and worship times. This celebrated the shared spiritual beliefs of people.

People were complimentary about the meals and told us they enjoyed them. People were offered a choice of nutritious meals.

Staff recruitment was robust and reduced the risks of unsuitable staff working in the home.

During this inspection we spoke with three people who used the service. We also spoke with several staff members. The feedback we received was very positive. People expressed satisfaction with their care and spoke highly of the management team and staff. Their comments included,

‘’They (the staff) know me. We always have a laugh!’’ and "I am very satisfied with everything here. I have no concerns at all."

A visiting professional told us, "I come here on a regular basis to undertake staff training, they always make me feel welcome and involved. Staff are always polite, and really know how to get people involved in their own care and support."

People living at the home told us that they had been involved in the care planning process and in the review of the care provided. People said that they enjoyed the atmosphere within the home, and the spiritual aspect of the home, and that they felt well cared for. The staff said that the training was in depth and very useful to their work. Information held within the training records showed that staff received a comprehensive training programme geared towards the work they undertook. One person living at the home said that they thought the staff were very knowledgeable and always willing to learn. One resident commented, ‘’It always seems nice and clean to me. They keep things lovely for us.’’ We carried out a tour of communal areas and some residents’ bedrooms. We found all areas to be clean and comfortable.

People living at the home said that they felt involved in the running of the home, and in the management of their own care and support. The staff were seen to work alongside people in a positive way, and people were seen to be cared for in ways that suited them. We saw that people were given opportunities to inform the staff of their personal support requirements. Staff were found to be involved in assessing people's needs, and there were systems in place to monitor how those needs were met. The home had systems in place that could be used by the staff to assess people's needs; report any problems to the management team; ensure people were keep safe; and plan care on a personalised basis. The management team were seen to be involved in monitoring the care and support arrangements in place for people, and had systems in place to audit records, deal with emergencies and ensure people's health and welfare was protected and promoted.

A number of people spoken to during the review confirmed they received appropriate care and attention from the staff. They also said that they were all very polite, attentive and helpful.

We spoke to people about their experiences living in the home and were told the staff team provided sensitive and flexible personal care support and they felt well cared for.

"They are always there when I need them".

"The staff can’t do enough for you".

“I always receive my tablets on time and I get painkillers when I need them.”

“The food is very good”

“I feel full and content”,

“Very nice food”

“Always a choice and will do you something different if you do not fancy what is on offer”

Public Protection Officers representing the Health and Safety and Environmental Health Sections of Blackpool Council’s Quality Services Directorate visited the home on 11th March 2010. They told us the premises were very well run and the level of cleanliness and structural maintenance were also of a high standard.

The contracts department of Blackpool County Council told us that in the 5 years they have been collecting information there has been only one concern raised about this service which was in February 2010: This concern was about the care home not coping with the service user's needs in prompting medication and food. The concern was raised during a nursing assessment. The home responded positively to the concerns and to the advice given.